You should not expect the texture of the epidermis to be porcelain-smooth. The openings of the pores and sweat glands cause small indentations, and there are small ridges covering the surface. Many people have a false sense of how smooth adult skin should appear because they see models and celebrities who seem to have perfect skin in magazine photos, on TV and in movies.

Only children or people who have generally avoided sun exposure have this type of skin. Most close-up magazine photos are touched-up to smooth skin texture, and both men and women wear a lot of makeup on TV and in the movies. (There is a web site with candid photos showing that many celebrities have the same skin problems as everyone else.)

Even politicians and news-people wear a lot of makeup on TV. Special camera lenses, filters, lighting, and digital image processing help to hide wrinkles and rough skin. A recent magazine article and companion network news report had an interview with a famous actress who showed exactly how her skin was "cleaned up" for magazine photos with computer software. Remember too, that after about age 50, many celebrities have facelifts, which stretch the skin and make the
surface appear smoother than normal (often unnaturally smooth).

Based on skin anatomy, we can say that a true anti-aging skincare treatment will produce one or more of the following effects:

1. Prevent or repair damaged collagen and elastin in the dermis;
2. Promote the growth of new collagen and elastin;
3. Repair other damaged cells in the dermis;
4. Promote epidermal growth to thicken the epidermis; or
5. Smooth the epidermal surface.

How to tell if something has true anti-aging effects? 

There are scientific methods to determine if a substance or procedure has any of these effects, and research in this field is ongoing. However, despite advertising claims, most skincare products sold today don't have any effect on collagen or elastin, and just temporarily change the appearance of the upper epidermis. For example, most moisturizers work by adding oils to the epidermis to trap more water in the skin.

The oils also retain the upper epidermal layers so they don't flake off. The effect is to temporarily smooth fine lines that appear more prominent in dry skin. However, the "special" ingredients in many moisturizers like collagen or vitamins do not penetrate into the dermis, so they can't permanently improve lines or wrinkles.

Also, the type of cleanser you use to wash your skin will not affect it's structure; you've probably been washing your underarms and other sun-protected areas with plain soap all your life, and the skin there looks like a baby's. Unfortunately, many people believe cosmetics advertising, and waste a lot of money on expensive products that don't work any better than the inexpensive brands.

This FAQ does not constitute professional medical advice. You should consult a medical professional for that advice. Most internists and general practitioners have basic medical skincare knowledge, but for specialized advice and procedures you should consult with a dermatologist or a nurse or physician-assistant who specializes in dermatology. Plastic surgeons also do certain skincare procedures such as resurfacing and scar revision.