Different Agents Used in Anti-Aging Skin Care

The Science of Skin Aging

Skin aging occurs through two primary mechanisms: intrinsic aging (genetic factors, cellular metabolism) and extrinsic aging (UV exposure, pollution, lifestyle). Changes in aging skin include:

• Decreasing collagen and elastin production
• Accumulated oxidative damage
• Cellular senescence
• Impaired skin barrier function
• Reduced cell turnover
• Glycation of structural proteins

Common Ingredients

Tretinoin: A Well-Studied Anti-Aging Ingredient

Tretinoin (all-trans retinoic acid) is one of the most thoroughly researched topical agents for photoaging and is commonly prescribed to address multiple signs of aging.

Mechanisms of Action:

• Increases epidermal cell turnover
• Stimulates collagen production
• Reduces matrix metalloproteinases that break down collagen
• Normalizes melanocyte function to improve pigmentation irregularities
• Improves vascularization in the dermis

When It's Compounded:

A prescriber may order compounded tretinoin when they want a strength, base or combination that isn't sold commercially. Your prescriber sets the strength and base. Compounded medications are not FDA-approved.

Niacinamide

Niacinamide is a form of vitamin B3 used widely in skin care. It is usually well tolerated.

Mechanisms of Action:

• Enhances ceramide and fatty acid levels in the stratum corneum, improving barrier function
• Reduces transepidermal water loss
• Decreases redness and blotchiness through anti-inflammatory effects
• Inhibits melanosome transfer to keratinocytes, improving hyperpigmentation
• Reduces yellowing through anti-glycation effects
• Minimizes pore appearance and regulates sebum production

In Compounded Formulas:

Prescribers sometimes add niacinamide to a compounded cream. The prescriber sets the strength.

Topical Estriol

Estrogen receptors are present in the skin, and estrogen levels fall after menopause. Facial estriol is an off-label use.

Mechanisms of Action:

• Increases dermal collagen content
• Improves skin hydration and thickness
• Enhances vascularization
• Stimulates glycosaminoglycan production, improving moisture retention

In Compounded Formulas:

Estriol is a weaker estrogen. It is still a hormone and is prescription-only. Your prescriber decides whether it fits your history and sets the strength.

Cosmetic Peptides

GHK-Cu (Copper Peptide)

This naturally occurring tripeptide complexed with copper is one of the most-studied cosmetic peptides, prized for how skin looks and feels after consistent use.

Why formulators reach for it:

• Supports the look of firmness and elasticity
• Helps skin feel smoother and more even
• Pairs well with retinoids and vitamin C without adding irritation
• Well tolerated across skin types
• Used in post-procedure recovery routines

Application in Compounded Formulations:

GHK-Cu is used in cosmetic topical products. Topical use is cosmetic; it is not an approved drug.

Signal Peptides

These cosmetic peptides are short amino-acid chains studied for their effects on the skin's support structure:

Examples:

• Palmitoyl Pentapeptide-4
• Palmitoyl Tripeptide-1 and Palmitoyl Tetrapeptide-7
• Palmitoyl Oligopeptide

Neurotransmitter-Inhibiting Peptides

These cosmetic peptides are studied for their effect on the look of expression lines:

Examples:

• Acetyl Hexapeptide-3
• Pentapeptide-18
• Dipeptide Diaminobutyroyl Benzylamide Diacetate

Customized Combination Approaches

Prescribers often combine ingredients that work in different ways. Common combinations include:

Morning Products

Often include:

• Antioxidant complexes (vitamin C, E, ferulic acid)
• Peptide blends
• Niacinamide

Evening Products

Often include:

• Retinoids
• Alpha/beta hydroxy acids
• Peptide complexes
• Barrier-repairing ingredients
• Specialized moisturizing compounds

What Your Prescriber Considers

Your dermatologist or prescriber considers your:

• Skin type and sensitivity
• Specific aging concerns
• Environmental exposures
• Hormonal status
• Previous treatments and tolerances

If your dermatologist or prescriber writes a compounded formula, they can send it to us and we will prepare it as written.