There's nothing wrong with aging naturally. But there's a difference between chronological aging, which is what happens naturally to our cells between birthdays, and photoaging, which is caused by exposure to ultraviolet (UV) radiation from the sun.

Over time, sun exposure can cause skin to wrinkle, thicken, develop hyperpigmented age spots (dark spots), and lose elasticity. How much photoaging you experience depends on your skin phototype and how much time you spend in the sun.

If you're over 30 years old, have a light or medium skin tone that sunburns easily (skin phototypes I to III), and you've spent a lot of time outside without broad-spectrum sunscreen protection, then you're likely to see the effects of photoaging on your skin. If this bothers you, there are a number of clinically proven anti-aging and anti-wrinkle prescription medications and over-the-counter (OTC) ingredients that can help undo some of this sun damage.

Prescription medications

The Federal Drug Administration (FDA) has approved several prescription medications that are clinically proven to slow or reverse some of the effects of photoaging. These anti-aging creams, serums, lotions, and gels are called topical retinoids. Retinoids are synthetic and naturally occurring forms of retinol (vitamin A) that are about 10 times more potent than retinol. Topical retinoids and retinol can have similar anti-aging effects on the skin by boosting skin cell turnover, but retinoids tend to work much faster because they're prescription-strength. These drugs are:

• Adapalene
• Tazarotene
• Tretinoin (retinoic acid)

Clinicians may also prescribe these medications, as well as isotretinoin (Accutane), to treat acne.

Over-the-counter (OTC) treatments

Countless companies promote the anti-aging properties of their cosmetic products. But because face lotions and serums aren't technically drugs, these claims aren't regulated by the FDA. Informally known as cosmeceuticals, many of these drugstore products contain active ingredients that clinical research has shown to reduce fine lines and wrinkles, boost skin elasticity, and even out skin tone. Here are some of the more vetted ingredients you can look for on cosmeceutical labels:

• Alpha hydroxy acids (AHAs) like glycolic acid, lactic acid, and citric acid
• Alpha-lipoic acid
• Azelaic acid
• Bakuchiol, a plant-based retinol alternative (phytoretinol)
• Beta hydroxy acids (BHAs) like salicylic acid
• Ceramides
• Coenzyme Q10
• Collagen peptides
• Ferulic acid
• Hyaluronic acid
• Melatonin
• Nicotinamide, also known as niacinamide, a form of vitamin B3
• Polyphenols and flavonoids (plant compounds) like coffee berry/caffeine, grape seed, green tea, Ginkgo biloba, and ginseng
• Retinol, retinaldehyde, and retinyl esters like retinyl palmitate
• Soybean derivatives, which are rich in flavonoids and amino acids
• Vitamin C (L-ascorbic acid)
• Vitamin E (alpha-tocopherol)

In general, vitamins, polyphenols, and flavonoids are considered antioxidants that work by neutralizing the free radicals that cause oxidative stress in our bodies. Retinols and peptides are considered cell regulators that work by influencing collagen production.

Other therapies and procedures

The following cosmetic therapies and procedures can also reduce the signs of photoaging in skin, although they tend to be more expensive and invasive:

• Botulinum toxin injection (Botox Cosmetic, Daxxify)
• Chemical peel
• Face lift (rhytidectomy)
• Laser resurfacing
• Photodynamic therapy (PDT)
• Skin or dermal fillers (soft tissue injections)

You may see improvement after about 4 weeks of tretinoin (Retin-A) treatment, but it usually takes about 3 to 6 months before you'll see the full effects on your skin.

How your skin ages is largely determined by your genes and your skin phototype. For example, people with darker skin tones (phototypes V and VI) might start seeing the effects of photoaging 10 or 20 years after their peers with lighter skin.

But sun exposure, smoking, and air pollution can all accelerate the natural aging process. Can you delay aging? Research shows that it's possible to prolong a youthful appearance by taking the following steps:

• Eat a healthy diet, loaded with antioxidant-rich foods like colorful fruits and vegetables
• Stay hydrated
• Keep your face moisturized
• Avoid tanning beds and prolonged sun exposure
• Wear broad-spectrum sunscreen (SPF 30 or above) every day, even when you're not in direct sunlight (yes, even indoors)
• Don't smoke--it damages skin cells
• Get plenty of sleep

Remember that your skin's appearance tends to be a reflection of your overall health, and health starts from the inside. No matter how old your face looks, it's beautiful, because it's a testament to the life you've lived.

Your clinician may prescribe a retinoid like tretinoin (Retin-A, Retin-A Micro, Avita, Atralin, Renova), adapalene (Differin), or tazarotene (Tazorac, Avage). Initial therapies will be those demonstrated to cause fewer adverse skin reactions.

Please note: This information is for general reference only. Your clinician will review your symptoms and health history to determine which (if any) treatments are medically necessary.

It's unlikely that health insurance will cover the cost of medications like tretinoin (Retin-A) when prescribed as anti-aging and anti-wrinkle skin care treatments. A tube of Retin-A may have an out-of-pocket cost of $12 to $50.