The eternal truth is that time goes only in one direction and we are all too familiar with the process of ageing.
As young individuals we all enjoy smooth and supple skin, that with the passage of time starts showing signs of ageing - fine lines at the eye corners, deepening of expression lines and appearance of wrinkles, pigmented spots, loss of elasticity, broken capillaries etc.
These visible changes are a result of the ageing of the skin and are influenced by two major processes.
First, the natural ageing process also known asintrinsic ageing, that is genetically determined and irreversible. Genetics determine the rate at which skin ages by impacting the skin durability, the hormonal mechanisms and the skin thickness.
Second, environmental factors such as cumulative sun exposure, air pollution, prolonged exposure to wind, cold, air-conditioning or poor treatment of the skin, stress or lifestyle habits as smoking can lead over time to a cumulative damage to the skin. These changes in the skin due to environmental factors are also known asextrinsic ageing and they usually appear in the areas of the body that are the most exposed to the elements - face, neck, decolletage and hands.
Solar radiation is the major factor causing the premature ageing of the skin. The ageing of the skin caused by the cumulative sun exposure is also called‘photoageing’. In particular,photoageing is demonstrated by the premature appearance ofwrinkles,dryness,sallow complexion,age spots,loss of firmness and elasticityorvisible capillaries.
And while we can’t stop the natural ageing process, we can learn how to manage and minimise signs of premature ageing caused by the exposure to the elements.
In this article we try to look at the mechanisms of skin ageing and measures to prevent and manage the damage to the skin as a result of:
CHANGES IN THE SKIN DUE TO THE NATURAL AGEING PROCESS (INTRINSIC AGEING)
With the natural passage of time many changes occur in all areas of the body irrespective of their exposure to the sun. Skin loses its firmness and elasticity, wrinkles appear, the skin becomes thinner and more fragile and these are mainly due to:
Degeneration of the collagen fibers
Collagen fibres are collected together into bundles oriented in different ways to form a fibrous structure the main function of which is support the internal structure of the skin. Changes in collagen due to the natural ageing process are characterised by the thickening of collagen fibres and clumped and disorganized collagen compared to the organized pattern of collagen seen in younger skin. These alterations of collagen in ageing skin lead to theformation of wrinkles.
Degeneration of elastin fibers
Elastin fibres form a loose mesh and their main function is to give the skin the elasticity and resiliency, i.e. the skin’s ability to return to its original state after stretching. In ageing skin the elastic fibers undergo changes that are characterised by the thickening and coiling of elastic fibres. This leads toloss of elasticity of the skin that in turn may account for much ofthe sagging of the skin often seen in elderly people.
Thinning of the skin
With ageing metabolism slows down and the cell renewal process becomes less efficient. The time needed for renewal of the outermost layer of the epidermis orstratum corneum is 20 days in young adults and approximately 50 days in older adults. The longer time needed for cell renewal leads to a slower replacement of stratum corneum and slower wound healing. This in turns results in the development of dead cells heaps onto the skin that renders its surface dull and rough in appearance. Skin is visibly thinner and more fragile.
The fatty layer of the skin also becomes thinner. The loss of the fatty layer is more prominent in certain areas like the face, hands and calves.
Skin becomes dryer
With age, skin loses its ability to retain moisture and it becomes dryer. This is partly due to the gradual decline in the activity of sebaceous glands, especially apparent after menopause in women. Sebaceous glands produce the skin's natural oil known also as sebum that together with sweat form a lipid layer on top of the skin that serves as barrier preventing the loss of moisture from the skin and growth of bacteria. Therefore, a decrease in production of sebum will lead to dryer and more sensitive skin.
Skin complexion becomes sallow
With ageing blood circulation slows down and the number of blood and lymphatic vessels in the skin reduces. Therefore, nutrients and oxygen essential to the healthy appearance of the skin are not brought as quickly to the underlying tissues and respectively waste products and toxins are not removed properly. This results in the development of yellowish complexion and pallor that give the skin unhealthy looks.
CHANGES IN THE SKIN DUE TO THE PHOTOAGING PROCESS (EXTRINSIC AGEING)
Exposure to the sun is the major environmental factor causing damage to the skin. Also, exposure to other environmental factors like cold, wind or ill treatment of the skin can cause cumulative damage to the skin over time. As mentioned above, the major reason in the wrinkle formation and loss of firmness is the degeneration of elastin and collagen fibers. These fibers degeneration occurs naturally and gradually in naturally ageing skin, but it is intensified by prolonged exposure to the sun. The changes in ageing skin due to environmental factors, especially sun exposure, differ in presentation from the skin changes due to the natural process of skin ageing. For example, in photoaging skin more cells are formed in the epidermis, which makes the skin thicken in irregular patterns. This is in stark contrast to the thinning of the epidermis due to the natural ageing process of the skin. In addition to this, photoaging skin is characterised by changes like appearance of uneven pigmentation, age spots, dilated blood vessels.
Changes in skin due to natural ageing process
Changes in skin due to photoaging
Skin becomes thinner
Skin becomes thicker in irregular patterns
Collagen and elastin fibers degenerate gradually
Collagen and elastin fibers degenerate with accelerated pace
Skin becomes lighter due to the decreased production of melanin
Appearance of uneven pigmentation - age spots
Skin becomes dryer
Appearance of visible blood vessels
Premature appearance of fine lines and wrinkles due to sun damage
The cumulative sun exposure or the ultraviolet (UV) radiation can cause significant damage to the skin tissues and cells. The UVB rays are high-energy emissions that are responsible for sunburn and tanning. The energy of UVA light is less than that of the UVB rays, but the UVA light can penetrate deeper into the skin tissues causing premature damage of the collagen and elastin fibers leading to the skin losing its strength and elasticity. In turn skin loosens, fine lines appear, expression lines deepen and wrinkles appear.
Appearance of pigmented spots as a result of cumulative sun exposure
Suntanning is the result of sun exposure and leads to the darkening of the skin. In fact, tanning is the natural skin mechanism to protect itself from the solar radiation. Special cells in the epidermis, called melanocytes, produce melanin, which is a pigment with dark colour that makes the skin darker. Melanin provides the skin with natural protection against the damage caused by the solar radiation. However, the quantity of melanin produced by the melanocytes is not enough to provide people with adequate levels of sun protection and repeated exposure to the sun will lead to damage. Some damage appears in the form of uneven distribution of pigment in the skin resulting in dark areas on the skin, of varying shades of brown.
Sagging of the skin due to sun damage
The main damage to the skin due to the prolonged exposure to the sun is the deterioration of the quality of collagen and elastin fibers. Therefore, the skin loses its elasticity and strength and this combined with the loss of subcutaneous fatty tissue due to chronological ageing may lead to skin loosening and wrinkles. Gravity pulls the loose skin even further thus causing sagging skin.
Broken capillaries due to sun damage
In addition, cumulative exposure to the sun damages the delicate blood vessels of the skin and the supporting tissues.The blood vessels become more fragile, making them more prone to hemorrhages (bleeding) following relatively minor injury. Similarly, the capillaries of the face may enlarge and become visible. Visible capillaries that results from cumulative skin damage are usually in the form of lines.
Dry skin as a result of sun damage
Excessive exposure to the sun dries out the skin. When there is constant dryness of the skin over a prolonged period of time, the skin’s health and quality is affected
MEASURES TO PREVENT PREMATURE AGEING OF THE SKIN
A healthy mental and emotional state
It has been well documented that a prolonged exposure to negative emotions can affect the skin. Emotional states trigger series of physiological reactions in the body that change the blood supply and oxygenation to the skin’s underlying tissues, irritate the nerves in the skin, increase inflammation that in turn can lead to dull and dry skin. A prolonged state of anxiety may therefore cause damage to the skin texture and its health. Also, expression lines due to anger, prolonged stress or depression can turn into permanent expression lines and wrinkles.
There is a relationship between a healthy mental and emotional state and healthy and radiant skin. Therefore, techniques and activities that bring stress levels down can result in better skin and fewer expression lines.
A healthy and balanced diet
A healthy balanced diet composed of all groups of foods, vitamins and minerals accompanied by maintaining steady weight is highly recommended in order to avoid the appearance of premature signs of ageing. Various nutritional deficiencies can have different manifestations onto the skin as rashes, dry or flaky skin, skin lesions, reduced ability to heal wounds etc. On the other side, unhealthy diet and lifestyles are directly related to weight fluctuations that can lead to the appearance of sagging skin and wrinkles.
Good sleep is essential for the health of the skin. Your skin repairs and recovers itself while you sleep and enough sleep - 7 to 9 hours - can ensure numerous benefits for your looks. Fewer sleep hours are likely to affect your appearance and in the long run, sleeplessness may cause cumulative damage to the skin looks.
While you sleep, skin makes new collagen that prevents the formation of wrinkles and skin sagging. Also, blood supply to the skin is boosted and nutrients and oxygen are delivered to the skin tissues while toxins are removed that ensures glowing complexion and less puffiness and dark circles under your eyes. During sleep the growth hormone that plays a signiﬁcant role in maintaining the quality of tissues, including muscles and skin is secreted. Inappropriate sleep may hinder the secretion of growth hormone that, in any case, tends to decrease after 40 years.
Regular exercise and increased activity has a pumping action on the blood vessels thus pushing blood to the heart which improves blood and lymphatic circulation that in turns brings more oxygen to the tissues and efficiently removes waste products and toxins. Regular exercise helps the skin to retain its healthy and radiant complexion.
The benefits of a facial massage are similar to these from regular exercise. They include increased blood supply to the skin tissues and underlying muscles thus increasing the inflow of nutrients and oxygen and stimulating collagen production, improved lymphatic circulation that facilitates the removal of waste products and toxins accumulated in the skin tissues and stimulating or relaxing effect on nerves that helps the release of stress.
Facial massage is a powerful form of anti-ageing therapy that ensures healthy and radiant looks.
Use of broadspectrum sunscreens
The damage of the skin caused by cumulative sun exposure has been well documented. We have discussed above the mechanisms ofphotoageing. Therefore, in order to manage signs of premature ageing of the skin excess sun exposure should be avoided. You should regularly use of broad spectrum creams - sunscreen that can protect you from both UVA light (ageing rays) and UVB light (burning rays). The broad spectrum sunscreen also helps to prevent skin cancer, sunburn and premature ageing of the skin, including the appearance of coarse wrinkles, pigmented spots, dryness, loss of elasticity and broken capillaries. The use of hats and protective clothing when outdoors are also highly recommended. The use of sunglasses is also recommended as they will prevent the damage caused by UV radiation to the eyes and the inevitable response of squinting that helps the appearance of crow’s feet.
Use of products with AHA
Alpha-hydroxy acids (AHA) are compounds derived from dairy products (lactic acid), fruit (malic acid and citric acid) or sugar cane (glycolic acid). Regular application of topical treatments with AHA has demonstrated to reduce roughness of the skin and improve wrinkling and pigmented spots. It has also been documented that AHA-s lead to improvements in the thickness of the skin epidermis and collagen density. A new generation of AHA, called polyhydroxy acids appear to have similar benefits as well as anti-oxidant properties without the irritation effect common to AHA.
Use of products with retinoids
The regular application of products containing retinoic acid (retinoids resembles vitamin A in their chemical composition) improves, to a certain extent, the signs of photoaging and chronological skin ageing. Retinoic acid was originally intended for acne treatment. However, dermatologists observed its beneﬁcial effect for treating signs of ageing when treating adult women with acne. These patients reported that their skin became somewhat smoother, and ﬁne wrinkles ﬂattened and nearly disappeared. Dark spots were lightened, and some completely dissolved. Subsequently, the efﬁcacy of the product was compared to creams with similar ingredients but without retinoic acid. Both creams were applied for prolonged periods, each on a different side of the face. The studies demonstrated the efﬁcacy of retinoic acid, both in the prevention of skin ageing and in improving preexisting damage.
We are familiar with free radical damage that occurs with oxidative stress caused by sun, environmental pollutants, and lifestyle habits such as cigarette smoking. Free radicals are molecules containing oxygen with one or more unpaired electrons which makes them very unstable and prone to react with other molecules. In order to become stable, free radicals are looking to steal one or more electrons from other molecules, which leads to chain of undesirable chemical reactions in the skin cells. These undesirable chemical reactions are also called oxidative stress and leave the skin cells damaged and unable to function properly.
Antioxidants are molecules that can give away unpaired electrons to free radicals thus stabilizing the free radicals and preventing skin cells damage and degeneration.
The use of antioxidants in any anti-aging skin care regimen is essential in order to combat and prevent further damage to the skin. For many years, vitamins have been used to combat free radical damage. Enzymes are also efficient free radical scavengers; however, they depend on the presence of a healthy cellular environment and certain trace minerals to synthesize them.
There is growing evidence of the synergy that exists in using combinations of antioxidants along with sunscreens. Some antioxidants have protective benefits while others work as protectants in addition to stimulating age-reversal changes.
Facial muscles are attached directly to the skin. With every facial expression muscles on the face contract that also causes folding of the skin. In young individuals when muscles are relaxed facial expressions from the skin disappear as the skin returns to its original form due to its well functioning elastic fibers. However, when muscles contract under tissue with degenerated collagen and elastic fibers, fine expression lines appear as the skin is not able to return to its original form. With time these fine expression lines become deeper, more pronounced and permanent. Every individual has unique facial expressions and usually expressive habits are unconscious and remain throughout life. Facial expressions affect the formation of wrinkles. For example crow’s feet form when squinting or forehead horizontal lines are formed due to the repeated raising of eyebrows.