Skin aging and what you can do about it
Skin aging is a complex biological process influenced by a combination of endogenous or intrinsic (genetics, cellular metabolism, hormone and metabolic processes) and exogenous or extrinsic factors (chronic light exposure, pollutions, ionizing radiation, chemicals, toxins). Because of the fact that skin health and beauty is considered one of the principal factors representing overall “well-being” and the perception of “health” in humans, several anti-aging strategies have been developed during the last years.
Our skin is actually at the mercy of many different factors that set in motion the start of the aging process like sunlight, harsh weather, bad habits, cosmetics that you apply, stress, etc. The skin definitely changes as one ages, some areas faster than the others. Genetics, definitely, has a say in these changes, together with the external factors that could hasten it. Certainly, these changes are different for each age group.
How skin ages will depend on a variety of factors, such as your lifestyle, diet, heredity and other personal habits. For instance, smoking and alcohol can produce free radicals (once-healthy oxygen molecules that are now overactive and unstable). These free radicals damage cells, producing premature wrinkles. Primary factors contributing to wrinkled, spotted skin include normal aging (intrinsic aging).
Exposure to the sun, on the other hand, leads to photoaging (dermatoheliosis, pollution, loss of subcutaneous support [fatty tissue between your skin and muscle]). Other factors that contribute to aging of the skin include stress, gravity, daily facial movement, obesity and even sleep position.
Aging results in the following skin changes:
- Rough skin – slowing the epidermal turnover, which is usually every 28 days, becomes 40 to 60 days or more.
- Growth of benign tumors like acrochordon (kuntil), seborrheic warts etc.
- Skin becomes slack due to loss of elastin tissue and skin hangs loosely.
- Skin becomes transparent. This is caused by a flattening of the area where the epidermis and dermis (layer of skin under the epidermis) come together.
- Easy bruisability due to thinning of the blood vessel plus the thinning of the epidermis and dermis.
- Unwanted pigmentation also begins to appear.
Changes also occur in the deeper areas:
- Loss of fat below the skin in the cheeks, temples, chin, nose, and eye area may result in loosening of the skin, sunken eyes and a skeletal appearance (emaciated look, like in full-blown HIV).
- Bone resorption, or bone loss mostly around the mouth and chin, may become evident after age 60 and cause puckering of the skin around the mouth (smoker’s lips).
- Cartilage loss in the nose causes drooping of the nasal tip and accentuation of the bony structures in the nose.
The solution:
Laser and energy-based devices. The likes of Profractional lasers and Microfocused Ultrasound tighten the skin by stimulating collagen and elastin that has thinned out due to aging. The difference is the downtime that you will have when you use Profractional lasers. You will need several sessions for both until the patient is satisfied with the result. You also need to evaluate the patient’s problem carefully (skin color, presence of scars, density of fats in the area to be treated, etc.) to be able to decide on what energy-based device is the best for the patient.
Threads can also be used for sagging skin and wrinkles, for face contouring, jawline lift, brow lift, nose augmentation, skin tightening and many more.
Injectibles. These days, we are bombarded with injectibles in our practice. Injectibles to grow hair, injectibles for melasma, injectibles for dynamic superficial wrinkles (wrinkles seen during facial movements and also for static deep wrinkles (wrinkles seen even if there is no facial movement): botulinum toxin, fillers, ultracol (also stimulates collagen using pulverized threads which can last up to 18 months) Ultracol is used for difficult, challenging areas such as the glabella, dark eye circles, wrinkles in the under-eye areas where fillers can cause complications if done in those areas. Injectible cocktails which are biocompatible and totally absorbable may include hyaluronic acid, vitamins, minerals, phytonutrients, hormones, growth factors, amino acids, autologous cultured fibroblasts, homeopathic products, etc.
The use of exosomes, which I really like as it addresses all the problems of aging: sagging, fragility, discoloration/pigmentation, large pores, scars, for puffiness and periorbital darkening, etc. For me, I can improve on everything by using this. Added to this is that I have both the injectible and the topical (yung pinapahid lang). Plus, there is the infusion type which can make hair denser/thicker) while rejuvenating the entire skin and helps in other existing diseases that the patient may have, like liver disease, heart disease, lung disease, dementia, Parkinsons, stroke and other neurological diseases.
The cosmeceuticals. These are cosmetic products with biologically active ingredients purporting to have medical or drug-like benefits. Cosmeceuticals are commonly used in skincare regimens to maintain healthy skin and improve visible signs of aging. Like cosmetics, cosmeceuticals are applied topically and contain ingredients that influence the skin’s biological function.
Cosmeceuticals include most of the bioactive food components such as milk peptides, certain vitamins and minerals, phytonutrients, various oils and botanical extracts. Different kinds of cosmeceuticals have been introduced like anti-wrinkle creams, sunscreens, moisturizers, bleaching agents, anti-dandruff shampoos, eye wrinkle creams, etc. In general, cosmeceuticals are often used in the field of dermatology to improve skin tone/whitening, increase skin radiance, decrease the appearance of skin wrinkling and provide anti-aging benefits. The area in which cosmeceuticals have shown the most promise is the treatment of skin aging.
Photoaged skin typically develops coarse wrinkles, uneven pigmentation, atrophy, whereas naturally aged skin is characterized by finer wrinkles. Both types of aging are partially the result of decreased production of new collagen, a target of many cosmeceuticals, while other agents reverse signs of aging skin via regulation of fibroblasts (secrete collagen) proliferation, regulation of metalloproteinase (an enzyme that causes collagen degradation or destruction) activity, and elastotic fiber turnover (elastin provides strength and elasticity to our skin; too much sun exposure can damage it, thus the deposition of abnormal or disorganized elastic fibers in the upper dermis damaging the skin and leading to aging skin.