Skin Care

The Ageing Skin
There are, in fact, two distinct types of skin ageing. ageing that is caused by our inherited genes is called intrinsic (internal) ageing. The other type of ageing, extrinsic (external) ageing and is caused by our environment, such as exposure to the sun’s rays or pollution.

Our Intrinsic ageing
This is the natural ageing process, is a continuous process that normally begins in our mid-20s. Within the skin, collagen production slows, and elastin, the substance that enables skin to snap back into place, has a bit less spring. Dead skin cells do not shed as quickly and turnover of new skin cells may decrease slightly. While these changes usually begin in our 20s, the signs of intrinsic ageing are typically not visible for decades. The signs of intrinsic ageing are:

  • Fine wrinkles
  • Thin and transparent skin
  • Loss of underlying fat, leading to hollowed cheeks and eye sockets.
  • Bones shrink away from the skin due to bone loss, which causes sagging skin
  • Dry skin that may itch
  • Inability to sweat sufficiently to cool the skin
  • Greying hair that eventually turns white
  • Hair loss
  • Unwanted hair
  • Nail plate thins,
  • Receding gums

Genes control how quickly the normal ageing process unfolds. Some notice those first grey hairs in their 20s; others do not see greying until their 40s.

Extrinsic Ageing
By far the biggest culprit in premature ageing of our skin is sun exposure. Smoking is another major reason why skin ages faster than normal. Other extrinsic causes include repetitive facial expressions, sleeping and gravity.  

The Sun
Without protection from the sun’s rays, just a few minutes of exposure each day over the years can cause noticeable changes to the skin. Freckles, age spots, spider veins on the face, rough and leathery skin, fine wrinkles that disappear when stretched, loose skin, a blotchy complexion, actinic keratoses (thick wart-like, rough, reddish patches of skin), and skin cancer can all be traced to sun exposure.

Photo-ageing” is the term dermatologists use to describe this type of ageing caused by exposure to the sun’s rays. The amount of photo-ageing that develops depends on: 1) a person’s skin colour and 2) their history of long-term or intense sun exposure. People with fair skin who have a history of sun exposure develop more signs of photo-ageing than those with dark skin. In the darkest skin, the signs of photo-ageing are usually limited to fine wrinkles and a mottled complexion.

Photo-ageing occurs over a period of years. With repeated exposure to the sun, the skin loses the ability to repair itself, and the damage accumulates. Scientific studies have shown that repeated ultraviolet (UV) exposure breaks down collagen and impairs the synthesis of new collagen. The sun also attacks our elastin. Sun-weakened skin ceases to spring back much earlier than skin protected from UV rays. Skin also becomes loose, wrinkled, and leathery much earlier with unprotected exposure to sunlight.
People who live in sun-intense areas can show signs of photo-ageing in their 20s. In fact, some people who live in sun-intense areas develop actinic keratoses (AKs) and skin cancer in their 20s.

While it may seem that the signs of photo-ageing appear overnight, they actually lie invisible beneath the surface of the skin for years. UV photography enables us to see the damage accumulating beneath the surface of the skin years before the signs of photo-ageing appear. Most people are surprised by the amount of photo-ageing that the UV camera shows.

Facial Expressions
If you perform facial exercises to maintain a youthful-looking appearance, it is time to stop. Repetitive facial movements actually lead to fine lines and wrinkles. Each time we use a facial muscle, a groove forms beneath the surface of the skin, which is why we see lines form with each facial expression. As skin ages and loses its elasticity, the skin stops springing back to its line-free state, and these grooves become permanently etched on the face as fine lines and wrinkles.

Gravity constantly pulls on our bodies. Changes related to gravity become more pronounced as we age. In our 50s, when the skin’s elasticity declines dramatically, the effects of gravity become evident. Gravity causes the tip of the nose to droop, the ears to elongate, the eyelids to fall, jowls to form, and the upper lip to disappear while the lower lip becomes more pronounced. Yes , it all goes south!

Sleeping Positions.
Resting your face on the pillow in the same way every night for years on end also leads to wrinkles. Called sleep lines, these wrinkles eventually become etched on the surface of the skin and no longer disappear when the head is not resting on the pillow. Women, who tend to sleep on their sides, are most likely to see these lines appear on their chin and cheeks. Men tend to notice these lines on the forehead since they usually sleep with the face pressed face down on the pillow. People who sleep on their backs do not develop these wrinkles since their skin does not lie crumpled against the pillow.

Cigarette smoking causes biochemical changes in our bodies that accelerate ageing. Research shows that a person who smokes 10 or more cigarettes a day for a minimum of 10 years is statistically more likely to develop deeply wrinkled, leathery skin than a non smoker. It also has been shown that people who smoke for a number of years tend to develop an unhealthy yellowish hue to their complexion. Additionally, a study conducted in 2002 showed that facial wrinkling, while not yet visible, can be seen under a microscope in smokers as young as 20.

These signs can be greatly diminished, and in some cases avoided, by stopping smoking. Even people who have smoked for many years, or smoked heavily at a younger age, show less facial wrinkling and improved skin tone when they quit smoking.

For Healthier, Younger-Looking Skin - Prevention
While you cannot stop or even slow down the intrinsic ageing process, you can prevent signs of premature ageing by protecting your skin from the sun, quitting smoking, and eliminating facial exercises.

Dermatologists recommend comprehensive sun protection in hot climates to help prevent premature ageing caused by the sun as well as sunburn which is particularly damaging to skin. Comprehensive sun protection includes:

  • Avoiding deliberate tanning, including use of indoor tanning devices.
  • Staying out of the sun between 10:00 a.m. and 4:00 p.m., when the sun’s rays are the strongest.
  • Wearing protective clothing, such as a wide-brimmed hat and long sleeves, when outdoors during the day.
  • Sunscreen should be broad spectrum (offers UVA and UVB protection) and have a Sun Protection Factor (SPF) of 25 or higher for children especially. Sunscreen should be applied 20 minutes before going outdoors to all skin that will be exposed. It should be reapplied after sweating or being in water.

If you are bothered by visible signs of ageing, a number of treatments are available. Injectable fillers to lift up wrinkles and botulinum toxin to relax muscles are suitable for people with busy lifestyles who do not want the inconvenience of a long recovery. Radio-frequency is a procedure that offers an alternative to the traditional facelift. Microdermabrasion, laser resurfacing, chemical peeling  and some topical treatments can restore skin, giving it a smoother and refreshed appearance.

Scientific research in the field of anti-ageing continues to give rise to new and promising treatment options.