What is Aging Skin?
Intrinsic aging is a continuous process that normally visibly begins in our mid-20s, with gradual progression over time. Here are some of the features attributed to intrinsic aging:
- Fine wrinkles
- Thin and transparent skin
- Loss of underlying fat, leading to hollowed cheeks and eye sockets as well as noticeable loss of firmness on the hands and neck
- Bone loss, causing sagging skin
- Dehydrated dry skin from depleted skin barrier
- Graying hair
- Thinning hair
- Hair in unwanted locations
Our genes control how quickly the normal aging process unfolds.
Most signs of aging skin, and especially prematurely aged skin, result from extrinsic aging, most notably excessive sun exposure. The hallmarks of photoaging are:
- “Liver spots”
- Melasma and generally mottled irregular pigmentation
- Loss of dermis, subcutaneous fat, bone, and muscle causing paper thin skin, deep hollows and sagging skin
- Leathery dull skin
- Bumpy or “cobblestoned” skinthat is somewhat yellowed and sallow
- Scaly pink and brown precancerous patches or bumps
- Spider veins of the face
- Excessive bruisability
- Giant blackheads
- Excessive wrinkling, both deep and fine
- Flared or poorly controlled rosacea
- Poor skin tone and quality with intermixed dry and oily areas
- Enlarged pores
- Skin cancers
While environmental pollution and cigarette smoke have a role here, the major cause of Extrinsic Aging (and the major cause of skin aging in general) is ultraviolet (UVA/UVB) light. The amount of photoaging one develops is the sum of 2 forces: the intensity or duration of sun exposure and the fairness or sensitivity of the skin to sun and burning. Although photoaging is a cumulative process of skin damage occurring over many years, some people experience the sensation of a “tipping point”, whereby certain visible signs of aging (wrinkles, brown spots, etc) seem to have occurred “overnight”. The good news: extrinsic aging can be prevented or modified by your behavior and skin care regimen.
As the loss of collagen, elastin and facial support (bone, muscle, fat) progress, gravity exaggerates the process. Much like a tent with the poles shortened, or a beach ball with some of the air released, the loss of facial structure and support results in drooped cheeks, jowls, chin and nose, hollows in the eye sockets and temples, elongated ears, and shrunken lips.
Treating Aging Skin
The basic approach to treating aging skin is two pronged: Prevention against further damage and Repair of past and ongoing damage.
The hallmark of prevention is comprehensive sun protection, which 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.
- Applying sunscreen year round. Sunscreen should be broad spectrum (offers UVA and UVB protection) and have a Sun Protection Factor (SPF) of 30 or higher. 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.
Dermatologists have been telling their patients for years to wear sunscreen to protect against skin cancer and premature aging. The impact of this advice may be diluted by a variety of factors. First, the negative effects of sun on skin are frequently delayed, and have been culturally overwhelmed by society’s long time underlying message that tanned skin is healthy and beautiful. Second, optimal sun protection is difficult to achieve. Sunscreen labeling and recommended wear practices are far from ideal. Sunscreen consumers often only apply product when actively seeking sun, routinely under apply the recommended amounts of product, and do not reapply frequently enough (every few hours) to achieve continuous protection. Compounding this, many sunscreens are not broadly UV protective. While those in the industry know that SPF relates only to UVB protection, and that protection levels higher than 30 do not confer any significant benefit, consumers are infrequently aware of this, and fall prey to the marketing of super high SPF formulas which imply super broad protection and durability. Consumers also are generally unaware that UVA light can penetrate windows (even some tinted windows) and is seen throughout the lit day all year round.
If you are bothered by visible signs of aging, a number of treatments are available. In addition to sun protection, using topical products to help rejuvenate the skin and repair some of the damages incurred are appropriate no matter how aggressive a plan you decide to embark upon
Managing aged, or prematurely photo aged skin, takes 3 general forms
- Well-designed skin care program tailored to your particular skin needs
- Selected minimally invasive injectable treatments, such as neurotoxins or filler, or minimal downtime resurfacing procedures such as laser and chemical peels
- Traditional cosmetic surgical intervention.