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Aging Skin

What is skin aging?
Skin aging is a biological process characterized by gradual changes in the structure of the skin that occur with the passage of time.

What are the causes of aging skin?
There are two main causes of aging skin:

1. Intrinsic (internal) – Natural aging process due to the genes we inherit
2. Extrinsic (external) – Premature aging as a result of the environment and our lifestyle

Intrinsic (internal) aging

- Begins in our 20s and continues at different rates depending on our individual genetic make up. Visible changes may not appear until many years later.

- Involves changes in collagen and elastin leading to decreased firmness and elasticity.

- There is also loss of other supporting structures like ground substance (containing hyaluronic acid) and fat.

- Bone loss may cause bones to draw away from the skin.

- Dead skin cells do not shed from the skin’s surface as quickly, and are replaced at a slower rate.

What are the visible signs of intrinsic skin aging?

• Fine lines and wrinkles
• Skin thinning
• Hollowed cheeks and eye sockets or sagging cheeks (jowls) and lower eyelids
• Rough, dry skin
• Hair loss, graying hair, unwanted facial hair
• Nail thinning and ridging

Extrinsic (external) aging
Certain external causes may cause premature aging which is superimposed on the natural aging process, appearing to speed it up. These factors include:

• Sunlight or ultraviolet radiation (photoaging)
• Cigarette smoking
• Excessive alcohol
• Pollutants, harsh chemicals
• Poor nutrition
• Repetitive facial expressions
• Gravity, sleeping positions
• Stress

Photoaging is usually the main cause of extrinsic or premature aging. It develops over years of repeated long term or intense short term sun exposure. Although individuals with fair skin usually develop more features of photoaging than darker skin types, all races are susceptible. Repeated UV exposure alters collagen and elastin. It may eventually lead to skin cancer especially in fairer skin types.

What are the features of photoaging?

• Freckles, age spots
• Rough, leathery skin
• Mottled complexion
• Fine wrinkles which disappear when stretched
• Dilated blood vessels e.g. spider veins

Can I prevent the signs of aging?
We have no control over our natural aging process. However, we can help prevent premature aging by the following measures:

• Sun protection*
• Avoiding smoking and excessive alcohol
• Healthy skin care routine
• Healthy diet rich in fruits, vegetables, lean meats etc.
• Sleep on your back or use a special pillow that prevents your face from pressing against it
• Reduce facial expressions e.g. frowning

* Tips on Sun/UV protection

1. Avoid intense sunlight between 10am and 3pm
2. Avoid tanning, including indoor tanning devices
3. When outdoors wear protective clothing e.g. long sleeves, wide brimmed hat
4. Apply a broad spectrum sunscreen (UVA and UVB protection) with an SPF of at least 15 (preferably at least 30). This should be done every day with reapplications after sweating and exposure to water.

What treatments are available for aging skin?
There are many treatment options for those who are concerned about the appearance of aging skin. The table below is a basic guide to various treatment options for different chronological ages and stages of photoaging (Glogau’s classification). Your dermatologist can help you decide which treatment or combinations of treatments are best for you.