Ageing Skin

Aging is a dynamic process; as we age several changes occur in our skin. These changes are induced by either intrinsic or extrinsic factors. Intrinsic aging is a natural process of everyone’s skin and the severity of some elements of intrinsic aging have genetic basis allowing some people’s skin age more than others.

However the most dramatic changes seen are due to extrinsic causes, the most important being sunlight (particularly the invisible UV light), smoking and pollution. UV rays in sunlight are responsible for sun burns, premature wrinkles, dark spots (lentigines and freckles), unsightly growths, rough skin texture with yellow hue and even skin cancer. The fairer the skin, the most susceptible it is. The harmful effects of UV rays are cumulative and generally not visible until middle age, even though the damage would have occurred in teenage years. Hence avoidance of sun-exposure should begin in early life.

Sun Protection: This can be achieved by use of protective clothing and sun-screens. Most clothing absorb or reflect UV rays, but white fabric like loose knit cotton and wet clothes (due to sweating) do not offer much protection. The tighter the weave, greater the protection.

Sun-screens should be used regularly and every day, whether the person is indoors or outdoors. Sun-screens are of two types – physical blocks and chemical sun-screens.

Physical sun-screens (zinc oxide and titanium dioxide) create a physical barrier for the penetration of UV light (UV-A and UV-B). These are quite effective, but cosmetically unacceptable. Now micronised titanium dioxide is available for better acceptance.

Chemical sun-screens (PABA and its derivatives, parsol etc.) absorb UV rays; some absorb only UV-A (parsol) and some only UV-B (PABA and its derivatives).

SPF (Sun Protection Factor) of a sunscreen indicates protection against burning that is caused by UVB. UVA penetrates deeper and plays a significant role in wrinkling, loss of elasticity and pigment changes. Our skin rarely burns. What we need is a protection against UV-A in addition to UV-B. Therefore daily use of broad spectrum sun-screen is a must.

Treatment of aging: Choice of treatment depends on severity and type of wrinkles along with the aesthetic needs of the patient.

Cosmetic camouflage is an effective, temporary means of concealing aging skin problems like wrinkles, mottled pigmentation and xerosis.

Treatment of aging skin includes surgical and non-surgical methods. Non-surgical treatment include use of retinoic acid (RA) and alpha hydroxy acids (AHAs). AHAs are derived from fruits and referred as fruit acids – glycolic acid from sugarcane, citric acid from citrus fruits and mallic acid from apple. But glycolic acid available in the market is synthesized in the lab and not extracted from fruits. These acids reverse the changes caused by photo-damage by increasing the epidermal thickness, dermal collagen and ground substance. AHAs take minimum of 6-8 weeks to show improvement. Results will be better if RA and AHA are used together.

Surgical methods include

  • Chemical peeling
  • Liquid nitrogen peel
  • Dermabrasion
  • Laser resurfacing
  • Injection of fats, collagen
  • Injection of botulinus toxin (for wrinkles caused by muscle contraction)
  • Face lifts and blepharoplasty

Sunscreens are the best agents anyone can use to maintain a youthful skin

Points to remember while using a sun screen:

  • Use a broad spectrum sun screen (that protects against both UVA and UVB)
  • Should be used at the right time (between 8am and 5pm)
  • Should be used in sufficient quantities (2mg/cm2 area)
  • Should be used regularly, whether indoors or outdoors
  • In countries like India, it should be used through out the year

Sun screens used in right time prevents/improves:

  • Sunlight induced skin disease
  • Pigmentation changes on the face
  • Growths on the face
  • Wrinkling of face
  • Acne scars and comedones
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