Understanding skin aging – How does skin age and how should I care for it?

From around the age of 25 the first signs of ageing start to become apparent on the surface of the skin. Fine lines appear first, and over time wrinkles and a loss of volume become noticeable.

Our skin ages for a variety of different reasons. Of these reasons not all are inevitable and cannot be changed. However the others can be controlled to an extent by a holistic approach to prevention.
Understanding the way that internal and external factors affect the skin’s structure and function can help to inform choices about treatment and prevention.

There are three main manifestations of general skin ageing. Each one affects the look of the face in a different way.

Wrinkles
The first noticeable sign of ageing from 25 onwards are fine lines and wrinkles. These lines appear on different areas of the face and are the easiest signs of ageing to spot. First to appear are fine lines. These small, shallow wrinkles tend to become noticeable at the outer corners of the eyes. These are also known as laughter lines or crow´s feet. Fine lines can also be found on the cheeks. On the forehead, wrinkles become noticeable as horizontal lines, they are triggered by facial expression and tend to become deeper as time goes by. Smaller, vertical lines between the brows are caused by frowning.

Deeper wrinkles form between the nose and mouth, called nasolabial folds. These are linked to sagging skin and are often associated with a loss of volume.

Loss of volume
Sometimes difficult to identify, a loss of volume is also sometimes known as saggy skin, loss of contours, turkey neck, chicken skin or ‘looking drawn’. Unlike wrinkles, it changes the overall appearance of the face in ways that are transformative but hard to pinpoint. Most noticeably the diminishing volume and slackened facial contours associated with a loss of volume can give the face a negative, sad or stressed look. This can, in turn, lead to incorrect perceptions of a person’s mood or outlook.

Loss of elasticity and deep wrinkles
As our skin matures its structure weakens and it loses elasticity and firmness. Skin also becomes drier, appears more `crepey` and loses the radiance we associate with youthful skin. Again, because our skin is as individual as we are, these changes become visible at different ages but are most commonly experienced by those who are 50+.

Rather than a single cause, the skin ages due to a combination of factors, both internal and external. An understanding of these causes will help to create a holistic approach to the prevention of skin ageing.

Some of the causes of ageing facial skin are inevitable and cannot be changed. Our biological age determines the structural changes in the skin and the efficiency of the cell functions. These slow down with each passing year.

A poorer blood supply to the skin means the delivery of nutrients and oxygen to the skin’s surface is impeded.

Genetics have a key role in how the skin ages. The ethnicity and skin type we are born with make a difference to how quickly the signs of ageing appear on the surface of the skin. For example a fair sensitive skin is prone to wrinkles at an earlier age, while asian skin can be prone to uneven skin tone and wrinkles appear at a later age. Age induced dryness can also be caused by a persons specific genetic make-up

The external factors affecting the speed with which the skin ages are all due to one process, oxidative stress. This is the release of molecules called free radicals, or reactive oxygen species, in the body. Free Radical Theory of Ageing states that we age due to the accumulation of damage due to free radicals as time goes by. A free radical is a highly volatile atom or molecule that consists of a single unpaired electron in an outer shell. The majority has extensive ability to damage all cell structures including lipids and proteins.

Under normal circumstances free radicals are caught and neutralised by anti-oxidants in the skin: molecules with the ability to absorb and stop them. However, over time, the skin’s ability to de-activate free-radicals decreases. The result is damage to all components of the skin cell. Oxidative stress is accelerated and triggered by a variety of lifestyle factors.

Sun
Exposure to the sun’s rays is the primary external factor responsible for skin ageing via oxidative stress. Damage to the skin caused by both prolonged exposure, and everyday exposure to the UV rays is called Photoageing, which is also responsible for uneven pigmentation.

Pollution
Allowing the skin to be exposed to pollution, most commonly in cities, can trigger the release of skin damaging free radicals. In addition, pollution worsens the effects of sun exposure accelerating oxidative stress.

Smoking
The chemicals and nicotine contained in cigarettes are responsible for an upsurge in the amount of free radicals in the skin. Like pollution they intensify the effects of sun exposure, leading to oxidative stress.

Nutrition
Anti-oxidants are molecules with the ability to neutralise the free radicals that damage skin, speeding up skin ageing. A diet lacking in antioxidants will do nothing to help slow down general skin ageing. However, eating lots of antioxidant-rich fruits and vegetables can become a key tool in a holistic approach to prevention of the ageing process.

Too little care
Skin that is poorly cared for will age more quickly. Thorough cleansing using products appropriate for skin type together with regular application of anti-aging skin care products targeted to the skin’s primary concern, can influence the skin to a great extent. Use of effective sun protection when exposed to sunlight is a key part of prevention.

Changes within the skin’s layers show themselves on the surface as signs of ageing.

Epidermal layers
A slower cell turnover and reduction in lipid production on the skins surface means roughness and dryness are more likely. As this particular layer of the skin ages, it becomes more sensitive to UV light. The skin is less efficient at healing itself, and a reduction in immune function can lead to an increase in skin infections, together with slower wound healing.

Dermal layers
From the age of 25, there is a 1% annual decrease in collagen, one of the ‘building blocks’ of the skin. Together with a decline in elastin this leads to dermal tissue disorganisation. The structure of the skin is compromised and wrinkles are more likely. Elasticity is reduced, making the skin more prone to damage and broken capillaries. Reduced blood flow means a less efficient delivery of nutrition and oxygen to the surface.

Subdermal layers
In the deeper layers, the most notable changes are to the size and number of lipid-storing cells in the adipose layer. This decrease has a knock-on effect on loss of volume, and can lead in turn to deep wrinkles, hollow cheeks and impaired wound healing.

Understanding the skin’s ageing process informs decisions about how to treat it. The two key signs of ageing: loss of volume and wrinkles are examined in more detail in separate articles. If there is still uncertainty about which treatment route to take, the skin test may be a useful diagnostic tool. Both minimising the effects of ageing and preventing further ageing can be achieved through a holistic approach. This approach involves areas of lifestyle and care being examined and changed accordingly.

Lifestyle
As oxidative stress is the primary cause of external skin ageing, any lifestyle changes should be targeted towards minimising its effects as much as possible.

Nutrition
A healthy diet, rich in fruits and vegetables will ensure an intake of anti-oxidants that can help to limit the damaging effects of free radicals on the skin. As much variety as possible should be included, but some foods are known to be particularly high in anti-oxidants and might even have a skin protecting effect: Carrots, apricots and other orange and yellow fruit and vegetables, blueberries, leafy green vegetables, bell peppers, tomatoes, beans and other pulses, fish – particularly salmon, and nuts.

As well as choosing the right foods, there is evidence to suggest that some should be avoided. A diet too high in fat and carbohydrates has been found to promote ageing.

Smoking
Smoking accelerates ageing remarkably, reducing elasticity and causing dullness. Stopping smoking will help to improve the appearance of the skin by cutting out the chemicals and nicotine present in cigarettes.

Skin Care
The skin changes with each life stage and the way it is cared for should reflect its changing needs as time goes by.

A good skin care routine is an essential part of a holistic approach to treating all signs of ageing: loss of volume, loss of density, wrinkles and related conditions such as age induced dryness or sensitive ageing skin.

If your skin is healthy, good care will ensure your skin stays in condition. If not, a consistent routine can help to improve it. A skincare routine should consist of three steps, cleanse, care and sun protection.

Cleansing removes make-up, dirt and chemicals from the skin. This is vital, as chemicals on the surface as a result of pollution can be a trigger for oxidative stress.

Care is the replenishment and hydration of the skin, using the appropriate anti-aging products for the sign of ageing that is the primary concern. By targeting the concern with the correct products and their actives such as Hyaluronic Acid, Glycine-Saponin or Arctiin improvements can be made to the appearance of the skin. Protecting the skin from UV rays is the most important step in the prevention of future skin ageing. The SPF product used should be selected with skin type and skin concern in mind.