What is skin aging?
New treatments for aging skin are required to target either facial or body skin. Different agents may be required dependent on how these different skin sites age. Skin aging is a complex process associated with dramatic changes in both skin structure and its chemistry. It is a natural consequence of chronological aging (simply getting older) and is accelerated by external insults, such as UV radiation which leads to photoaging (premature skin aging). The clinical changes to skin associated with photoaging are age spots (freckles or ephelides, solar lentigines and solar keratoses), skin dryness, wrinkles and a general loss of skin elasticity, softness, smoothness and firmness. Similar changes in chronologically aged skin (non-UV exposed skin) can also occur but skin atrophy (skin thinning) plays a more important role. Reductions in endogenous hormone (estrogen) levels can also contribute to the chronological aging process during menopause. Optically, the skin lacks radiance, luminosity and takes on certain dullness. Lifestyle factors (e.g. habits, diets, smoking), diseases (e.g. diabetes) and the effect of gravity also further exacerbate the changes in appearance associated with aging.
In both chronological and photoaging, the synthesis of dermal collagen slows. In chronological aging lower estrogen levels result in less collagen formation. In photoaging, the effect of slowed collagen production is compounded by the destruction of collagen driven by increased levels of certain proteases such as matrix metalloproteases (MMPs) formed as a result of UV exposure. Equally, elastosis is a hallmark sign of photoaging. These changes can lead to both fine lines and deep wrinkles.
As a result of this dermal destruction and the effects of gravity, sagging of facial skin becomes particularly apparent in the aged. Dry skin occurs more frequently on both types of aged skin where it becomes less hydrated due to reduced levels of stratum corneum natural moisturising factors (NMF) derived from filaggrin and lower levels of barrier lipids (ceramides, cholesterol and fatty acids).
The main cause of photoaging is exposure to UV radiation. UV irradiation can directly damage cellular membranes which leads to the formation of reactive oxygen species that initiate the aging process. Subsequently, increased levels of inflammatory cytokines (Interleukin-1α (IL-1α) etc) accentuate the inflammatory state. Interference with specific transcription factors like Activator Protein-1 (AP-1) also leads to the changes in collagen synthesis and expression of MMPs. Aged skin cells also have a reduced metabolic efficiency leading to reduced production of essential dermal structural proteins.
The skin can repair some of these changes provided that UV exposure is avoided or reduced. Additionally, topical application of certain skin care technologies can reverse the appearance of “aging” by addressing the decreases in key skin protein and lipid levels and by minimizing levels of certain by-products of UV exposure.
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Skin Management System by Dr. Strauss
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