There are between 25 and 30 different theories of aging recognized by the NIH (National Institute of Health). There is no unified theory of aging. Otherwise, only one ingredient in only one skincare product would serve to treat all aging skins. Therefore, aging must be approached from a multi-factor point of view with multiple ingredients and products. (By Charlene DeHaven, MD, FACEP, Clinical Director).
Because skin changes are among the most visible signs of aging, before we get into the causes of aging, let’s take a look at the structure of the skin and what happens to it during the aging process:
Your skin does many things. It protects you from the environment, helps control your body temperature and fluid balance, and contains nerve receptors that allow you to feel sensations such as touch and pain. Although the skin has many layers, it can be generally divided into three main parts:
- The outer part (epidermis) contains skin cells, pigment, and proteins.
- The middle part (dermis) contains blood vessels, nerves, hair follicles, and oil glands. The dermis provides nutrients to the epidermis.
- The inner layer under the dermis (the subcutaneous layer) contains sweat glands, some hair follicles, blood vessels, and fat. Each layer also contains connective tissue with collagen fibers to give support, and elastin fibers to provide flexibility and strength.
- The aging skin “genes” you inherited, over which you have little control: If you are fortunate enough to know older generations of your family members, you may see patterns of aging skin in their faces and bodies. These can include:
- Furrows in the brow or forehead
- Tiny lines or crinkles around the eyes
- Deep creases along the sides of the nose to the mouth
- Drooping eyelids
- Loose skin along the jaw line
- A “tired” look
- The tendency to develop cellulite
- Male pattern baldness or female pattern baldnes.
If you see any of these indicators of aging skin—or others—in your older family members, chances are that you will experience at least some of them too. Some people choose cosmetic treatments, surgery, hair transplants, and other choices to slow the external signs of aging skin, but the fact remains that everyone ages. If you are lucky and live long enough, aging skin will catch up to you and the years you acquire will eventually show on your face. One of the healthiest things you can do for yourself is to work on accepting your aging process with dignity…and grace…and style.
- The external factors that act on aging skin, over which you have a lot of control and which will be explained later.
How does the aging process work?
With aging, the outer skin layer (epidermis) thins, even though the number of cell layers remains unchanged. The number of pigment cells (melanocytes) decreases, but the remaining melanocytes increase in size. Aging skin thus appears thinner, more pale, and clear (translucent). Large pigmented spots (called age spots, liver spots, or lentigos) may appear in sun-exposed areas.
Changes in the connective tissue reduce the skin’s strength and elasticity. This is known as elastosis and is especially pronounced in sun-exposed areas (solar elastosis). Elastosis produces the leathery, weather-beaten appearance common to farmers, sailors, and others who spend a large amount of time outdoors.
The blood vessels of the dermis become more fragile. This leads to bruising, bleeding under the skin (often called senile purpura) and cherry angiomas.
Sebaceous glands produce less oil as you age. Men experience a minimal decrease, usually after the age of 80. Women gradually produce less oil beginning after menopause. This can make it harder to keep the skin moist, resulting in dryness and itchiness.
The subcutaneous fat layer thins, reducing its normal insulation and padding. This increases your risk of skin injury and reduces your ability to maintain body temperature. Because you have less natural insulation, you can get hypothermia in cold weather.
Some medications are absorbed by the fat layer, and loss of this layer changes the way that these medications work.
The sweat glands produce less sweat. This makes it harder to keep cool, and you are at increased risk for becoming overheated or developing heat stroke.
Growths such as skin tags, warts, and other blemishes are more common in older people.
Aging changes in the face
The typical appearance of the face and neck changes with age. Muscle tone may be lost, causing a flabby or droopy appearance. The jowls may begin to sag, leading to a “double chin” in some people. In some people the nose lengthens slightly and may look more prominent.
There also may be an increase in the number, size, and color of colored spots on the face. This is largely due to sun exposure.
The skin may thin, become dryer, and develop wrinkles. Although wrinkles are inevitable to some extent, sun exposure and cigarette smoking are likely to make them develop faster.
The ears may lengthen slightly in some people (probably caused by cartilage growth). Some men may find that they develop hair in their ears that becomes longer, coarser, and more noticeable as they age.
Wax glands drop in number and activity, and ear wax becomes drier. This drier wax can more easily become impacted and block the ear canal, reducing your ability to hear.
The eyebrows and eyelashes become gray. The skin around the eyelids becomes loose and wrinkled, often making a “crow’s feet” pattern. The eye socket loses some of its fat pads, making the eyes look sunken and limiting eye movement.
The lower eyelids may appear baggy, and drooping eyelids are fairly common, occasionally limiting vision. The outer surface of the eye (cornea) may develop a grayish-white ring. The colored portion of the eye (iris) loses pigment, making most very elderly people appear to have gray or light blue eyes.
Loss of teeth can make the lips look shrunken. The jawbone loses bone material, reducing the size of the lower face. The forehead, nose, and mouth thus look more pronounced. Gums may also recede, contributing to dental problems and changes in the appearance of the mouth.
PREVENTION (External Factors for which YOU DO have control!)
Skin changes are related to environmental factors, genetic makeup, nutrition, and other factors. The greatest single factor, though, is sun exposure. This can be seen by comparing areas of your body that have regular sun exposure with areas that are protected from sunlight. Because most skin changes are related to sun exposure, prevention is a lifelong process.
- Loss of elasticity (elastosis)
- Noncancerous skin growths (keratoacanthomas)
- Pigment changes such as liver spots
- Thickening of the skin
- Sun exposure has also been directly linked to skin cancers, including basal cell epithelioma, squamous cell carcinoma, and melanoma.
Natural pigments seem to provide some protection against sun-induced skin damage. Blue-eyed, fair-skinned people show more aging skin changes than people with darker, more heavily pigmented skin.
2. Weight -You’ve probably waited a long time to find out when having a few extra pounds actually works to your advantage. If you’re over 40, a slightly higher Body Mass Index (about 4 points) makes you look up to 3 years younger. If you’re over 55, you’ll look even younger than that! If you’re less than 40, the reverse is true.
9. Alcohol use – Alcohol contributes to aging skin by dilating small blood vessels in the skin and increasing blood flow near the skin’s surface. Over time, these blood vessels can become permanently damaged, creating a flushed appearance and broken vessels on the skin’s surface.
This theory is more commonly known as the free radical theory of aging. All cells need energy to perform their particular function. This energy is a very “hot” process and uses free radical generation to burn fuel. In this process, extra free radicals are created. These extra free radicals bounce around inside the cell, damaging all cellular structures they contact. Over a lifetime, these free radical “hits” gradually accumulate leading to a physiologic decline in structure and function. We label this decline as “aging.” In relationship to sun exposure, depending on whether the sunscreen chosen is physical or chemical, these solar free radicals can be blocked or neutralized. Antioxidants are helpful because they combine with free radicals and prevent the ongoing cascade of free radical damage. Only about one percent of oral antioxidants reach the skin so topical antioxidants are also critical. Smokers have huge amounts of free radicals floating about in their bodies.
A certain amount of inflammation is required for health. Through its inflammatory response the body combats infections, clears away damaged tissue and heals sunburn and other oxidative processes. Excess inflammation results in accelerated rates of aging, scarring and destruction of normal tissue architecture. Free radical damage is well-known to trigger excess inflammation. The inflammatory response is elevated in those having higher levels of oxidative stress byproducts.
DNA is contained inside chromosomes in the nucleus of the cell. This DNA contains our genetic material and also directs the function of the cell in which it resides. A cell with
damaged DNA cannot properly function and may even become cancerous. Increased DNA damage in skin occurs with photoaging and high oxidative stress. DNA is subject to free radical damage so antioxidants improve rates of DNA damage.
An important part of any anti-aging skin care program is to know what you may be doing that is harming your skin and speeding up your skin’s aging process. While some signs of aging skin are inevitable, there’s a lot you can do to look your best at any age. Attacking the processes of aging in younger years is preferable. But even though “younger is better”, any time is better than never. Taking good care of yourself is the most important step in your anti-aging skin care program.