Ageing

What are the signs of ageing skin?
Fine lines, wrinkles, dryness, loss of plumpness, thinning and sagging skin, enlarged pores, age spots and uneven skin tone.

What are the causes?
Increasing age, genetics, ultraviolet light exposure, pollution and smoking.

What can help ageing skin?
Topicals: sun protection, moisturiser, antioxidants such as vitamin C and niacinamide, topical retinoids, alpha hydroxy acids.
Injectables: dermal fillers, botulinum toxin
Physical treatments: intense pulsed light, lasers, chemical peels, radiofrequency, ultrasound.

Preventing and reducing the skin signs of ageing is one of the most common skincare queries. Fortunately, even though we can’t unwind the clock, there’s lots that can be done to reduce the signs of ageing, and it’s never too late (or early) to start! 

What are the signs of skin ageing?

Signs of skin ageing include fine lines and wrinkles, areas of dryness, loss of plumpness, thinning and sagging skin. Others include enlarged pores, age spots and uneven skin tone

What causes ageing skin?

Collagen and elastin are two proteins found in the skin, which help keep the skin plump, firm, and stretchy. As skin ages, there’s a reduction in collagen and elastin, a redistribution of fat, and slower cell turnover. This can lead to the skin appearing less plump, and more saggy and wrinkly. In addition, as we age there’s an increase in water loss through the skin, also known as transepidermal water loss, which contributes to dryness of the skin. 

Both intrinsic and extrinsic factors influence ageing. Intrinsic factors include the passage of time and our genetics. Extrinsic factors include environmental factors such as sun exposure and pollution, and lifestyle factors such as smoking. 

What can be done to improve the appearance of ageing skin?

To improve the appearance of ageing skin, strict sun protection and a good moisturiser is essential. Key topical agents that help include antioxidants such as vitamin C and niacinamide, and topical retinoids. Alpha hydroxy acids, used either in leave-on products or in higher concentrations in chemical peels, can be useful. Dermal fillers can help replace volume loss, and muscle relaxants such as botulinum toxin can help reduce the appearance of some wrinkles by relaxing certain facial muscles. 

There are a range of lasers that can help improve signs of ageing in various ways, by evening out pigmentation, treating dilated blood vessels, reducing the appearance of fine lines and wrinkles, and stimulating collagen production. Intense pulsed light can improve skin tone, and radiofrequency treatments can help improve skin texture and fine lines. The use of ultrasound technology can help with skin tightening. The use of platelet-rich plasma has been suggested for anti-ageing, in particular improving skin texture, but the evidence supporting its use is limited. 

I’d like to take steps to prevent and treat skin ageing. Where should I start? 

Step 1: A healthy lifestyle, including limiting sun exposure and avoiding smoking.  

Step 2: Sunscreen: SPF 50+, 365 days a year. And plenty of it.

Step 3: A topical retinoid, at night (providing you’re not pregnant), alternating with an alpha hydroxy acid.

Step 4. Antioxidants in the morning, such as vitamin C and/or niacinamide

See the relevant posts for more information on how to incorporate these items into your routine. Always start slowly with one new ingredient at a time, and do a test patch first. If after incorporating these for several months you’re still not seeing the results you’re after, it may be worth seeing a dermatologist for a skin assessment and advice regarding other treatment options for you.

References
Aşiran Serdar Z, Aktaş Karabay E, Tatlıparmak A, Aksoy B. Efficacy of high-intensity focused ultrasound in facial and neck rejuvenation. J Cosmet Dermatol. 2020 Feb;19(2):353-358.

Ganceviciene R, Liakou AI, Theodoridis A, Makrantonaki E, Zouboulis CC. Skin anti-aging strategies. Dermatoendocrinol. 2012;4(3):308-319. 

Krutmann J, Bouloc A, Sore G, Bernard BA, Passeron T. The skin aging exposome. J Dermatol Sci. 2017 Mar;85(3):152-161. 

Maisel-Campbell AL, Ismail A, Reynolds KA, Poon E, Serrano L, Grushchak S, Farid C, West DP, Alam M. A systematic review of the safety and effectiveness of platelet-rich plasma (PRP) for skin aging. Arch Dermatol Res. 2020 Jul;312(5):301-315.

Parrado C, Mercado-Saenz S, Perez-Davo A, Gilaberte Y, Gonzalez S, Juarranz A. Environmental Stressors on Skin Aging. Mechanistic Insights. Front Pharmacol. 2019;10:759.

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ABOUT THE AUTHOR

Dr-Julia-Rhodes

Spotlight on Skin was created by award-winning Melbourne-based dermatologist, Dr Julia Rhodes.

Julia knows first-hand how overwhelming the skincare world can be, and that’s with over 10 years of experience practicing dermatology. Given that even she gets overwhelmed, she appreciates how hard it can be for those of you without a scientific background to make sense of all the information available, and choose products that are right for your skin…