The idea of the fountain of youth has captivated humanity since time immemorial--and though we have long given up on finding this fabled font, the search for a cure to aging continues. Every year, there are millions of dollars poured into research and product development to find the Next Big Thing that will make us feel, move, and look younger.
In no industry is this more apparent than the beauty industry. From face creams to hand lotion, cosmetics to makeup techniques, from laser therapy to face massage--the sheer number of products and services marketed with an “anti-aging” spin belies an intense desire to have supple, wrinkle-free, healthy skin.
As much as we want to believe these products when they promise us the retention of our youthful skin, we must take these claims with a grain of salt. Skin aging is a complicated process, but basic knowledge of how it works can help you decide your approach to combat it.
What is aging
The World Health Organization defines aging as follows: At the biological level, aging results from the impact of the accumulation of a wide variety of molecular and cellular damage over time.
With this definition, we cannot escape the process of aging because it’s dependent on time. Each and every moment, our bodies experience wear and tear associated with carrying out its function and being exposed to stressors--and the skin, being our largest organ and the one that is in direct contact with the environment, is by no means exempt from the process.
Intrinsic and extrinsic factors
Skin aging is affected by two types of factors. Intrinsic factors are determined at birth by genetics, and by the wear-and-tear that normally comes with age, while extrinsic factors are determined by our exposure to the environment. Intrinsic aging is inevitable, while extrinsic aging can be mitigated with long-term lifestyle changes.
Intrinsic aging is best represented by the aging of skin in areas where the sun does not reach, while extrinsic aging is manifested in sun-exposed skin. The former will appear as dry, pale to almost transparent, even-toned, smooth, and papery thin, whereas the latter will appear as dry, with an uneven skin tone that may show depigmented areas, hyperpigmented areas, mottling, spider veins, wrinkles, and skin lesions that may be benign or malignant (Ayer, 2018).
Intrinsic factors
According to a study by Wong and Chew (2021), the intrinsic factors that have the most effect on the skin’s appearance include age, gender, and ethnicity.
Age, of course, needs no introduction--the number of years we’ve been on earth determines the number of years our skin has been working, and it’s bound to wear out. Older people’s skin is thinner because the skin cells capacity to multiply and regenerate slows down (Kohl et al., 2011; Chaudhary et al., 2020). These cells are responsible for producing collagen and providing nutrition to the surface layers of the skin. This manifests as skin that is less elastic and no longer supple.
Gender plays an important role in determining the outward appearance of an individual as they grow older, primarily as a consequence of hormones. As we age, our sex hormone levels fall, but what hormone falls to what level differs with gender. A study by Farage et al. (2012) found that post-menopausal women experience a drop in estrogen production, leading to decrease skin thickness, hydration, elasticity, and collagen content. On the other hand, men are more likely to experience baldness as an effect of an x-linked deficiency in an enzyme required for dihydrotestosterone production. Supplementation of both genders with the precursor of the sex hormones was found to improve the thickness, hydration, and oil production of the skin.
Ethnicity also affects skin aging, but how much of an influence it has is difficult to ascertain because this variable is hard to isolate from the effects of other skin aging factors. In large part, differences in skin aging based on ethnicity revolves around the skin’s melanin content and how it reacts to the sun. The latter is categorized as Fitzpatrick skin type, where the scale ranges from type I, fair skin that burns and never tans, to type VI, dark skin that tans easily and never burns. These two factors are inextricably tied in with the most important extrinsic skin aging factor, the sun (more on that later).
Vashi et al. (2016) did a literature review on the aging of colored skin and found that races with a higher melanin content experience the hallmarks of facial aging a decade after their lighter-skinned counterparts do due to a thick dermis, more photoprotective melanin content, and greater size and number of collagen-producing cells. However, aged colored skin is more likely to show uneven skin tone due to dark spots--again, related to the melanin content.
Extrinsic factors
Extrinsic factors are the ones that we are exposed to as we grow older. By far, the most crucial one is sun exposure--so much so that scientists have coined a separate term for sun-induced aging: photoaging.
The ultraviolet rays of the sun damage the very DNA of our cells, accounting for as much as 80% of visible aging on the face (Flament et al., 2013). UV radiation breaks down the proteins that give our skin structure and firmness by not only slowing down their production, but also stimulating enzymes that destroy them (Reiche and Sebaratnam, 2020). The end result is the gradual deepening of wrinkles.
In an attempt to protect the skin from sun damage, more melanin is produced and the inflammatory process is triggered (Poon et al., 2014). This leads to an uneven skin tone that may be red and painful, or spotted with dyspigmentation.
But the scariest aspect of photoaging is the increased propensity for skin growths. When the skin is chronically exposed to UV rays and the compensatory effects are no longer as efficient, the DNA damage compounds (Rastogi et al., 2010). A complex and long-drawn out process that affects cell signaling may result in the skin tumor growth. At best, the lesions are benign and affect only the appearance. But the risk for malignant growths, particularly those involving the squamous cells at the skin surface, the basal cells right underneath, and the melanin-producing cells (Armstrong and Kricker, 2001).
Because extrinsic aging is based on exposure to elements rather than time, people who do not protect or avoid these factors tend to look older than their years.
Smokers should also beware about the effects of the habit on their skin. Nicotine and its derivatives contain carcinogenic and mutagenic substances, and promote oxidative damage to our cells. The “smoker’s face” appearance is directly related to the number of packs used daily and how many years spent smoking (Ortiz and Grando, 2012). There is a gaunt appearance, a dull, grayish complexion, and a high degree of wrinkling, especially around the cheeks and mouth where the muscles to hold the cigarette are activated. Note that even exposure to cigarette smoke can irritate and dehydrate the skin--what more for those who actually smoke.
Knowing the difference between intrinsic and extrinsic aging factors helps you set realistic goals for yourself as you embark on your own personal journey for the fountain of youth. We must accept that our body and skin wears as we grow older, and take pride in what it helped us get through. On the other hand, we must remember to take care of our skin in an effort to preserve as much of its appearance and function for as long as possible. With lifestyle changes that include photoprotective measures, avoiding smoking, and observing proper nutrition, this is possible.
This content is for general information only and is not a substitute for medical advice.
References:
https://www.who.int/news-room/fact-sheets/detail/ageing-and-health
Armstrong, B. K., & Kricker, A. (2001). The epidemiology of UV induced skin cancer. Journal of photochemistry and photobiology. B, Biology, 63(1-3), 8–18. https://doi.org/10.1016/s1011-1344(01)00198-1
Ayer, J. 2018. Skin ageing. Accessed 10 November 2022. https://dermnetnz.org/topics/ageing-skin
Chaudhary, M., Khan, A., & Gupta, M. (2020). Skin Ageing: Pathophysiology and Current Market Treatment Approaches. Current aging science, 13(1), 22–30. https://doi.org/10.2174/1567205016666190809161115
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Reiche L., Sebaratnam, D. (2020). Photoaging and Sunscreen. Accessed 11 November 2022. https://www.researchreview.co.nz/getmedia/f7fda103-b7fd-441c-8146-61b58331b768/NZ-ES-Sunscreen-and-photoaging.pdf.aspx?ext=.pdf
Wong, Q.Y.A., Chew, F.T. Defining skin aging and its risk factors: a systematic review and meta-analysis. Sci Rep 11, 22075 (2021). https://doi.org/10.1038/s41598-021-01573-z
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