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Ageing Gracefully

We’re never ready for it but ageing is inevitable.
We’re ageing both inside and outside but the skin, which is the largest organ in the human body, suffers from the added onslaught of environmental factors more than any of our internal organs.

Certainly, we all care more about what is visible than what is not seen. As a result, ageing of the face, neck and chest area is considerably more bothersome to most even if we may suffer from a myriad of other systemic diseases. The truth is that a healthy and beautiful exterior appearance
represents overall well-being, and looking good makes people feel better psychologically and emotionally.

An even more interesting observation is that most patients want to look ‘better’ for their age and not necessarily ‘younger’.

So yes, we’re going to age, and yes how quickly we age is largely determined by our genetic make-up, but is it worth trying slow down the inevitable?

No matter how old you are there is always something that can make a difference if you should want to do so.

Where do I start with anti-ageing?

Let’s start with Skincare
Our skin changes as we age and while most of us did very little in our youth, we will need to do more to maintain a healthy skin as we grow older. Remember that most of your efforts with anti-ageing skincare also help to protect the skin from skin cancer.

As we age our skin is more susceptible to drying and easily becomes irritated and sensitive. A dry, dehydrated skin has a more wrinkled, dull appearance.

Maintenance of the skin barrier with a suitable moisturiser prevents dehydration and penetration of organisms, allergens and irritants that can cause inflammation of the skin.

Antioxidants and calming botanicals reduce inflammation which also prevent melanocyte stimulation and resultant hyperpigmentation.

The epidermal turnover rate decreases leaving dead surface skin cells and resultant poor texture and loss of skin radiance. Chemical exfoliation with glycolic acids helps to improve epidermal turnover. There is also resultant signalling to the dermis to improve collagen and elastin formation.

Advanced skincare formulations allow penetration of selective active ingredients into the dermis where we need them to work to prevent breakdown of collagen and elastin as well as stimulate the formation of new collagen to ultimately decrease the appearance of wrinkles.

Antioxidants combined with sunscreens neutralise free radicals for optimum sun protection. There is much evidence to prove the benefits of topically applied antioxidants to reduce skin cancer risk and decrease the breakdown of collagen and elastin in the dermis by scavenging free radicals.

Vitamin C, B3 (niacinamide), and E are the best-known antioxidants with good penetration into the skin. Antioxidants have significantly greater antioxidant properties when combined than alone.

Niacinamide is a powerful anti-ageing ingredient that regulates cell metabolism and cell regeneration. It has also been shown to reduce redness, improve hyperpigmentation and skin elasticity.
The optimal concentration in skin care in 5%.

Green tea polyphenols and numerous other botanicals have varying antioxidant properties that have proven a useful benefit in anti-ageing skincare.

Retinols (Vitamin A) have often been described as the ‘gold standard’ for anti-ageing. They stimulate the formation of collagen and elastic fibres to reduce wrinkles and fine lines and improve skin elasticity as well as increase and regulate cell turnover to improve skin texture. Retinols have antioxidant effects, reduce the signs of UV induced sun damage, improve hyperpigmentation and uneven skin tone.

Retinols, peptides and growth factors have numerous benefits which include stimulating collagen production ultimately leading to a plumper dermis and a healthier younger looking skin.

Sun protection includes responsible sun behaviour and sunscreen of at least SPF30. The sun is responsible for photo-ageing which is an accelerated form of ageing visible on sun exposed areas of our skin. New sunscreens with DNA repair enzymes have been shown to reduce the number of
precancerous lesions with regular use.

Anti-ageing ingredients are often found in combination to assist with incorporating more that one ingredient in a skincare regimen.

Most dermatologists and skincare therapists make use of a skincare pyramid which can be seen as a stepwise method of introducing anti-ageing skincare, starting from the basics at the bottom of the pyramid, which include sunscreen, antioxidants and DNA repair enzymes, and gradually adding more active ingredients based on tolerance and response.
We are also guided by your individual goals as in ‘what you are looking to improve the most’.

Anti-ageing Procedures
Chemical peels may be superficial, which include alpha and beta hydroxyacid peels and 10-30% TCA (trichloroacetic acid) peels; medium depth peels like 30-50 %TCA; or deep peels which include >50% TCA and phenol peels.
Superficial chemical peels are suitable for most skin types and have minimal downtime. It is important to go to a reputable therapist as not all peels are suitable for all skin types.

Dermal needling or collagen induction therapy makes use of fine needles to penetrate the skin, to break down old collagen in the dermis and stimulate fibroblasts to produce new collagen. Active ingredients for anti-ageing may be applied to the skin and ‘needled in’ for optimal benefit.

IPL (Intense pulsed light), lasers and radio-frequency devices are aimed at targeting various skin structures like blood vessels, collagen and pigment to improve the appearance of ageing skin.

Hyaluronic acid fillers injected superficially into the dermis can activate and stimulate fibroblasts to produce new collagen and inhibit the enzymes that break down collagen. More robust hyaluronic acid fillers injected deep onto bone or into deficient fat pads in the face can have a significant lifting effect and improve volume loss, simulating a face lift. This is often referred to as a non-surgical face lift.

Platelet rich plasma (PRP) is derived from whole blood which is spun down in a centrifuge. The plasma contains growth factors which is injected into the skin to stimulate collagen synthesis.

Botulinum toxin is injected into muscles to stop contraction. In this way they prevent repetitive creasing of the skin which in time would lead to a permanent wrinkle or furrow. The best benefit for this treatment is seen on the frown lines, forehead lines and crow’s feet. Injections need to be repeated every 3- 4 months and in time there is significant improvement in skin wrinkling. The treatment does not work on static lines.

There are various options to include anti-ageing procedures in your skin treatment plan. Chemical peels and dermal needling are usually added as a course of treatments after preparing the skin with a homecare regimen. Filler treatments are carried out according to a pre-discussed plan.

Is anti-ageing all about products and procedures?
In general, a healthy lifestyle with responsible sun protection is important to slow skin ageing.

A well-balanced diet is a great source of nutrients and oral antioxidants which also benefit the skin.

A good exercise routine, alleviates stress which through various mechanisms not fully understood, worsen disease and make us age faster. Perhaps less stress and anxiety makes us frown less with resultant less wrinkles.

Smoking increases the breakdown of collagen and elastin in the dermis leading to a more wrinkled skin.

There is a growing body of evidence that all forms of atmospheric pollution is detrimental to the skin and body, causing premature ageing, skin cancers and hyperpigmentation.

Though this seems like an exhaustive list, it is by no means complete!
Consult with your dermatologist or skincare therapist and come up with a treatment plan that you are comfortable with.

What you are able to achieve also depends on how much time, effort and budget you are willing to invest.

Start early, start simple, start somewhere…