Healthy ageing - the skin

About healthy ageing - the skin

Skin is the first body part to show the signs of age. Healthy age-related skin changes are inevitable and include thinning, sagging, wrinkling and the appearance of age spots, broken blood vessels and areas of dryness. Unhealthy skin changes, such as skin cancer, are also more common as we age and are usually made worse by exposure to the sun.

Many people would like their skin to look as young as possible. Healthy lifestyle choices and good skin care can help you to minimise the signs of both healthy and unhealthy ageing.

There is a range of medical and surgical anti-ageing treatments available but these are not without risk. Make sure you have realistic expectations of the potential benefits and understand all the potential risks, complications and side effects of any treatment. Before having any surgical treatment, you should consult with a dermatologist or plastic surgeon.

Skin layers explained

The uppermost layer of the skin is called the epidermis. This layer contains pigment-producing cells (melanocytes) that give skin its colour. The epidermis renews itself constantly, with new epidermal cells arising from the lower cell layer of the epidermis. As the epidermal cells mature, they gradually rise to the surface of the skin where they ultimately die and are shed.

Beneath the epidermis is the dermis, which contains blood and lymph vessels, nerves, sweat glands and oil glands. Hair follicles are extensions of the epidermis that reach into the dermis. The dermis is made up of networks of elastic fibres (elastin) for suppleness and dense fibres (collagen) for strength. Finally, a layer of fatty tissue lies below the dermis to gives the skin its structure.

Signs of ageing skin

Some of the signs of healthy ageing skin include:

• Thinning – the basal cell layer of the epidermis slows its rate of cell production and thins the epidermis. The dermis may become thinner. Together, these changes mean skin is more likely to crepe and wrinkle.
• Sagging – older skin produces less elastin and collagen, which means it is more likely to sag and droop. Older skin is particularly vulnerable to the effects of gravity. For example, jowls along the jaw and bags under the eyes are simply skin that has yielded to gravity.
• Wrinkles – reduced elastin and collagen and the thinning of skin, mean those ‘high traffic’ areas of the face (like the eyes and mouth) are especially prone to lines and wrinkles.
• Age spots – the remaining pigment cells (melanocytes) tend to increase in number and cluster in certain areas, forming what’s known as age or liver spots. Areas that have been exposed to the sun, such as the backs of the hands, are particularly prone to age spots.
• Dryness – older skin has fewer sweat glands and oil glands. This can make the skin more prone to conditions related to dryness, such as roughness and itching.
• Broken blood vessels – blood vessels in older, thinner skin are more likely to break and bruise. They may also become permanently widened. This is commonly known as broken vessels.

Age-related skin conditions

In addition to the inevitable signs of ageing skin, some skin conditions are also more likely to develop as we get older. These unhealthy signs of ageing include:

• Seborrhoeic keratosis – a type of benign skin tumour that looks like a brown wart.
• Solar keratoses – spots of skin that are inflamed, scaly and dry. Common sites include the bridge of the nose, cheeks, upper lip and backs of the hands. Skin cancer (squamous cell) can develop in these areas, so examination by a doctor is recommended.
• Bowen’s disease – a type of slow-growing and scaly skin patch thought to be caused by the sun. It may be a pre-cancerous change.
• Skin cancer – including basal cell carcinoma, squamous cell carcinoma and melanoma.

Reducing the signs of ageing skin

Ways to reduce the signs of ageing include:

• Limit sun exposure and use sunscreen – sun exposure accelerates ageing of the skin. If you want proof, compare the skin on your hands with that on your buttocks. Avoid sunbathing and wear a hat, loose-fitting clothes, sunglasses and SPF30+ broad-spectrum sunscreen when outdoors.
• Don’t smoke – cigarette smoking promotes skin wrinkling and is thought to accelerate the damage caused by sun exposure. The action of puckering up for each drag on a cigarette increases the likelihood of wrinkles around the mouth.
• Moisturise regularly – dry skin is more likely to show fine lines and wrinkles. Moisturise regularly if you have dry skin.
• Care for skin gently – age-related dryness will be further exacerbated by skin irritants such as perfumed soaps, heavily chlorinated swimming pools and long hot showers. Use soaps, body washes or shampoos that are ‘neutral’ and pH-balanced (neither too acidic nor too alkaline).

Anti-ageing treatments

Make sure you understand the risks and the potential benefits of anti-ageing treatments including:

• Topical lotions – creams (such as tretinoin) are only available on prescription. These creams have been shown to visibly reduce fine lines and uneven skin colouration when used regularly. Niacinamide is available in a number of cosmetic creams and reduces uneven skin pigmentation.
• Injections – for example, body fat taken from other areas of the client’s body or synthetic collagen can be ‘piped’ along wrinkles via a small hypodermic needle.
• Facial peels – chemicals are applied to the face to ‘burn off’ the top layer of skin. This removes the wrinkles and age spots and encourages faster regrowth of newer, younger-looking skin.
• Botox – wrinkle-prone areas, such as around the eyes and between the eyebrows, are injected with the botulinum toxin. The resulting paralysis prevents the muscles from wrinkling the skin.
• Vascular laser – to remove broken blood vessels from the face or other areas of the skin.
• Laser resurfacing – used to treat wrinkles, age spots, scars and skin growths.

Cosmetic surgery

Some cosmetic surgeries that are designed to reduce the signs of ageing include the eye lift (blepharoplasty) and the face lift (meloplasty). Consult with an experienced plastic surgeon and make sure you understand all the potential risks, complications and side effects of surgery.

Facts about moisturisers

Moisturiser can keep the skin moist and reduce the appearance of fine lines. Many now contain sunscreen and some also contain agents that lighten the colour of the skin. Keep in mind that no product has so far been shown to ‘turn back the clock’. Consult with your doctor before buying an expensive moisturiser – you may be advised not to waste your money.

Where to get help

• Your GP (doctor)
• Dermatologist
• Plastic surgeon