Causes of
Aging Skin
Research shows that there are, in fact, two
distinct types of aging. Aging caused by the genes we inherit is called
intrinsic (internal) aging. The other type of aging is known as
extrinsic (external) aging and is caused by environmental
factors, such as exposure to the sun’s rays.
Intrinsic Aging
Intrinsic aging, also known as the natural aging process, is a continuous
process that normally begins in our mid-20s. Within the skin, collagen
production slows, and elastin, the substance that enables skin to snap back
into place, has a bit less spring. Dead skin cells do not shed as quickly
and turnover of new skin cells may decrease slightly. While these changes
usually begin in our 20s, the signs of intrinsic aging are typically not
visible for decades. The signs of intrinsic aging are:
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Fine wrinkles
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Thin and transparent skin
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Loss of underlying fat, leading to
hollowed cheeks and eye sockets as well as noticeable loss of firmness
on the hands and neck
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Bones shrink away from the skin
due to bone loss, which causes sagging skin
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Dry skin that may itch
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Inability to sweat sufficiently to
cool the skin
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Graying hair that eventually turns
white
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Hair loss
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Unwanted hair
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Nail plate thins, the half moons
disappear, and ridges develops
Genes control how quickly the normal aging
process unfolds. Some notice those first gray hairs in their 20s; others do
not see graying until their 40s. People with Werner’s syndrome, a rare
inherited condition that rapidly accelerates the normal aging process,
usually appear elderly in their 30s. Their hair can gray and thin
considerably in their teens. Cataracts may appear in their 20s. The average
life expectancy for people with Werner’s syndrome is 46 years of age.
Extrinsic Aging
A number of extrinsic, or external, factors often act together with the
normal aging process to prematurely age our skin. Most premature aging is
caused by sun exposure. Other external factors that prematurely age our skin
are repetitive facial expressions, gravity, sleeping positions, and smoking.
The Sun. Without protection from the sun’s rays, just a few minutes
of exposure each day over the years can cause noticeable changes to the
skin. Freckles, age spots, spider veins on the face, rough and leathery
skin, fine wrinkles that disappear when stretched, loose skin, a blotchy
complexion, actinic keratoses (thick wart-like, rough, reddish patches of
skin), and skin cancer can all be traced to sun exposure.
“Photoaging” is the term dermatologists use to describe this type of aging
caused by exposure to the sun’s rays. The amount of photoaging that develops
depends on: 1) a person’s skin color and 2) their history of long-term or
intense sun exposure. People with fair skin who have a history of sun
exposure develop more signs of photoaging than those with dark skin. In the
darkest skin, the signs of photoaging are usually limited to fine wrinkles
and a mottled complexion.
Photoaging occurs over a period of years. With repeated exposure to the sun,
the skin loses the ability to repair itself, and the damage accumulates.
Scientific studies have shown that repeated ultraviolet (UV) exposure breaks
down collagen and impairs the synthesis of new collagen. The sun also
attacks our elastin. Sun-weakened skin ceases to spring back much earlier
than skin protected from UV rays. Skin also becomes loose, wrinkled, and
leathery much earlier with unprotected exposure to sunlight.
Facial Expressions. If you perform
facial exercises to maintain a youthful-looking appearance, it is time to
stop. Repetitive facial movements actually lead to fine lines and wrinkles.
Each time we use a facial muscle, a groove forms beneath the surface of the
skin, which is why we see lines form with each facial expression. As skin
ages and loses its elasticity, the skin stops springing back to its
line-free state, and these grooves become permanently etched on the face as
fine lines and wrinkles.
Gravity. Gravity constantly pulls on our bodies. Changes related to
gravity become more pronounced as we age. In our 50s, when the skin’s
elasticity declines dramatically, the effects of gravity become evident.
Gravity causes the tip of the nose to droop, the ears to elongate, the
eyelids to fall, jowls to form, and the upper lip to disappear while the
lower lip becomes more pronounced.
Sleeping Positions. Resting your face on the pillow in the same way
every night for years on end also leads to wrinkles. Called sleep lines,
these wrinkles eventually become etched on the surface of the skin and no
longer disappear when the head is not resting on the pillow. Women, who tend
to sleep on their sides, are most likely to see these lines appear on their
chin and cheeks. Men tend to notice these lines on the forehead since they
usually sleep with the face pressed face down on the pillow. People who
sleep on their backs do not develop these wrinkles since their skin does not
lie crumpled against the pillow.
Smoking. Cigarette smoking causes biochemical changes in our bodies
that accelerate aging. Research shows that a person who smokes 10 or more
cigarettes a day for a minimum of 10 years is statistically more likely to
develop deeply wrinkled, leathery skin than a nonsmoker. It also has been
shown that people who smoke for a number of years tend to develop an
unhealthy yellowish hue to their complexion. Additionally, a study conducted
in 2002 showed that facial wrinkling, while not yet visible, can be seen
under a microscope in smokers as young as 20.
These signs can be greatly diminished, and in some cases avoided, by
stopping smoking. Even people who have smoked for many years, or smoked
heavily at a younger age, show less facial wrinkling and improved skin tone
when they quit smoking.
For Healthier, Younger-Looking Skin
Prevention. While you cannot stop or even slow down the intrinsic aging
process, you can prevent signs of premature aging by protecting your skin
from the sun, quitting smoking, and eliminating facial exercises.
Dermatologists recommend comprehensive sun protection to prevent premature
aging caused by the sun. Comprehensive sun protection includes:
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Avoiding deliberate tanning,
including use of indoor tanning devices.
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Staying out of the sun between
10:00 a.m. and 4:00 p.m., when the sun’s rays are the strongest.
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Wearing protective clothing, such
as a wide-brimmed hat and long sleeves, when outdoors during the day.
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Applying sunscreen year round.
Sunscreen should be broad spectrum (offers UVA and UVB protection) and
have a Sun Protection Factor (SPF) of 30 or higher. Sunscreen should be
applied 20 minutes before going outdoors to all skin that will be
exposed. It should be reapplied after sweating or being in water.
Treatment. If you are bothered by
visible signs of aging, a number of treatments are available. Injectable
fillers and botulinum toxin are suitable for people with busy lifestyles who
do not want the inconvenience of a long recovery. Radiofrequency is a
procedure that offers an alternative to the traditional facelift.
Dermabrasion, laser resurfacing, chemical peeling, microdermabrasion, and
some topical treatments can restore skin, giving it a smoother and refreshed
appearance.
Scientific research in the field of anti-aging continues to give rise to new
and promising treatment options. A dermatologist can help you sort through
the numerous options, including the myriad of over-the-counter products.
During a consultation, the dermatologist will examine your skin, discuss
your expectations, and recommend suitable treatment options. Next
Skin Cancer and Prevention
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References:
American Academy of Dermatology. “Turning Back the Hands of Time.” February
21, 2005.
Last accessed June 20, 2005.
Demierre MF et al. “Public knowledge, awareness, and perceptions of the
association between skin aging and smoking.” Journal of the American Academy
of Dermatology, 1999 Jul;41(1):27-30.
Fisher GJ. “The Pathophysiology of Photoaging of the Skin.” Cutis, 2005
Feb;75(2S):5-9.
Koh JS et al. “Cigarette smoking associated with premature facial wrinkling:
image analysis of facial skin replicas.” International Journal of
Dermatology, 2002 Jan;41(1)21-27.
Moschella S and Hurley H. (1992) “Aging and Its Effects on the Skin.”
Dermatology: Third Edition. Philadelphia: W.B. Saunders Company.
Oikarinen A. “Aging of the skin connective tissue: how to measure the
biochemical and mechanical properties of aging dermis.” Photodermatology,
Photoimmunology and Photomedicine, 1994 Apr;10(2):47-52.
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by the American Academy of Dermatology
