Youthful skin forever? A Dermatologist’s Guide to Anti-aging Treatments
Why does our skin age?
Aging is a complex process that is mediated by many factors. From what we, scientists, understand, the body and its many cells accumulate “wear and tear” damage over time. In the skin, this damage is caused largely by exposure to ultraviolet radiation from the sun, which results in oxidative stress (creation of highly active oxygenated molecules called free radicals that attach to DNA and proteins) in skin cells, ultimately causing damage to the cells. It is important to note that other environment toxins, such as tobacco, also cause similar damage in skin cells.
Under normal circumstances, our bodies are able to mitigate much of this damage by neutralizing these harmful free radicals from the production of antioxidants, and allowing the cells to regenerate or renew themselves. This ability of cell regeneration and repair however, diminishes over time as we advance in chronologic age, such that eventually, we are just left with “wear, tear, and diminished repair”. This state of decreased cell regenerative ability and repair is called cell senescence. Senescence is governed by a myriad of factors, mainly, one’s genetics. In the absence of cell regeneration and repair, accumulated wear and tear damage to skin cells result in visible changes in the skin, that we recognize as signs of aging. We call this photoaging, meaning, aging caused by a lifetime of sun exposure.
What are signs of skin aging?
Some common signs of skin aging include wrinkles and fine lines that remain when our faces are at rest, skin discoloration (brown spots, also known as “age spots”), dry skin, widened blood vessels in the skin (colloquially called “broken” blood vessels), skin that bruises easily, sagging skin due to loss of collagen, rough scaly spots on the skin known as actinic keratoses, and skin cancer.
How can I prevent or delay signs of aging?
There are several ways to prevent skin aging, including:
1. Sun protection: the biggest contributor to skin aging is the sun, so it's important to protect your skin from the sun's harmful UV rays daily. Wear sunscreen as part of your routine skin care daily, with at least SPF 30, and broad spectrum coverage (which means protection from both UVA and UVB). When spending extended time outdoors, wear protective clothing, such as long-sleeved shirts and wide-brimmed hats , and be sure to reapply sunscreen after 90 minutes.
2. Healthy diet: Eating a diet rich in antioxidants can help protect your skin from damage caused by free radicals. Include plenty of fruits, vegetables, and whole grains in your diet, and be sure to remain hydrated by drinking plenty of water daily.
3. Skincare: a good skincare routine will help keep your skin healthy and youthful. Dermatologists are the best skilled doctors to provide you with a skincare regimen, with the goal of keeping your skin healthy, preventing or delaying signs of aging, and treating visible signs of aging.
What treatments are available for visible signs of aging?
There are several anti-aging treatments available, including:
Topical treatments: These include creams, serums, and lotions that contain ingredients such as retinoids, antioxidants, and growth factors, which are chemicals that have been demonstrated in scientific studies to improve texture, tone, and elasticity in the skin, thus improving signs of aging.
Injectables: These include neurotoxins such as Botox, dermal fillers, and biomodulators such as Sculptra. Neurotoxin injection is a safe treatment, used to smooth out wrinkles and fine lines caused by muscle contractions, while dermal fillers are hyaluronic acid products used to plump up the skin and add lost volume. Sculptra is an injectable polymer of lactic acid, that when injected, enables your own skin to increase collagen production, thus helping to improve skin elasticity and reduce wrinkles without the use of hyaluronic acid fillers.
Chemical peels: These involve applying a chemical solution to the skin, which causes the top layer of skin to peel off. This can help to reduce the appearance of fine lines and wrinkles, age spots, as well as improve the overall tone and texture of the skin.
Non-ablative laser treatments: these involve use of a laser to treat multiple targets in the skin, including damaged collagen, broken blood vessels, age spots and other types of skin discoloration
Ablative laser resurfacing: This procedure uses a laser to remove the outer layers of damaged skin, revealing the smoother, more youthful skin underneath. Other than a facelift, this treatment usually provides the most drastic improvement in signs of skin aging.
Platelet-rich plasma therapy (PRP): Also known as the "vampire facial", this procedure involves using the patient's own blood plasma, which is rich in growth factors, to stimulate collagen production and rejuvenate the skin. This procedure is usually done in combination with an ablative laser treatment.
These treatments are best done by your local broad-certified dermatologist or plastic surgeon physician, who will examine your skin and recommend the treatments best for your skin. If in the San Francisco area, visit us at the California Center for Dermatologic Surgery for all your anti-aging concerns. Dr. Carlson consults with patients routinely for anti-aging education and treatment, and will help curate a treatment plan for your specific skin aging concerns.