Skin Care
AGING SIGNS AND SOLUTIONS TO INTERVENE, PREVENT AND IMPROVE SKIN WITH SCIENCE STANDARDS
Aging is a natural human body process that occurs due to endogenous and exogenous causes affecting the structure and function of the organ systems. During recent years, scientists have proven that the skin is also a complete organ system [1]. The manifestations of the skin aging process can be clearly observed [2]. Each manifestation of aging should be understood correctly about the reasons and methods of preventing and intervening in the right time to achieve the best anti-aging effect.

A quick look at what causes of skin aging
As we have learned a lot through various sources, skin aging has 2 types: chronological aging and exogenous skin aging. Each type caused by different factors and so for the manifestations on the skin’s surface.
Awareness of the causes will help women understand where anti-aging really needs to start to be effective, what causes can be adjusted or interfered with. To be more specific,
- Factors influencing endogenous skin aging: genes (race, sex), endocrinology, and internal metabolism [3].
- Factors that affect exogenous skin aging: sun exposure, gravity, active habits, smoking [4]
Features and signs of each skin aging process
After understanding the causes, we will find out the signs and manifestations on the skin surface under a scientific perspective.
Signs of Endogenous Skin Aging [3]:
Firstly, it is the implicit changes in skin structure. The skin cycle is nearly doubled, at the outermost layer (epidermis) the number of old cells is increasing more and more compared to young skin cells so that the connections in the dermis (collagen, elastin) gradually lost and lower fat cavity is atrophied or distributed elsewhere.
Skin manifestations altered due to endogenous aging can be observed:
- Thin skin, fine lines
- Skin remains smooth but dry, enlarged pores
- Loose, sagging skin, losing elasticity
- The skin is susceptible to damage, infection, and irritation to external factors
- It takes about 50% longer time to heal than non-aging skin
- Pale skin
Signs of Exogenous Skin Aging [3]:
We all know the exogenous factors that affect the skin from the outside such as: sunlight, dust, dust, food, sleep, daily life … all directly affect our skin health, but we often have a subjective judgement and pay less attention to care and protect the skin from these harms.
Let’s review the adverse effects of exogenous factors and skin manifestations when regularly influenced by these agents for a long time with the aims to understand and be proactive in protecting skin health, preventing aging.
Adverse effect on the skin of sunlight and aging skin manifestations due to the effects of light
1. UVB rays:
Effect on DNA of keratinocytes in the basal layer, creating reactive oxygen and nitrogen (ROS, NOS) radicals, inflammation, and degrading collagen. Wrinkle formation, sunburn, darkening.
During regular and long-term exposure, UVB rays destroy DNA causing the irreversible mutagenic and initiate apoptosis. Then, there would be an excessive accumulation of dead cells on the skin’s surface which leads to manifest thick and dry skin.
2. UVA rays:
This leads to dark skin and skin formation and hyperpigmentation. In addition, UVA rays damage connective tissue, blood vessels and extracellular matrix (collagen, elastin), causing skin to lose elasticity and appear wrinkles.
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3. Visible lights:
As mentioned in some studies, visible light can affect the skin the same way UVA rays do [5] but this may require more research on this.
4. Infrared rays:
First, infrared rays increase the production of the collagen-destroying enzyme MMP-1, excessively degrading collagen, leading to a weakening of the extracellular network (ECM).
Consequently, the skin becomes thin and fine lines are created. In addition, infrared rays trigger the inflammatory process, over-dividing cells to accumulate many cells on the skin’s surface, leading to thick and rough skin. Even infrared rays also increase blood vessel proliferation, leading to prolonged red skin.
5. Cigarette smoke:
Tobacco smoke changes skin structure by reducing blood flow to the skin, activating the enzyme MMP-1 causes collagen breakdown, inhibiting the synthesis of collagen types I and III, and reducing the formation of elastin. Thereby causes collagen and elastin fiber counts to decrease.
The manifestations of aging skin caused by cigarette smoke:
- The skin is often vasodilated (male) and has a gray tint
- Rough skin, loss of elasticity
- The skin directly exposed to the smoke is usually dry, thin, easily irritated and tends to be loose and sagging.
5. Facial expressions:
The natural expression of the face over time causes dynamic wrinkles (appearing when moving):
- Static wrinkles (appearing even when not moving), sagging skin.
- Dynamic wrinkles: formed by movement of the facial muscles such as smiling.
Static creases: Can not be changed. Formed after the appearance of dynamic wrinkles.
Interventions for various aging causes
For each cause and external manifestation, dermatology has various solutions to intervent, prevent and achieve the highest efficiency.
For endogenous aging, the following interventions are available:
- Hormone replacement therapy
- Stem cell infusionInjecting nutrients with collagen nourishing and regenerating ingredients such as hyaluronic acid, DMAE,…. or platelet-rich plasma (PRP)
- Non-invasive laser capable of collagen proliferation (long pulse Nd Yag 1064)
- Invasive laser resurfacing (Fractional Co2, Fractional ErYag)
- Peel skin with chemicals suitable for collagen proliferation. Depending on the type of indication
RF (Thermage) technology to overcome wrinkles, loose skin - Mesobotox in skin areas with fine wrinkles, large pores – botox with small content
- Fat-soluble and RF injections in the fat were redistributed in the chin and jaw
- Filler in areas of lost fat cavity: depending on the situation
- Use a suitable lotion to restore the skin barrier, avoid irritated skin with ingredients such as hyaluronic acid, ceramide,….
For endogenous aging, the following interventions are available:
- Careful shielding in the sun: It’s best to wear dark clothing and thick fabric
- Apply an adequate amount of sunscreen with the right index 30 minutes before going out in the sun
- Wearing sunglasses on a wide version can protect the skin under the eyes and temples
- Use a sunscreen that contains Polypodium Leucotomies
- Stem cell infusion
- Injecting nutrients with collagen nourishing and regenerating ingredients such as hyaluronic acid, DMAE,…. or platelet-rich plasma (PRP)
- Non-invasive laser capable of collagen proliferation (long pulse Nd Yag 1064)
- Invasive laser resurfacing (Fractional Co2, Fractional ErYag)
- Peel skin with chemicals suitable for collagen proliferation
- Apply preparations with retinoids to resurface
- The laser is capable of destroying pigments like the QS NdYag1064 laser
- Apply preparations with substances capable of lightening the skin, treating pigmentation such as hydroquinone, vitamin C, …
- Laser is capable of treating blood vessel problems such as PDL 585nm, KTP 532nm, Diode 940nm, NdYag pulse length 1064nm
Interventions for smoking-induced skin aging
- Quit smoking
- Stem cell infusion
- Injecting nutrients with collagen nourishing and regenerating ingredients such as hyaluronic acid, DMAE,…. or platelet-rich plasma (PRP)
- Non-invasive laser capable of collagen proliferation (Nd Yag 1064 long pulse)
- Invasive laser resurfacing (Fractional Co2, Fractional ErYag)
- Peel skin with chemicals suitable for collagen proliferation
- RF (Thermage) technology to overcome wrinkles, loose skin
- Laser is capable of treating blood vessel problems such as PDL 585nm, KTP 532nm, Diode 940nm, NdYag pulse length 1064nm
Interventions for skin aging due to facial expression
- Injecting nutrients with collagen nourishing and regenerating ingredients such as hyaluronic acid, DMAE,…. or platelet-rich plasma (PRP)
- Non-invasive laser capable of collagen proliferation (Nd Yag 1064 long pulse)
- Invasive laser resurfacing (Fractional Co2, Fractional ErYag)
- Peel skin with chemicals suitable for collagen proliferation
- Botox in areas with dynamic wrinkles
- Filler ± botox in areas with static wrinkles
- RF (Thermage) technology to overcome sagging skin conditions
REFERENCES
1. Mukherjee S., Date A., Patravale V., et al. (2006), “Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety”, Clin Interv Aging, 1 (4), pp. 327-48.
2. Farage M. A., Miller K. W., Elsner P., et al. (2008), “Intrinsic and extrinsic factors in skin ageing: a review”, Int J Cosmet Sci, 30 (2), pp. 87-95.
3. Makrantonaki E., Zouboulis C. C. (2007), “William J. Cunliffe Scientific Awards. Characteristics and pathomechanisms of endogenously aged skin”, Dermatology, 214 (4), pp. 352-60.
4. Ahuja A., Singh N., Gupta P., et al. (2017), “Influence of Exogenous Factors on Skin Aging”, Textbook of Aging Skin, Miranda A. Farage, Kenneth W. Miller, Howard I. Maibach, Editors, Springer Berlin Heidelberg, Berlin, Heidelberg, pp. 563-577.
5. Chiarelli-Neto O., Ferreira A. S., Martins W. K., et al. (2014), “Melanin photosensitization and the effect of visible light on epithelial cells”, PloS one, 9 (11), pp. e113266-e113266.