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Wednesday, 02 January 2019 08:20

Looking Your Age? Featured

For most of us the earliest and obvious sign of getting old appears when we look in the mirror. Our skin is the first to give the game away. The lines about our eyes, the brown spots that weren’t always there and the uncalled for sagging beneath our chin betray the pitiless hand of Father Time.

How did we get here?

 To quote Leon Trotsky:  “Old age is the most unexpected of all things that happen to a man.”

Where our skin is concerned there are two aging processes to blame: extrinsic and intrinsic.

Intrinsic aging is unavoidable and is determined predominantly by things beyond our control such as our genetics. The skin will appear dry, smooth, thin, transparent and unblemished. There will be some skin laxity with fine wrinkles caused by gravity and movement. The best guide to your intrinsically aged skin is to look at the inner surface of your upper arm, which has been exposed to little sun. People who live healthy lives in cold climates with only weak sun exposure will tend to only show this form of skin aging.

Most of what we regard as aging skin in Australia is extrinsic and caused by environmental factors interacting with our underlying skin type. Chief culprit is our heavy exposure to ultraviolet light. What we see and experience is mostly photo ageing (sun damage).

Ultraviolet light can damage the DNA of skin cells causing aberrant growths including skin cancers. It also impairs the immune function of the skin, which is important to maintain its integrity and prevent cancers. The UV radiation also interacts with proteins in the skin causing the deposition of disorganised elastic fibres. This process, called solar elastosis, causes the skin to appear yellow, thick with wrinkles, bumps and deep furrows.

The other external factor that prematurely ages our skin is cigarette smoking. Nicotine reduces blood flow to the skin, reducing the oxygen and nutritional supply. Other chemicals in the smoke degrade skin proteins like collagen and elastin, which gives the most visible signs of aging. The heat from the cigarette and the facial movement of sucking on it cause wrinkles about the mouth.

Nutrition can affect extrinsic ageing with a high intake of vegetables, olive oil, fish and legumes being somewhat protective. High fat and high carbohydrate intakes are associated with more aging changes in the skin.

Extrinsic aging affects on our skin are very common and very familiar. They tend to occur on sun-exposed areas of the body. The skin appears rough with ever deepening wrinkles as we get older. Other parts of the skin may appear smooth, thin and shiny.

The skin becomes increasingly fragile, prone to bruising and will show many small blood vessel overgrowths or “capillaries”. Pigmented brown spots such as freckles and lentigos will appear and for some people raised benign growths called seborrheic keratosis (senile warts) will become common. Unfortunately skin cancers such as basal cell and squamous cell carcinomas (BCC and SCC) are all too familiar to aging Australians.

Although there are some therapies that may in a limited and temporary way improve our photo-aged skin, the best course of action is prevention and to limit further damage. Excellent sun protection is necessary for all starting at the earliest age and continuing through life. Avoiding cigarette smoking is another essential measure. Finally a health lifestyle with plenty of exercise and a diet high in fruit and vegetables is also helpful.

The application of a simple moisturiser can be of some benefit for skin symptoms such as dryness or itch. Some retinoid creams (Vitamin A) can be of some use but there is insufficient evidence to advocate for many of the other creams that make claims to help aging.  At this stage there is also not enough evidence to recommend any particular oral supplement to turn back the effects of solar aging.

So look after your skin but accept your fate as the price of living for in the words of another great 20th Century intellectual:

“Wrinkles will only go where the smiles have been.”

                                                Jimmy Buffet