What are the signs of skin ageing?
Skin ageing can affect many parts of the skin and cause a variety of cosmetic and medical problems. The signs depend on the site of damage:

• Epidermis (superficial skin)
  • Xerosis or dryness.
  • Atrophy or thinning of the skin.
  • Seborrhoeic keratoses or age warts.
  • Actinic keratoses (solar keratoses).
  • Basal cell and squamous cell cancer cancers.

   

• Melanocytes (pigment cells)
  • Ephelides or freckles.
  • Actinic lentigines (solar lentigines) or "age spots".
  • Malignant melanoma
  • Idiopathic guttate hypomelanosis.

   

• Connective tissue
  • Wrinkles and frown lines.
  • Sagging skin, jowls, eye bags.
  • Yellow appearance of the skin.
  • Solar elastosis.

   

• Sebaceous glands
  • Senile comedones

   

• Hair
  • Thinning of the scalp (see androgenetic alopecia)
  • Increased in facial hair (see hirsutism).
  • White hair (see canities).

   

• Blood vessels
  • Cherry angiomas.
  • Telangiectasias or broken capillaries.
  • Senile purpura (easy bruising).
  • Venous lakes.

   

• Subcutaneous fat
  • Fat atrophy leading to sunken cheeks, thinned skin.

When does skin ageing occur?
Significant signs of ageing appear in the 40s and may occur a decade earlier in smokers and people who are heavily exposed to the sun.

What causes skin ageing?
Ageing may be classified into chronological (biological) ageing and photoageing (sun-induced ageing). Doctors believe that photoageing causes 90% and chronological ageing 10% of the signs of ageing.

How can I prevent skin ageing?
You cannot entirely prevent ageing because you cannot delay chronological ageing and you cannot entirely eliminate photoageing because you cannot entirely avoid the sun. However, you can reduce photoageing which accounts for 90% of the signs of ageing by taking precautions against the sun. If you want evidence of the effects of sun-damage just compare the skin on the inside of the upper arm and the backs of your hand. See how much better the inside of the arm is and just imagine how the back of you hands could look if you had protected your skin against the sun. See the next section on photoprotection.

How can I reduce photoageing?
Photoageing accounts for 90% of the signs of ageing. Photoageing can be prevented by taking precautions against the sun and this is the best and cheapest anti-wrinkle treatment.

• Avoid exposure to sunlight especially between 11am to 3pm.
• Wear protective clothing (densely woven fabric is best) and broad-brimmed hats.
• Use umbrellas and try to stay in the shade.
• Remember that the sun can penetrate through water and wet white clothing and UV-A can pass through window glass.
• Apply sunscreens to all exposed parts at least 30 minutes before going out. Reapply every 2 hours and more frequently if you are swimming or sweating profusely.

When should I start protecting myself?
The signs of photoageing takes 10 - 20 years so you should start taking precautions before the signs appear. It is never too early to protect your skin against sun damage.

Is there treatment for skin ageing?
Yes, there is treatment ranging from creams to chemical peels, collagen injections, plastic surgery to lasers which can help reverse some of the signs of ageing. Treatment can turn the age clock a little but it cannot stop the clock from ticking.

Do any of the so-called anti-wrinkle creams work?
Wrinkles are due to collagen degeneration and only tretinoin (retinoic acid) has been proven to stimulate collagen synthesis. Other products such as alpha-hydroxy acids (AHAs), beta-hydroxy acids (BHAs) and vitamin C are claimed to help reverse fine wrinkles but not all doctors agree about this. B careful as many of the anti-wrinkle creams available on the market are simply very good moisturisers which hide the lines rather than stimulate collagen production. Don't forget that sunscreens are, in a sense, anti-wrinkle products because because they screen out the sun's ultraviolet rays.

Does smoking accelerate skin ageing?
Most definitely, yes! Nicotine reduces blood flow to the skin, depriving it of nutrients and oxygen. Cigarette smoke also causes carbon monoxide to increase in the blood. Smokers are also more likely to develop lines around the mouth because of the use of the perioral muscles to hold the cigarette and lines around the eyes as a result them scrunching their eyes to avoid the smoke. Generally, heavy smokers age 10 years earlier than their non-smoking counterparts.

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