Healthy ageing - the skin

Many people would like their skin to look as young as possible. Healthy lifestyle choices and good skin care can help you minimise the signs of both healthy and unhealthy ageing.

A range of medical and surgical anti-ageing treatments is available, but none is without risk. Make sure you have realistic expectations of the potential benefits and that you understand all the possible risks, complications and side effects of any treatment. Before having any surgical procedure, consult an experienced dermatologist or plastic surgeon.

Skin layers explained#

The uppermost layer of the skin is called the epidermis. This layer contains pigment-producing cells (melanocytes) that give skin its colour. The epidermis renews itself constantly, with new cells arising from its lower layer. As these cells mature, they gradually rise to the surface, where they eventually die and are shed.

Beneath the epidermis is the dermis, which contains blood and lymph vessels, nerves, sweat glands and hair follicles. The dermis is made up of networks of elastic fibres (elastin) for suppleness and dense fibres (collagen) for strength. A layer of fatty tissue lies below the dermis and gives the skin its structure.

Signs of ageing skin#

Some of the signs of healthy ageing skin include:

• Thinning – the basal cell layer of the epidermis slows its rate of cell production, so the epidermis thins. The dermis may also become thinner. Together, these changes make skin more likely to crepe and wrinkle.
• Sagging – older skin produces less elastin and collagen, so it is more likely to sag and droop, and is especially vulnerable to the effects of gravity. Jowls along the jaw and bags under the eyes are simply skin that has yielded to gravity.
• Wrinkles – reduced elastin and collagen, along with thinning of the skin, mean that ‘high traffic’ areas of the face such as around the eyes and mouth are especially prone to lines and wrinkles.
• Age spots – the remaining pigment cells tend to increase in number and cluster in certain areas, forming what are known as age or liver spots. Areas exposed to the sun, such as the backs of the hands, are particularly prone to them.
• Dryness – older skin has fewer sweat glands and oil glands, which can make it more prone to roughness and itching.
• Broken blood vessels – small vessels near the surface may become permanently widened, commonly known as broken vessels.

Age-related skin conditions#

In addition to the inevitable signs of ageing, some skin conditions are more likely to develop as we get older. These include:

• Seborrhoeic keratosis – a benign skin growth that looks like a brown wart.
• Solar keratoses – inflamed, scaly, dry spots of skin thought to be caused by the sun. Common sites include the bridge of the nose, cheeks, upper lip and backs of the hands. They may be a pre-cancerous change, and skin cancer (squamous cell) can develop in these areas, so examination by a doctor is recommended.
• Bowen’s disease – a slow-growing, scaly skin patch thought to be caused by the sun, which may be a pre-cancerous change.
• Skin cancer – including basal cell carcinoma, squamous cell carcinoma and melanoma.

Reducing the signs of ageing skin#

Ways to reduce the signs of ageing include:

• Limit sun exposure and use sunscreen. Sun exposure accelerates ageing of the skin – if you want proof, compare the skin on your hands with that on your buttocks. Avoid sunbathing and wear a hat, loose-fitting clothes, sunglasses and SPF30+ broad-spectrum sunscreen when outdoors.
• Don’t smoke. Cigarette smoking promotes skin wrinkling and is thought to accelerate the damage caused by sun exposure. Repeatedly puckering up to draw on a cigarette also increases the likelihood of wrinkles around the mouth.
• Care for skin gently. Age-related dryness is made worse by skin irritants such as perfumed soaps, heavily chlorinated swimming pools and long hot showers. Use soaps, body washes or shampoos that are ’neutral’ and pH-balanced.
• Moisturise regularly if you have dry skin, to keep the skin moist and reduce the appearance of fine lines.

Anti-ageing treatments#

Make sure you understand the risks as well as the potential benefits of any anti-ageing treatment, including:

• Topical lotions – prescription creams (such as tretinoin) have been shown to visibly reduce fine lines and uneven skin colour when used regularly. Niacinamide, found in a number of cosmetic creams, can reduce uneven skin pigmentation.
• Injections – body fat taken from another area, or synthetic collagen, can be ‘piped’ along wrinkles through a fine needle.
• Facial peels – chemicals are applied to the face to remove the top layer of skin, reducing wrinkles and age spots and encouraging faster regrowth of newer-looking skin.
• Botox – wrinkle-prone areas, such as around the eyes and between the eyebrows, are injected with botulinum toxin, which relaxes the muscles so they no longer wrinkle the skin.
• Vascular laser – used to remove broken blood vessels from the face or other areas of skin.
• Laser resurfacing – used to treat wrinkles, age spots, scars and skin growths.
• Cosmetic surgery – procedures designed to reduce the signs of ageing include the eye lift (blepharoplasty) and the face lift (meloplasty).

Consult an experienced plastic surgeon and make sure you understand all the potential risks, complications and side effects of surgery.

Facts about moisturisers#

Moisturiser can keep the skin moist and reduce the appearance of fine lines. Many now contain sunscreen, and some also contain agents that lighten the colour of the skin. Keep in mind that no product has so far been shown to ’turn back the clock’. Consult your doctor before buying an expensive moisturiser – you may be advised not to waste your money.

Key points#

• Skin is the first body part to show the signs of age.
• Healthy age-related changes include thinning, sagging, wrinkles, age spots, broken blood vessels and dryness.
• Some unhealthy changes, such as skin cancer, are more likely with age, so have suspicious spots checked by a doctor.
• Limit sun exposure, don’t smoke, care for skin gently and moisturise regularly.
• Anti-ageing and cosmetic treatments carry risks, so understand them fully before going ahead.

Where to get help#