Do We Have To Get (Look) Older?

olderrrrThe process of getting older or aging is complex.  Aging results in:

  • A steady decline of most of the body’s functions
  • Inefficiencies in the way the body handles stress
  • Many stresses on the body from which we easily recovered as a youth taking longer and/or leaving their mark as we grow older.

While many cultures see these changes in their older members as signs of wisdom, most members of western societies, especially Americans, refuse to accept the signs of aging, especially on their skin.

The skin is seen by most as a reflection of one’s age, health, and beauty.  Because of this fact, more and more people are seeking solutions to skin issues to help them maintain a youthful appearance, and to correct previously-acquired skin damage.

There are two major mechanisms of skin aging:

  • Intrinsic aging, or chronological, aging, which is the type of aging that happens naturally.
  • Extrinsic aging, which is caused by outside or environmental factors.

naturevsnurture2So intrinsic aging would be the nature side of aging, whereas extrinsic aging is definitely more nurture.  For the purposes of this article, I will be primarily discussing and educating you on intrinsic aging, and will leave the external factors to another time in the near future.

To some extent, intrinsic aging is a natural process that is somewhat predetermined genetically.  Men were always told over the years that if you wanted to know what your girlfriend or wife would look like in 20 years, look at her mother.

As we age, our skin does appear thinner and drier.  This happens because collagen, which is a major component of the underlying support of the skin, degenerates over time.

Fibroblasts, which are the cells that produce collagen, are less common as we grow older.  The fibroblasts that remain also tend to be less efficient, meaning that they produce less collagen and not of the same quality as in younger days.  Since the foundation and support of the skin is lacking, laxity of the skin develops, resulting in wrinkles.

collagenAnother factor of aging is increases in reactive oxygen species, which are basically imbalanced and charged molecules that damage other molecules within the body.  These species, when combined with reduced anti-oxidant activity within the body as we grow older, cause damage to existing and newly-made collagen.

Studies have found many anti-oxidants to be helpful in prevention of skin aging, including vitamins C, E and B3 as well as carotenoids and Coenzyme Q10.  I will discuss in another future newsletter more specifics about vitamins and other natural treatments for aging skin.

aging-skin11Unfortunately, somewhat inevitable changes in hormone levels also play a significant role in skin aging. While decreases in hormones affect both genders as we age, women are definitely and more severely affected.

For example, after women undergo menopause, the decreases in estrogen associated with menopause results in thinner skin with decreased tone and elasticity.  Studies shows that women can lose as much as 20% of their collagen in the first 15 years after menopause.

Another factor as we age is the accumulation of what are called advanced glycation endproducts (or AGEs, with the acronym being an unintentional, not to mention surprising, coincidence).  Very basically, what happens is that normal chemicals formed within the body, such as collagen, end up with a sugar molecule attached to them.

When this phenomenon happens, the original chemical changes in terms of its ability to function.  In the case of collagen, it becomes less flexible and less able to resist breakdown metabolically or as a result of outside forces.

The effect of AGEs has been studied mostly in diabetics in whom it happens to its greatest extent.  However, it also happens in non-diabetics, especially those who have high carb diet or are overweight.

produceBecause of AGEs, many of the dietary recommendations related to preventing skin aging frequently include reduction of carbohydrate intake and general weight loss.  Both of these factors will improve the body’s ability to handle sugar.

This has been a summary of some of the factors affecting skin aging from the intrinsic or internal point of view.  Hopefully, I did not overwhelm you with too much biochemistry (This was one of my favorite subjects in school but when I shared that with my sons, I was told that I was “such a nerd”.).

In the very near future, I will discuss extrinsic factors affecting skin aging.  I will also write another separate article about treatments and interventions to prevent and treat this process.

About Dr. John Burke

John Burke M.D. has practiced medicine for over 25 years, and is the founding partner of MidMaine Internal Medicine. He established Maine Laser Skin Care in 2004 after devoting years to learning the latest in laser and dermatologic technology. Dr. Burke has treated patients from all over the United States. He is one of Maine's busiest practitioners in laser treatments, and in the use of Botox for upper facial lines and excessive sweating.
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