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Understanding aging skins
Research now shows there are two types of aging:
1. Extrinsic (external) aging
2. Intrinsic (internal) aging
Extrinsic aging
Unrecognized by most, major contributing factor to extrinsic aging is due to sun exposure. Other causes includes:
  • Photoaging from Sun
  • Repeated facial expressions
  • Gravity Pull on Skin
  • Sleeping postures
  • Smoking
  • Intrinsic aging
    Internal aging starts at around 20 yrs old, and includes:
  • Slowing of collagen production
  • Loss of skin elasticity
  • Slow shedding of dead skin
  • Reduced turnover of new cells
  • However, intrinsic aging is not apparent until after 30 yrs old, these include:
  • Fine Lines
  • Skin Dryness
  • Thin and transparent skin
  • Draping of skin
    (Due to prolonged gravity pull)
  • Loss of skin elasticity
    (Due to decreased collagen production)
  • Hollow cheeks and hollow eyes
    (tear trough) (Due to fat atrophy)
  • Inability to retain water
    (Due to decreased natural moisturizing factors production)
  • Fragile blood vessels that are easy to burst, leaving hemosiderin pigments on the skin
  • Onset of intrinsic aging is controlled genetically. Some people show signs and symptoms as early as 20s, while others start at 40s of age.
    extrinsic aging analysis
    1. Photoaging
    Imagine having your skin being burn on top of a fire for 5 seconds. This 5 seconds is equivalent to having your skin exposed to the sun on and off for about 40 years. Even a few minutes each day, damages can be accumulative.
    Harmful effects of Photoaging:
  • Freckles
  • Wrinkles
  • Age Spots
  • Loosening of skin
  • Actinic Keratosis
  • Uneven Skin Texture
  • Prone to Skin cancer
  • Actinic Keratosis
  • Prominent skin Veins
  • Roughened skin texture
  • Investigations has shown that Ultraviolet rays from the skin halt collagen production and cell regene-ration, leading to coarsening, loosening of skin and appearance of winkles. Those living in strong sunlight areas will have signs of photoaging as early as teenage. Some even begins to have Actinic Keratosis and skin cancer at an early age.

    Often photoaging symptoms can appear overnight as the damages starts to surface. But be assured that problems had been building up for many years under the epidermis. Those with whiter complexions or frequent sunlight exposures are particularly prone to photoaging.
    Degree of Photoaging is dependent on:
    Skin Color
    Skin Care Products Used
    Amount of Sun Exposure
    UV photography enable us to see the hidden damage done inside the skin. Many people are surprised to see the amount of damage evident under UV images.
    UV photography on skin
    2. Facial Expressions
    Repetitive facial expressions can cause wrinkles. Every time we utilize our facial muscles, creases are being created. Repeated usage, together with the loss of skin elasticity as we age, these temporary creases becomes permanent wrinkles.
    3.Gravity
    Gravity continuously exert a pulling effect everyday. As the skin loses its elastic, cheek skin, nose tip, ear lobes will all get pulled down.
    4.Sleep Lines
    We spend 1/3 of our lives in bed. Those who sleep on the side or prone is likely to have compression lines called sleep lines. Prone positions will create lines in the forehead, while sleeping sideways will create lines on the cheek and neck. Those used to sleeping supine will have no problem usually.
    5.Smoking
    Various chemicals within a cigarette can accelerate aging. On average it can accelerate aging by 10 yrs, causing skin coarsening, deepening of wrinkles, and yellow discoloration of skin. In one study it has been show these starts to occur at age 20 and is very prominent under the microscope. Smoking cessation can help reduce the damage, when even those who smoked for many years can enjoy some benefits.
    Signs of photoaging
    Early Photoaging Changes
    Photoaging has already begun if you experience:
    Middle/Advanced Photoaging Changes
    Photoaging is at a later stage if you have:
    • 1. Skin dryness
    • 2. Skin itchiness
    • 3. Uneven textures
    • 4. Skin thinning or thickening
    • 5. Difficult healing after damage
    • 1. Wrinkles
    • 2. Colored spots
    • 3. Telangiectasias
    • 4. Actinic keratosis
    • 5. Prominent Veins
    • 6. Cherry Angiomas
    • 7. Seborrhoeic Keratosis
    • 8. Senile or Actinic Purpura
    Prevent Photoaging
    There are 3 steps to combat photoaging:
  • Avoid strong sunlight
  • Employ effective sunscreens
  • Cosmetic medical rejuvenation modalities
  • Avoiding strong sunlight
    As sunlight is one of the main causes of skin aging, protection from ultraviolet rays are especially important:
  • Wear hats and long sleeves
  • Use an effective sunscreen daily
  • Use clothes with adequate coverage
  • Avoid going out from 10am to 4pm
  • Use an umbrella under strong sunlight
  • Prevent activities under strong sunlight such as watersports
  • Even in shady days, 80% of ultraviolet still arrives on earth. Thus sunscreens are just as important even if you can't see the sun.
  • Sunscreens and sun care products
    Sunscreen Products
    To prevent photoaging effectively, you need to look at the ingredient of a suncreen to see if they have these:
    Maryl
    Cinnamates
    Benzophenones (Oxybenzone)
    Avobenzone (PARSOL 1789)
    Zinc Oxide
    Titanium Dioxide
    Ingredients below has the best protective effect against UV-A
    Zinc Oxide
    Mexoryl
    Sunlight is composed with UV-A and UV-B
    SPF only denotes how well a product can stop UV-B. It does not mean a product can stop UV-A at all!
    Long Duration Sunscreens
    A normal suncreen only lasts for about 30 minutes to 1 hour under very strong sunlight before it is 'used up'. Thus there are long duration sunscreens available. These can last for greater than 4 hours under strong sunlight, and is waterproof.
    Sunscreen protection against UV-A
    To Prevent 'Milia' formation when using strong sunscreens
    Some people experience tiny acne like formations when using stickier sunscreens. To prevent this, one can use a newer generation fruit acids (PHA) under the suncreen. Not only can it prevent milia formation, it has strong moisturizing and wrinkle prevention properties. However one should test patch on the skin to look for any sensitivity first.
    Zinc Oxide Sunscreens
    Those with Zinc Oxide are usually more expensive
    Concentration of Zinc Oxide can range from 1% to 12%
    The higher the concentration, the greater the protective effect but is more sticky
    Correct way to use sunscreen:
    Start applying 20 minutes before sun exposure.
    Use a $5 hkd size of volume (most people use inadequate volume. Note do not miss ears, nose, hands and feet. Lips could be covered with an above SPF 15 lip balm)
    Reapply after 1 hour in strong sunlight, or after water activities, or profuse sweating
    A normal suncreen only lasts for about 30 minutes to 1 hour under very strong sunlight before it is 'used up'. Thus there are long duration sunscreens available. These can last for greater than 4 hours under strong sunlight, and is waterproof.
    It is our recommendation to use a suncreen at least SPF 30, with Zinc oxide >5% or has Mexoryl.
    Antioxidant Skin Care Products
    This is essential to combat photoaging.Antioxidants can undergo photoreaction in place of the skin, thus preventing any UV damage. The prototype of antioxidants are Vitamin C and E. On application for greater than 3 days, your skin will start to saturate with the compound. These have on average another 40% sunlight protection apart from using sunscreens.
    There are many forms of Vitamin C, such as L-ascorbic acid, or Magnesium Ascorbate. They have differences in terms of better absorption or stability in storage. But at the end of the day, the importance is its daily use in whatever form. Because antioxidants reacts to light, they must be stored in opaque plastic or tea colored glass bottles.
    Antioxidant skin care products
    cosmetic medical rejuvenation modalities
    Anti-aging treatment
    With the advance in medicine, we now have ways to reverse aging skin. Non-traumatize treatments have few side effects and minimal downtime, and are suitable for the busy cosmopolitan community.
    Treatment Includes
    Intense Pulsed Lights
    Radiofrequency Treatment
    Laser Skin Rejuvenation
    Acid Peels
    Diamond Dermabrasion
    Fillers
    Botox muscle relaxants
    Newer modalities of treatment come out everyday. With the confusing choices of treatments, over the counter products and commercials, it is best to obtain professional advise in terms of skin analysis, discuss on expectations and to suggest a proper course of skin care management.
    Laser/Lights Therapy
    These include intense pulsed lights, lasers and laser facials such as spectra peels. They are effective in removing freckles, colored spots, pore size reduction, removing small skin veins as well as skin rejuvenation. They can be combined with other treatments such as Botox or diamond dermabrasion for best effect.
    Radiofrequency Treatment
    This is an effective but non-surgical way to tighten and rejuvenate the skin, thus better than a conventional face lift. It can reduce wrinkles and cheek jowls without any downtime.
    Fillers
    Hyaluronic acid fillers can help remove scarring, as well as nose shaping and removal of nasolabial folds.
    Acid Peels
    Fruit acid peels can improve skin tone, remove acnes and help with scarring. Because it works be stimulating new growth, it can smooth out the skin and reduce wrinkles.
    Botox Injection
    Botox is a muscle relaxant, thus the underlying muscles can no longer form wrinkles on the skin. Starting injection at a young age can prevent any deep wrinkle formation.
    Diamond Dermabrasion
    It is one of the permanent way to remove skin scarring.
    There are different ways to delay skin againg process