They say, “Things get better with age.” Take for instance, wine. The more aged it is, the better. But can you say the same about your skin? Ever heard of skin getting better with age?
No! Because, it doesn’t.
You may wish for a fountain of youth to make all your age-related problems go away in a jiffy. But aging is here to stay. But that does not mean, your skin is forever at its mercy. You can control the effects that aging has on your skin. Let us understand the process, causes of skin aging and how we can delay it.

What is Skin Aging?
Skin Aging is a natural and on-going process. Various internal and external factors at work causes our skin to age. The factors contributing to aging are determined right from the cellular level to the environment level.

How to Identify Signs of Aging?
Have you ever caught yourself in the mirror wondering, “This is not how my skin was” Or do you find yourself consciously trying to keep your eyes visibly open while posing for a photograph? Has anybody ever told you why you always look angry, sad, tired or frowning, even when you are not? Chances are you have started to show the signs of aging. Skin aging becomes evident with the 3 most visible signs on your skin-: Wrinkles, Fine Lines and Pigmentation. Let us see how we can identify them on the skin.

  • Wrinkles: Wrinkles are depressions in the skin’s surface. These may be coarse or fine. Coarse wrinkles are often referred to as expression lines. They appear on the forehead, outer corners of the eyes (crow’s feet) and as vertical lines on either side of the mouth (laugh lines).
  • Fine Lines: Fine Lines are the earlier signs of aging. These are most visible especially in the most expressive areas of facial movement (eyes, mouth, upper lip, etc.). Fine lines lead to wrinkle formation.
  • Pigmentation: Pigmentation is the cause of skin discoloration; associated with aging. Issues include dark spots, uneven skin tone, extreme freckles and irregular
    pigmentation. One can notice these signs of aging from the age of as young as 25. Fine lines are the first to appear. Over time, the formation of wrinkles, loss of volume and elasticity become noticeable. These are associated with physiological changes such as bone loss and fat loss in the facial region.

The Downside of Dimples:
How we are allured by dimples! Be it on our favourite movie star or a sweetheart! We are fascinated by the endearing depressions around the cheeks that some people show. However, the adoration received in the present for the dimples can quickly turn tables when one ages.
With loss of volume in the cheeks, dimples turn into wrinkles and distinct lines that run down around the mouth; drastically changing its once adorable appearance.

The Triangle of Youth:
Our facial profile is determined by three prominent areas-: cheekbones, cheeks, jawline. An interesting concept called ‘The Triangle of Youth’ illustrates the difference between a young person’s face and an older person’s face. Moreover, it can best show the transition of our face from our younger years to the latter years.
The figure below shows an ideal Triangle of Youth. A youthful or young face has 3 unique features-: high cheekbones, full cheeks and a defined jawline. The base of the triangle is at the cheeks while the point is at the chin.

As we grow older (or age), this triangle becomes inverted. Features include an oblong face, flattened cheeks, distinct lines that run between nose and mouth, sagging jawline and double chin.

Causes of Aging:
The causes of aging can be divided into 2 categories; Intrinsic and Extrinsic. Let us look at both of them to find out if they are controllable.
Intrinsic Factors: These factors bring about change at the molecular level. The structural changes in our skin and efficiency of cell function are central to these factors. Our genes and biological age largely control when these changes will occur. Thus, these are naturally occurring phenomena which cannot be controlled, requiring consultation with your dermatologist.
Hormonal influences, poor blood supply to the skin can diminish the quality of our skin.
Collagen and elastin, two proteins present in our skin in the form of a network, are an essential component of our skin. They are responsible for keeping our skin firm. As we age, this protein network breaks down, leading to reduced quantities of both. The result is a weakened, saggy skin which has lost its support structure.
Extrinsic Factors: These are environmental factors and largely relate to our lifestyle. Thus, it is safe to say that extrinsic factors can be controlled by making the right lifestyle choices, thereby controlling the effect of aging to some extent.
To elaborate further, extrinsic factors share one process in common which accelerates your skin aging. Oxidative stress is a process that creates free negative radicals through toxins in the body. It is linked with lifestyle stress. Free radicals accelerate aging by damaging skin cell structure. Let us look at some extrinsic factors and you will know how closely they relate to our lifestyle choices.

    • Sun Exposure: One of the biggest causes of skin aging, prolonged exposure to sunrays or UV rays causes skin damage. This is also known as Photoaging. It is also responsible for pigmentation and uneven skin tone.
    • Pollution: Skin exposed to pollution, its harmful chemicals and particles accelerates oxidative stress. Release of free radicals hampers the skin’s ability to produce collagen leading to dry, saggy and lifeless skin.
    • Smoking: It is a huge creator of oxidative stress. Tobacco and chemicals like nicotine instigate premature aging of your skin. It is a no-brainer that it constricts blood vessels and lungs, restricting the flow of nutrients and oxygen to the skin. Moreover, smokers tend to squint their eyes to keep the smoke away, causing wrinkles. Crow’s feet and drooping of the skin around the eyelids is common among smokers. These are features of a ‘Smoker’s Face.’
    • Alcohol: Excessive drinking (Women — more than 1 drink a day; Men — more than 2 drinks a day) can speed up the aging process and bring about premature aging.
    • Diet: Unhealthy foods or diets with no nutritional value deprives the skin of the nutrients it needs to keep from aging. Junk food means feeding your skin junk; whereas even crash diets can have a reverse effect on your skin than that on your weight.
    • Sugar: Sugar is another big reason for aging. Consuming excess sugar, in any form, is bad for your skin. That means, so are the ‘only-fruit’ diets.
    • Stress: Modern day physical and mental stress can affect your skin leading to
      premature aging. Adrenaline and cortisol in the bloodstream, released due to stress, can inhibit new skin cell growth and break down collagen. Burnout, extreme work- related stress can permanently hamper your skin’s texture leading to pale complexion and sagging.
    • Other Factors: Daily facial movements, obesity and even sleep position are some secondary factors that contribute to aging.

How our Face Ages Over Time?
The below infographic shows how our face ages over time. Although aging is an on-going process, the more prominent changes on our face become evident only in the latter years.

Effects of Skin Aging:
We have already looked at the signs of aging. Let us now look at the effects the process of aging has on our skin, its appearance and how it affects the function of our skin.

    Fat loss results in loosening of skin, sunken eyes and skeletal appearance. Evident below the cheeks, temples, chin, nose and eyes.

  • Bone loss around the mouth and chin causes evident puckering of the skin around the mouth.
  • Cartilage loss in the nose causes drooping of the nasal tip.
  • Hanging skin due to loss of elastin.
  • Thinning of epidermis (surface layer of skin) can cause the skin to look transparent.
  • Fragility of the skin can be caused to flattening of epidermis and dermis (secondary layer of skin).
  • Rougher skin
  • Skin can develop lesions; some of which may be benign tumours.
  • Skin can become more easily bruised; due to thinner blood vessel walls.

How to Control the Aging Process?
Aging is inevitable. However, you can have full control over how fast you want to age. Extrinsic factors accelerate aging; but they also accelerate the intrinsic factors to bring about aging at a faster rate. With proper care, modifications in lifestyle choices and a good skin routine, you can delay the signs of aging. Here are some of the preventive measures you can take :-

  • Adequate sun protection. Always wear a sunscreen (365 days a year) with an SPF of 15 and higher. Wear sun-protective clothing. Cover your head with a hat with a brim while outdoors.
  • A good skin routine is incomplete without moisturisation. Moisturise your skin regularly with a suitable moisturiser to avoid drying of skin.
  • Kick the butt. Give up smoking to save your skin from premature aging and unnecessary damage.
  • Watch your alcohol intake. Limit yourself to moderate drinking.
  • Eat a healthy, well-balanced diet. Increase your intake of veggies, green leafy vegetables, fruits, whole grains and lean proteins. Ensure that you consume foods and supplements containing antioxidants and vitamins. Antioxidants are your best bet to fight free radicals that cause the most skin damage.
  • Cut out sugar. If you cannot do without it, keep your sugar intake to the minimum.
  • Increase your fluid intake. Hydration is the key.
  • Keep stress at bay. Practice meditation or unwind with your favourite activities to relax.
    Exercising and working out also help in keeping yourself stress-free.
  • Avoid certain behaviours like squinting, sleeping on the side or stomach to help prevent mechanical premature aging.

Beyond Controlling Aging…
Our skin is at the mercy of a number of factors that we have discussed. Preventive measures help holistically in caring for your skin as well as body. However, they can only take you only so far in the fight against aging.
How would you like to reverse your aging process? With the advent of certain procedures in dermatology, it is now possible to arrest and reverse the effects of aging that have already occurred or may occur in your latter years. Whether you made unhealthy lifestyle choices for a long time, or did not care for your skin enough or have intrinsic factors that are strong at play; reversing effects of aging to a great extent is now possible due to technology advancement in dermatology. Aging can be drastically slowed down and dramatic improvements in your skin can be made. Looking your age can mean looking the best version of your age. All this for a better YOU and an enhanced YOU!
More on anti- aging procedures in my next blog.