The ageing of the skin
There are many different theories on ageing. We do not necessarily want to commit ourselves to one of these theories for our topic, because many contribute with partial insights to a holistic theory of ageing that will hopefully be developed at some point.
However, for you as readers who have an interest in aesthetic medicine, it is important that the fight against old age is not just about aesthetics. In general terms, aesthetics is only one part of anti-aging medicine. It has set itself the task of accompanying the processes associated with ageing and, where possible, facilitating or improving them. This includes many different therapeutic approaches, such as hormone replacement therapy, orthomolecular medicine or infusion therapy with essential phospholipids such as highly purified lecithin for the therapy of cell membranes.
In aesthetics we deal with the visible changes of ageing and especially with the ageing of the face. This is triggered by a variety of processes. They affect the skin, the fat deposits in the face, the retaining ligaments and also the bones. All these anatomical units are subject to ageing and ultimately influence the appearance.
In general, we can distinguish 2 important areas: Skin ageing changes our surface, while the other processes change more the contours and anatomical proportions. Which influences more the appearance, the skin status or the change of the facial structure? This question cannot be answered conclusively. Both can contribute to losing the attributes of youthfulness. But what exactly happens during the ageing process and when does it start? Aging as a whole begins – perhaps this surprises you – immediately after birth and only ends with death. So it is a lifelong process.
Skin
If we only look at the skin, we can say that the first small signs of ageing can become visible from around the age of 25.
The skin first becomes rougher, often drier, then the pores become larger. The hyaluronic acid that stores water decreases, collagen and elastin are no longer reproduced as quickly, which leads to slackening and loss of elasticity. There are both intrinsic (=coming from within) factors that set these processes in motion, for example, genetic conditions play a role in whether the skin ages faster or slower. And there are extrinsic (= externally stimulated) factors that cause our skin to age. Probably the most important factor here is light (the so-called light ageing) and here above all the influence of ultraviolet radiation.
The visible effects depending on age are then the change in complexion or facial colour, pore size, often colour shifts like the well-known age spots, but also the emergence of bluish or reddish shades, loss of firmness and elasticity, wrinkle formation, skin injuries such as acne scars can also become more prominent with increasing age.
What is our skin actually made of? We are learning more and more about a highly complex organ – because that is what our skin is, an organ. The exchange with everything that reaches us from outside is guaranteed by this very thin membrane. It consists of 3 different layers, the epidermis or upper skin, the cutis or dermis (also called leather skin) and the subcutis or subcutaneous tissue. It contains many different elements such as hair follicles, collagen fibres formed from fibroblasts (cells that are part of the connective tissue and are needed to build the extracellular matrix), skin cells, nerve cells, blood vessels and veins. In addition to the various cell types, there is also the extracellular matrix, i.e. the space between the above-mentioned cell types, which has many functions, especially regulating the elasticity, firmness and water content of the skin.
The most recent addition is the dWAT, dermal fat cells, which are located in the subcutaneous layer, especially around the hair follicles, and whose importance is currently the subject of much debate. The whole organ is in a constant state of change, we must never imagine the skin as a static structure – otherwise it could not age at all.
Modern aesthetic medicine does not start its work when “the child has already fallen into the well”, but it starts much earlier, namely when it influences the factors that accelerate skin ageing. In New German we call this “prevention”. The aim of aesthetic prevention therapy is to slow down skin ageing by supplying the skin with substances that lead to the intrinsic and above all extrinsic factors not being able to exert such a rapid and massive influence. There are a large number of different therapeutic options for the treatment of ageing skin. When deciding on a particular therapy, the most important factor is how old you are when you first wish to have an aesthetic treatment and how badly the skin has already been affected. Just to give you an idea of the whole scale: Prevention begins with so-called cosmeceuticals or dermatocosmetic active ingredients, which are either applied to the skin as a serum or cream or are introduced into the dermis by microfine injections. Vitamins in particular play an important role here. At the other end of the scale, the severely damaged skin may be at the other end of the scale, which then requires very intensive intervention, for example through surgery (a facelift), or skin resurfacing (removal of the uppermost layer of skin by laser or deep chemical peeling).
Next we will talk about the wrinkles, which many of you find particularly disturbing. In terms of aesthetics, we distinguish between 2 causes of wrinkling. The loss of elasticity and with increasing age of the water-binding hyaluron leads to the formation of wrinkles. Another cause is due to mimic activity. There is a large number of muscles in the face, which are also used to express ourselves mimically. We have already mentioned the frown line in this blog, but have not yet discussed how it develops. It is caused by too much muscle activity, which can have many triggers, such as strong concentration, tension or stress. If the muscle is overused for years, mimic wrinkles will form.
Do you want to read the second part on the ageing process right away? Then just follow this link.