The Science Behind the Inevitable
As a cosmetic doctor I frequently see people that either want to halt or reverse ageing. But to see if this is possible, it’s best to understand the science behind why our faces age.
How does the face age?
The face is made up of several different layers, each of which age. It comprises the skin, fat, collagen, muscles, ligaments and bone. No one layer is immune to ageing and unfortunately each of them have their own ageing processes.
Let’s start with the skin. The skin is the largest organ on the body and serves its purpose as being a barrier to the outside world. Skin is comprised of elastin and collagen. Elastin is responsible for giving our skin elasticity making our skin bounce back and collagen is responsible for maintaining the structure and firmness of the skin.
Unfortunately, collagen production starts to decline at around 25 years of age. There is a noticeable loss of elasticity when we are in our 30’s and 40’s. Whilst the loss of collagen impacts the plumpness of our skin, elastin reduction causes our skin to be looser.
Not only do we loose collagen and elastin, our skin becomes drier and rougher thanks to a reduction in sweat and oil glands. Additionally, we start to develop ‘age spots’, these are small flat dark areas on the skin which are tan brown in colour. This is due to overactive pigment cells. When UV light hits the skin, it speeds up the production of melanin which is the pigment responsible for skin colour. Skin that has had years of UV exposure tends to get more age spots as melanin gets clumped in high concentrations. It is important to check any new moles with your medical doctor to ensure no pathology is missed.
With age comes increasing facial expressions and if you’re a particularly expressive person you’ll start to notice wrinkles appearing due to the loss of elastin inhibiting our skin to ‘coil back’. These wrinkles are noticeable on the forehead, the frown lines or around the eyes when smiling.
The ageing process continues to the fat layer beneath the skin.
We have fat pads all over our face. When we are younger, the fat pads are distributed evenly and allow us to have plump cheeks, temples and around the eyes. With age, the volume of the fat pads reduce. In addition the superficial fat pads shift down due to gravity. The impact of which makes our faces appear heavier at the bottom causing jowls to appear around the jaw line.
Beneath the fat
Beneath these layers are ‘retaining ligaments’ there are 4 main facial retaining ligaments that form the architectural anchorage of the face. With time these ligaments weaken and loose their tone. The combination of which makes the face appear saggier and deep folds appear.
More than skin deep
Of course under these layers there is bone. The bones are responsible for our facial structure, for example our fabulous cheek bones or the perfect jawline. As we age, bone density decreases and this is noticeable in the face, particularly around the eyes, jawline and chin — which typically recedes. The orbital hollows also involute, giving an appearance of sunken eyes. Whilst these features occur, the nose, forehead and mouth become more pronounced.
Environmental Factors
Every individual is different, some may continue to have a ‘baby face’ throughout life, whereas others appear to age quickly. This is dependant on genetics, lifestyle and any underlying health conditions. However, there are some factors that can have a degree of being controlled.
- Smoking — studies have shown that smoking reduces collagen formation, resulting in collagen degradation. Nicotine is also found to reduce skin thickness. The net result is a reduction in skin elasticity.
- Alcohol — this dehydrates the skin, increasing the appearance of dry, saggy and wrinkled skin.
- Sun — As mentioned previously, chronic sun exposure leads to the development of ‘age spots’. The UV light also damages the elastin fibres, causing skin to look wrinkled and less firm.
- Stress — whether this is physical, mental or emotional, it has been documented for a long time that stress negatively impacts the skin. Stress causes changes to the chemicals in the body, which in turn reduces elasticity of skin.
If any of these modifiable factors are cemented into your day to day life, it could be worthwhile taking a pause and reviewing your behaviours to help to reduce ageing of the skin.
What Can Be Done
Aside from looking at the modifiable factors in your lifestyle, there are a number of in-home and in-clinic treatments that can aid to reduce the appearance of ageing skin.
Several moisturisers have come onto the market in recent years with much hype on anti-ageing properties. You will find that some of the top rated moisturisers have a few compounds in common. Generally they contain Vitamin E — which is an anti-oxidant but also helps to retain the skins moisture strengthening the skin barrier. Hyaluronic acid (HA), also helps to maintain skin hydration. Of note HA is also the main ingredient for dermal fillers, topical preparations won’t work in the same way as an injectable filler however the purpose of HA is to make the face appear plump again and reduce the appearance of wrinkles. Topical vitamin A1 (commonly known as Retinol), a fat-soluble vitamin, is another common ingredient in skincare products, this works on the inner layer of the skin and slows down collagen degradation helping to reduce the appearance of fine lines and wrinkles. It also increases skin cell turnover, however results aren’t usually seen for a few months after starting. It is important to note that if you are using this, to use adequate sun protection, as your skin will be much more sensitive to sunlight. There are also some groups of people where this chemical is not advisable so it’s always best to consult with your medical doctor before starting any new treatments.
There are also a number of in home devices that can be used, such as IPL for example. In addition to home devices, there are a number of in-clinic treatments ranging from anti-wrinkle injections, to hydration boosts, to dermal fillers to aid the ageing face. With each of these methods carries risks and you should always consult with an appropriately trained healthcare professional to find out which is the most suitable for you according to your medical and cosmetic needs.
If you simply don’t want to try any of these treatments, my best advice would be to start using — if you don’t already — Sun block at least spf 30 on a daily basis along with a moisturiser. Drink plenty of water to hydrate the skin and avoid excessive alcohol and stress.
One final note, I tell all my patients to look after their teeth. After-all, if you have sculpted the perfect face with no wrinkles and plump skin, if your dentition is not up to scratch then this can certainly have an impact on your overall appearance.
I hope that you have found this article helpful.
Take care and stay healthy,
Dr Nora x
Please note that the contents of this article are not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or medical condition.
