Anti-ageing congress, Bucharest, October 2012

 

 

 

 

Few weeks have passed since I enrolled in writing my bit about anti-ageing skin care products. Although I did my research, I found the information overwhelming in quantity but also, medical terms. Bottom line is I did not understand the issue of ageing at all. My heart was not into it. I used to think there are more important things in life than worry about few wrinkles. Not only that, I went so far to even think wrinkles can make one more beautiful, they are signs of a wise person; I compared them with life paths to touch gently and feel transported through experiences that person has gathered along many years.

Leaving my romantic and simplistic view behind, the way we look is important for us and this includes the state of our skin. After I attended the anti-ageing congress here, in Bucharest I learnt it is plenty we can do to care for our skin. Starting with prevention of different skin problems that appear as we age, implementing good skin care habits and eventually correcting different imperfections that may bother us.

There is another aspect: through our face we communicate with the world. We can express different emotions whether positive or less positive they will affect our face, and consequently, the skin. (e.g when we are sad it shows in our body and face; the corners of the mouth are dropped and surely our skin looks lifeless. By contrary, when we are happy the expression is luminous and our skin is glowing). The subjects of reading the face also face armour, and the non-verbal communication between the client and therapist through what face reveals are super interesting however, I won’t get into it at this moment.

I will start by exposing some face and body ageing signs and then focus on ways to prevent and slow down ageing. Some basic skin anatomy is necessary in order to understand the changes the skin suffers as we age, how cosmetic products work into the skin and why some don’t.

Ageing is a process of cells damage due to internal and external factors; this process is a natural one and begins at birth. As ageing starts to take place between infancy and puberty and ends at death, maybe we can view ageing not as something to be feared of but as something we can manage gracefully?

 

There are different classifications of wrinkles such as Glogau’s:

1. Static wrinkles – treated with exfoliants (peels)
2. Dynamic wrinkles – smile lines, frown lines – treated with Botox and neuropeptide agents
3. Skin fold wrinkles – due to skin sagging – nasolabial folds – treated with surgery

From the times when we notice static wrinkles we would recommend skin care products to boost the collagen and elastin in the skin. We do not mean we put these people in a classification as ‘old people’, but simply that the structure of our skin changes with our age and our skin needs different ingredients.

Why some creams are ineffective

1. they do not contain the active ingredients our skin needs
2. if they do those are in negligible quantity (just read the label and if these ingredients are somewhere between middle to the end of the list then they do not offer you the best)
3. the ingredients cannot penetrate deep into the skin (they do not have a system of transportation) and they are not hydrolyzed (they are not broken down in small molecules that skin can ‘digest’)

Imagine the structure of the skin as a sponge with three layers of porosity (the first layer is the epidermis, is the one on the surface, then dermis and the deeper layer hypodermis); we add on top of it water. The water will be able to penetrate let’s say the first layer of the sponge as the other two are made of very tight and fine porosity. This happens in our skin too.

Some face skin creams do not work because they cannot penetrate any deeper from the protective outer layer of the skin. So they may ‘work’ for some time as they protect to some degree the epidermis. However, if we need to solve any issues regarding our skin, such as fine lines our skin needs active ingredients that will have to be able to get to the dermis level. Why? Because at that level our skin produces new cells and in this way we tackle the root of the problem.

To enhance topical absorbency we need good products that have:

• Mechanism of penetration with advanced carriers
• Specially chosen active ingredients with quality and technology of emulsions (delivers the ingredients)
• The best microemulsions are tri-phase described as Water/Oil/Water as they contain three embedded dispersion phases that coexist as one => the product will be more hydrating, highly stable and long lasting => these are called tri-phase creams. They will allow better penetrability of ingredients that they carry.

 

We can also enhance the efficiency of our skin care products by preparing our skin through:

• Exfoliation – to help keep a healthy epidermis by desquamation (shedding) of the keratinised cells from the surface while new cells are pushed to the surface from the deeper layers where cell division happens = process also called cellular turnover
• Hydration – water is highly important to our skin as equally to our whole body. When we prepare for a detox regime we start with the hydration phase before adding different supplements, quality foods etc, and exactly the same should be applied for the skin. Before nourishing our skin with a newly purchased cream with great actives, let’s think hydration first
• Skin care cream with active ingredients: vitamins, hyaluronic acid, collagen, elastin, caviar

 

So what are all these ingredients?

The dermis, the second layer of our skin is tough and elastic as it contains collagen fibres interlaced with elastic fibres, and chains of sugar molecules called glycosaminoglycans (GAGs), which hold water.

Collagen makes about 80% of the dermis and binds water, gives the skin strength, and its degradation leads to wrinkles.

Elastin enables the skin to bounce back; it is elastic to allow movement of underlying muscles and joints.

Collagen and elastin are produced by cells called fibroblasts. They have an important role in the healing process of the skin by repairing scars or replenishing collagen to rebuild the structure of the skin, and keep it in good shape. As we age the production of these cells slow down. Therefore, stimulation of the production of new cells especially after a certain age is highly important for prevention of premature ageing.

 

Some facts from scientists:

• Around the age of 30, the production of collagen starts to decrease with 1% collagen every year, and in general a reduction of the performance of fibroblasts (collagen and elastin) happens
• After the age of 40 the skin turnover takes 38-40 days instead of 28 days as in younger age
• Impairment of vascularity and tissue nutrition = ‘skin starvation’

 

These are the reasons that around the age of 30 our skin needs collagen and elastin or other active ingredients to stimulate our own skin production of collagen and elastin. But these proteins are large compounds that just sit on top of the skin as they cannot enter, if the technology behind the product does not provide an efficient transporter to the level of dermis.

Research showed also that vegetable source is not that efficient as fish collagen and elastin polypeptides. The compatibility with human skin and absorption of collagen and elastin from marine source is by far the best resource.

There are two types of ageing:

1. Internal ageing (chronological ageing) is the process by which people age under normal circumstances – affected by heredity and depends on time
2. External ageing – due to external factors such as sun exposure and harsh environments: air pollution, smoking, alcohol abuse and poor nutrition.  Skin experts believe that as much as 85% of visible ageing is caused by these factors.

The subject of sun exposure will be detailed later on, only for now to state that skin care experts will warn us that wrinkles produced by staying in the sun without UV protection produces photo-damaging to our skin that is harder to correct than any other lines. It is important physical and chemical sunscreens to protect from both, UV-A and UV-B rays.

 

Signs of face skin ageing

• Dehydration – decreased production of hyaluronic acid => skin easily irritated and pigmented
• Dryness as sebaceous glands produce less oil => the skin is less protected
• Thicker stratum corneum which is the dead skin cells layer on the surface of our skin (epidermis)=> dullness appearance
• Thinning of epidermis and dermis due to less new cell production => thin, translucent and fragile skin
• Decreased glycosaminoglycans in the dermis – which play a key role in the structure of the skin and its resilience
• Subcutaneous hypotrophy = loss of volume/plumpness of our complexion due to loss of fat in the hypodermis
• Pigmentation disorders due to chaotic melanin production in the dermis
• Vascular disorders due to impaired microcirculation in the dermis
• Skin colour becomes paler due to slower capillary circulation
• Skin growths due to long term sun exposure
• Laxity = diminished skin tone/loss of elasticity due to less production of elastin=> flaccid skin
• Lines and wrinkles due to collagen decreasing
• Diminished skin texture on the face & exposed body skin to sun
• Abnormal appearing of elastic fibres in dermis due to cross linking

 

Signs of body skin ageing

• Muscle tone decreases leading to sagging skin
• Fat loss decreases so skin has less cushioning
• Skin becomes drier due to estrogen loss during menopause
• Wrinkles become more apparent in sun-exposed areas
• Elasticity loss increases dramatically, especially if sun damage has accumulated and excessive weight loss has occurred through the years
• Saccharides (natural sugars in the dermis) decrease loosening the dermal-epidermal junction
• Saccharides decrease loosening the attachment bonds between collagen & elastin proteins
• Collagen is lost at rates of 1% a year from adulthood on
• Hand wrinkles & solar pigmentation become apparent

 

GENERAL RECOMMANDATIONS

1. Drink more water as the water:

• helps to keep a healthy metabolism
• cleanses and detoxify the body
• beautifies the skin
• plumps the tissues
• enhances cellular functions
• reduces pigmentation
• improves natural healing

2. Management of stress

 Sources of stress could be sleep deprivation, exams, illness, pain. Some of these are part of our lives, but chronic stress is what we should try to sort as this can impair the health of our body, but also the state of our skin. Chronic stress affects negatively the epidermal barrier, which can delay wound healing.

Part of a treatment program we should consider relaxation therapy, yoga, and exercise.

We also should try to eliminate as much as possible sources of free radicals that are proven to age the body: UV rays, high temperatures, pollution, using microwaves etc. We can counteract the free radicals by eating a diet with lot of fruits and vegetables containing antioxidants. Other antioxidants that can be used topically as well: vitamins A, E and C, coenzyme Q10, alpha lipoic acid, glutathione and retinoids.

3. Good nutrition – Two process are important here:

Chronic inflammation will diminish the body’s ability to heal itself and limits the cell renewal. Chronic inflammation happens when any disease is left untreated for long time which makes us feel worn down and also, we age prematurely. Inflammation can be produced by consuming a diet high in sugar.

Glycation causes collagen and elastin to breakdown and causes loss of skin elasticity, resulting in wrinkling and sagging. It also increases the effects of sun damage.

Glycation is a process whereby the glucose (from sugars and carbohydrates) we digest bind to lipids and the proteins in the body, such as collagen, and form advanced glycation end products (AGEs). These are destructive inflammation producing molecules that contribute to disease; they increase free radical damage and wrinkles.

It is important to know that more testing need to be done on glycation and the skin; however, the skin care experts have their opinion shared:

1. That there is a long way to go before it is proven that eating carbohydrates and sugars can destroy the collagen in the dermis. It is not accurate to conclude “sugar causes wrinkles”, because the processes happening in the body are more complex and they involve more than sugar alone.
2. Other experts are convinced that too much glycation may affect the type of collagen we can build. Their opinion that ‘the damaging effects sugar can have on our looks are clearly evident in diabetics who have a hard time controlling their blood-sugar levels. Diabetics often show the signs of premature aging because they can go for years with undetected high blood sugar, causing them to physically age quicker.’ Skin care expert, Paula Begoun

When sugar is in our diet the rate of glycation increases and that adds to the advanced glycation end products (AGE), consequently to age faster. However, cutting on the following products helps diminished the AGEs and chronic inflammation:

• Excess sugar, high fructose corn syrup, honey causes AGEs.  Certain fruit juice drinks, many breakfast cereals, and sugar-yogurts
• Trans-fats such as margarine and most shortenings
• Processed meats and red meat (the nitrites and nitrates are a source of inflammation)
• Highly processed foods: fast-food and pre packaged meals
• White flour
• Salty foods as they cause bloating, puffiness, and tired-looking skin

5. Exercise to keep good muscles tone

6. Heavy metal chelation – to detoxify the body of heavy metals

7. External care:

Professional skin care – have a facial treatment once a month. Why? There is a process of new skin cell production in the dermis, skin cells move up from the dermis to the epidermis in a span of 28-30 days. This process is called cellular turnover. As these cells are moving up the surface of the skin, their nucleus becomes non-functional; they are ‘dead cells’ that eventually will shed away by themselves. However, within a polluted environment, using make-up and by not having a strict cleansing routine sometimes breakouts happen. The solution is to exfoliate the skin, hydrate and nourish it with all the good ingredients that it needs. A professional treatment once a month will help this cellular turnover to be more efficient.

MAIN GOALS OF A PROFESSIONAL TREATMENT:

Skin hydration
Skin protection UV, UB
Stimulation of skin renovation
Boosting anti-free radicals
Activating microcirculation for proper nutrient delivery
Deep nourishment

Home skin care:

• Choose natural products
• Avoid astringents and products with alcohol
• Exfoliate once a week face and body
• Hydrate your skin
• Moisturise your face and body
• Use concentrates to address skin dryness
• For early signs of ageing such as wrinkles and lines start to use products with elastin, collagen and hyaluronic acid
• After the age of 50 use skin care products based on caviar
• Keep your skin care products in the fridge and use a wooden spatula provided to prolong their life. For eye products they will work better in reducing puffiness around the eyes too.

Medical skin care – general trends

Aesthetics

• Skin care treatment
• Vitamin infusion
• Chemical peels
• Epidermal resurfacing
• Light based treatment
• Topical peptides infusion
• Lightening treatment
• Masking treatment
• Machine assisted treatments

Medical

• Botox –  Botulinum toxin
• Radio frequency treatment
• Fractional laser and IPL
• Dermal fillers
• Dermabrasion
• Surgical treatment
• Mesotherapy and virtual mesotherapy
• ‘Vampire facelifts’ –Platelet Rich Plasma
• Subdermal and injections of cocktails

8. Protection from the environmental aggressors

 

How to prevent future ageing

1. Exfoliate your face and body skin once a week (or even twice if the skin is clogged and pores are not free of sebum)

Exfoliation of dead skin cells is really important before doing an anti-ageing treatment. Otherwise none of the elements will ever enter or they will do but less effective.

The cells turnover (production of new cells) is happening fast (28-30 days), when we are young and gets slower as we get older. (After the age of 40 it may take as long as 40 days). Our outermost layer of skin, the stratum corneum of the epidermis is composed of dead cells that shed on a regular basis. This happens while cells from the lower layers, the dermis are continually produced and they travel to the surface and push the cells off, adding to the outer layer of the „dead skin cells”.

This cellular turnover would have been enough for our skin to look healthy, however due to sun damage, loss of estrogen, and how well we cleanse morning and evening can all affect this natural exfoliation process that takes place.  Consequently, we may experience rough and thickened skin, more lines and pigmentation and also breakouts, blackheads or other blemishes. There are different forms of exfoliation to help to remove the built up of dead cells, uncovering a more luminous and healthy looking skin, that was just hiding beneath.

Types of exfoliation:

1. Mechanical exfoliation – using products containing abrasive particles of fruit seeds, bamboo etc. They work by gently ‘massaging’ with circular movements over the skin

using microdermabrasion, a popular treatment these days that works by shedding the dead cells through a machine with rotative ends that uses a flux of crystals or diamonds on top of our skin

2. Enzymatic peeling – in this case the exfoliation happens with the help of the enzymes from the papaya fruit, pineapple, grapefruit and milk (the casein enzyme). These enzymes will ‘digest’ through the first layers of the skin, helping to easily remove the dead cells layer and also they are used in professional care to prepare the skin for extractions.

The enzymatic peeling can be available in the retail form in which case the product is left on the skin (usually needs to me mixed with water), for 5-7min after which time it can be taken off. This is one of the easiest ways to keep skin clear, as it is a gentle exfoliation yet very effective

3. Chemical peels are done with the help of Alpha Hydroxy Acids (AHAs) and Beta Hydroxy Acids (BHAs). These acids occur in natural products.

AHAs and BHA allow good penetration of active ingredients (like retinol) by removing unhealthy layers of built-up skin cells caused by sun damage.

AHAs are extracted from fruits and the most used ones are:

–      Malic acid (extracted from apples)
–      Citric acid (found in citrus fruits)
–      Lactic acid (milk and black currant)
–      Tartric acid (grapes)
–      Glycolic acid (sugar cane) – this is the most used one as it has the smallest molecular weight which makes it the best to penetrate the cells

The role of AHA is to deeply exfoliate the skin and hydrate it. They are used in professional treatments such as intensive hydrating treatments, cellular renewal, anti-ageing treatments, treatment of photo-ageing/pigmentation, deep wrinkles, acne and also to brighten the skin.

BHA is salicylic acid extracted from the willow bark, wintergreen and sweet birch leaves. Used as a peeler. BHA is recommended for oily, acne-prone skin and for treating blackheads and white bumps and also rosacea. BHA can get through the oil that’s clogging the pores. BHA has anti-inflammatory, antibacterial action and may have a lightening action too.

How peels work:

1. Chemical dehydration – it is a controlled process where

Lipid barrier is compromised
Corneocytes and ‘desmosomes’ breakdown
Remaining corneocytes start to shed

2. Desquamation – occurs when dead cells detach from the top layer (visible or not)
3. Re-Epithelialisation = it is the process of wound healing whereby new skin is synthesized.

Recovery time:
3-4 days after superficial peels
7-9 days for medium peels
10-12 days after deep peels

 

2. Limit the time in the sun (and avoid tanning beds)

The sun gives off two types of UV rays: UV-A rays and UV-B rays.
The UV light emitted from the tanning beds is composed primarily of UVA radiation because that is what causes us to tan.
The sun’s UVB rays cause sunburn, but it’s the UVA rays, from the sun and from tanning bulbs, that are much more damaging:

• as they can penetrate the skin deeply they are also mutagenic, which means alter the cellular DNA
• they destroy collagen and elastin, making the skin to sag and wrinkle which in turn causes abnormal cells to be produced (skin cancers)

From the skin care expert, Paula Begoun: „Let us say it again: Any color change to your skin is a sign it has been damaged. It’s a fact: The more you tan, whether indoors or out, the worse your skin will look as you age”.

 
Steps to protect ourselves from the sun:

• Use a sunscreen that protects from both UV-A and UV-B radiation, and has a sun protection factor (SPF) of at least 15. The SPF number refers to the duration of protection and not strength.
• Use it 365 days a year no matter the weather! Children should use a higher SPF such as 30 or 45 (a sun block). If we let our children to sunburn, the chance of having skin cancer as an adult is greater
• Always apply the sunscreen protection last, as a final step in the skin care routine
• We can mix few drops of our foundation or tinted moisturizer (SPF 15) with the sunscreen, but no more than that or we risk diluting our sun protection
• Protect our neck with a non-makeup product of a SPF 15 or greater and be gentle when you apply it. The neck area is as sensitive as the eye area.
• Wear protective clothing (protect the ears and feet too)
• Stay out of the sun between the hours of 10 A.M. and 3 P.M
• Wear sunglasses that absorb both UV-A and UV-B radiation. Darkened sunglasses can expose the eyes to more damage than usual because the pupils dilate in the shade. For this reason, children should not wear “fun” sunglasses outside in the sun
• Avoid tanning machines unless prescribed by a physician for Seasonal Affective Disorder (SAD).

Synthetic sunscreen actives (avobenzone, octinoxate, and oxybenzone), should be applied 20 minutes before sun exposure and mineral sunscreen actives (titanium dioxide or zinc oxide), offers us immediate sun protection.

3. Eat a healthy diet – Try not to lose or gain weight suddenly. A skin-friendly diet can help our skin build healthy new collagen, improve its elasticity, and make our skin look radiant. From what clients are telling us of their experience by reducing or taking out totally dairy products and red meat from their diets, excellent results are not delayed to appear for the improvement of skin texture and health, in general.

The Best Anti-Aging Foods!

• These foods have been shown to reduce inflammation, and reduce the glycation process:
• Green tea and red teas slow down ageing as they are antioxidant, collagen-protecting, and have anti-inflammatory properties
• Fruits especially berries are full of antioxidants; they protect our skin from free radicals that contribute to ageing
• Deeply-coloured vegetables as they are rich in beta carotene have anti-ageing benefits because they slow the damage caused by sun exposure
• Salmon and other cold water fish is loaded with omega-3 essential fatty acids and antioxidants. Eating salmon can reduce sun damage, reduce inflammation that leads to collagen breakdown, and help skin look young, plump, and radiant.
• Other essential fatty acids that benefit skin: flaxseed, pumpkin seeds, walnuts, and avocadoes
• Olive oil used also topically in care creams
• Whole grains (the fibre reduces inflammation)
• Spices such as ginger, cayenne pepper, cinnamon, coriander, fenugreek, and turmeric. These spices are fighting sun damage, and some have antibacterial properties
• Yogurt (preferably plain or those with reduced sugar or sugar-free)
• Red wine has anti-ageing abilities due to its high concentration of antioxidants, including resveratrol (=natural phenol found in the skin of red grapes)

4. Exercise to tone muscles and skin. Avoid rapid weight loss or gain as it compromises the state of elastin in the skin

5. Use anti-ageing active ingredients in professional skincare formulations proven to hydrate, restore, resurface and renew skin

6. Reduce alcohol and caffeine drinks consumption. Their effects on the body

• They dehydrate the body, depleting the skin from vital nutrients and making it appearing dull.
• Facial blood vessels dilate which may cause permanent red visible veins

Water instead will serve:

• as an internal moisturiser for our skin
• help to smooth out wrinkles, causing our skin to appear brighter and younger

 

7. Stop smoking (Vitamin C depletion) vasoconstrictor =>

• Wound healing is compromised
• Effects of facial peels and clinical body treatments are not as effective and long lasting
• When the blood vessels constrict the cells are depleted of oxygen=> dull complexion
• The skin absorbs environmental pollutants including the smoke fumes. This creates a build up of toxins around our face and mouth and damages the DNA in skin tissue
• The carcinogens in tobacco smoke also kill off collagen, so a smoker’s skin becomes wrinkled and less elastic before its time
• Researchers showed that cigarette smoke degrades collagen and elastin (in a similar, lethal way as ultraviolet rays do), and decreases cells turnover in the skin

8. Receive body massages and body treatments to increase circulation & condition the skin.

Massage Therapy:

1. Improves lymphatic drainage
2. Increases circulation
3. Stimulates fibroblast formation
4. Improves tone and strength to connective tissue
5. Increases EGF’s (Epidermal Growth Factors)

In the next post, I shall refer to active ingredients in skin care creams. Until then my thoughts go to an ex-cancer patient who shared the lessons of her experience in dealing with the illness: to approach every day with joy in the heart and she learnt she is important too. One more thing: from her serene look, I could tell she made a daily practice out of her lessons. And as C. Jurist, MD started his presentation of anti-ageing congress, ‘the secret to longevity is to be happy’, I leave you to connect the dots, and I shall finish here this post about anti-ageing.

Iuliana Simion, therapist Eden Spa Sibiu

 

References

Christian Jurist, MD and Global Corporate Trainer, Pevonia International, LLC
Tino Lerma, Medical Esthetic Educator, Pevonia International, LLC.
Paula Begoun, Skin care expert