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The Sun and Ageing of the Skin
As the body ages, the appearance and characteristics of the skin alter – say “looks real ugly.” The areas of skin exposed to the sunlight’s ultraviolet radiation suffer the most damage and expectedly age faster. It can occur at an early age in people who have spent much time outdoors and those who are often badly sunburned, particularly those who are fair skinned. The dreaded process is known as photoageing. It is attributed to a combination of short wavelength (UVB) injury to the epidermis (outside layers of the skin) and long wavelength (UVA) to the dermis (middle layers). Again, ultraviolet radiation is largely to blame. The continuous and profound effects of oxidation, ionisation and genetic changes of cellular components including DNA (deoxyribonucleic acid) Weakens the skin’s immune system. Hence, aging skin is prone to skin cancer. Scarring from repeated inflammation due to sunburn (also acne and other skin diseases) increases dermal collagen and causes the dermis to lose elasticity. The epidermis becomes thinner so the skin easily dries up, blisters, and tears. The skin is weaker than normal and feels dry because it is less able to hold water. The ageing changes are particularly apparent on the face where fine lines and wrinkles, discolouration and textural changes can be noticed – at closer look or in serious cases, remarkably noticeable. Lingering under the sun without adequate protection causes overactivity of tanning cells, called melanocytes. Consequently, ugly sights of blotchy pigmentation with brown freckles, solar lentigines and white marks would appear. Tangled masses of damaged elastin protein in the dermis result to yellow thickened bumps (elastosis or heliosis). Aging skin is also very prone to develop brown warty lesions (seborrhoeic keratoses), cherry red spots (angiomas), dilated small blood vessels (telangiectases) and bruises (senile purpura).
Tender red dry spots or solar keratoses (also known as actinic keratoses), though more common on the backs of the hands are also often found on the temples, bridge of nose, cheeks and upper lip. The degree of photoageing has been classified by dermatologists as: Mild (age 28-35 years): Few wrinkles, no keratoses; Moderate (age 35-50 years): early wrinkling, sallow complexion with early actinic keratoses; Advanced (age 50-60 years): persistent wrinkling, discoloration of the skin with actinic keratoses; and, Severe (age 65-70 years): severe wrinkling, photoaging, gravitational and dynamic forces affecting skin, actinic keratoses with or without skin cancer. To remedy, or if only to delay further harm, it is still best to completely protect sun-damaged skin from more sun exposure. Outdoor activities during the middle of the day, especially on summer should be avoided. Almost obligatory, sunscreens should be applied daily, more often when outdoors. Range of cosmetic products to care for ageing skin – from simple moisturizers and sunscreens to retinoid creams and Alpha-hydroxy acids are available in the market today.
A dermatologist or plastic surgeon is still the best source for expert advice. A cosmetic surgeon may suggest clinical treatments that rejuvenate photoaged skin such as BOTOX® Cosmetic to reduce frowning and several resurfacing procedures such as dermabrasion, chemical peels, and laser resurfacing remove the top layer of damaged skin. Cosmetic surgery is required to remove redundant sagging skin, baggy eyelids necessitate blepharoplasty while a face lift is needed to tighten the jowls.
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