QUESTIONS & ANSWERS
We’ve all heard the clichés that wrinkles are the roadmap of one’s life writes but many of us would rather not be reminded of the distance we’ve travelled.
A wrinkle is definitely the skin blemish most dreaded by women. The appearance of the first wrinkle, of age, is often perceived as about when they reach 30 years the unfair ravage of age. The mirror and the way others look at them lead women to try to treat and hide these marks of time.
Q: What is a wrinkle?
A: A fold in the skin caused by age or weight loss; ‘a small ridge or furrow on a surface, a crease’ is the dictionary definition. Histological studies of wrinkles have revealed a series of major changes: cell renewal is slower and cells’ ability to synthesise the supporting fibres is diminished.
It has now been established that the skin gets thinner with age, that the sinusoidal dermoepidermal interface gets flatter reducing the area of exchange between the dermis, which supplies the nutrients (it contains blood capillaries), and the epidermis.
The quality of the epidermis also depends on the interface between it and the dermis. The loss of adhesion between these two structures, which is normally provided by collagen iv (a multi-sheet structure or basal layer) and collagen vii (anchored to the sheet’s structure), results in deficiencies in nutritional exchanges and a slowing of the circulation of the messengers that promote neo-synthesis processes.
Paradoxically, mature skin contains more elastin. Collagen is less efficiently replaced and this leaves empty spaces, which are gradually filled in by elastin nodules. With age, the accumulation of these degraded elastic fibers (fragmented, calcified, excessive lipid content, etc.) Implies a loss in the skin’s resistance to stretching.
Q: What is the main cause of the aging process?
A: Aging of human skin, particularly after 50 years, is accompanied by a change in its macromolecular components that results in dramatic changes in visco-elastic characteristics of the intercellular skin matrix.
In particular, the epidermis’s hyaluronic acid content decreases progressively. Recent studies demonstrate that the major change in the dermis is the increased binding of hyaluronic acid with tissues, and its loss of extractability, which explains its diminished ability to take on skin hydration.
Consequently, the alterations of aged skin, including the decrease of turgidity, wrinkling, appearance of dryness, and altered elasticity, are closely related to the modifications in the hyaluronic acid pattern in the skin.
Q: What can cosmetologists do about the aging scenario?
A: The possibility of interstitial filling through the injection of collagen, silicon or hyaluronic acid has been suggested, but none of these techniques is actually widely used: all of them require great skill in administering peri-epidermal injections.
Although they are immediately effective, the effect may be short-lived in patients whose skin is undergoing very active biodegradation.
- Chemical peeling and resurfacing lasers are both effective methods, but have a rather brutal effect on the skin, which remains red and fragile for several weeks.
- The use of retinoic acid derivatives and precursors has been a decisive turning point in dealing with wrinkles. This elegant solution stimulates the turnover of aging keratinocytes.
- Vitamin c and alpha hydroxy acids are less potent than retinoids, but they too occupy an important place in anti-wrinkle products, and act by promoting cell turnover and gag synthesis.
All these substances have the drawback of being either unstable or having irritant properties which restricts their use and efficacy.
Q: What are the solutions to face the aging process?
A: Of course a healthy way of life is important but nowadays everybody is involuntarily subjected to stress, pollution, life’s excesses.
For the skin, you need to take care of it from the inside and you can help it from the outside by giving it needed nutrients and removing impurities and dirt.
These rules are to be followed on a daily basis and an additional boost can regularly be given through a nourishing and purifying mask, which can have a maximum impact in a minimum amount of time.
Q: Are there alternative solutions to the aging scenario?
A: This situation tempts us to turn to solutions that more closely mirror the physiological situation and therefore to consider endogenous factors, which can promote cell turnover and synthesis of the extra-cellular matrix. Two systems are involved in the natural renewal of the skin:
A central system, dominated by the pituitary (and the hypothalamus) which secretes hormones such as the growth hormone and insulin growth factors, the levels of which tend to decline with age, leading to a slowing of cell metabolism.
A local system, which depends on the peptides derived from secretions by various cell types. This local system was invented by nature both to provide a rapid response to tissue injury (from wounds or chemical aggression) and to ensure regular replacement of tissues.
This category includes factors such as fibroblast growth factors (fgfs), transforming growth factors (tgfs) and insulin growth factors (igf).
Peptides are small molecules and are generally easier for the cosmetologist to handle. These fragments are produced by targeted cleaving of “precursor proteins”, such as those of collagen, fibronectin and elastin, and they have an important feedback role on their own neo-synthesis system and thus they too contribute to tissue replacement.