An old tomato loses volume, becomes wrinkled and discolored. A human face, for that matter, is very much like a tomato. When we are old, our face looks hollow, furrows with folds and discolours with dark shades and shadows. Generally, the collagen under the skin of our face depletes by 1 percent every year. Thus, when we are 50, we lose 50 percent of our face volume or perhaps 50 percent of our youthful look.
Man yearns to continue looking young and beautiful. However, all things are impermanent and subject to continuous change. Our skin like any other organ gets old with time that marches on incessantly. Yet the rate of ageing of our skin can be significantly modified. The expression of our genes of ageing can be modified by the epigenes that largely depend on how we live and what we eat.
The No. 1 secret to skin ageing is the sun. The rays of the sun bombard our skin all over continuously 12 hours a day. These rays comprise destructive ultraviolet (UV) radiation that continues to insult our skin all day long. The resulting wear and tear over the years accumulates into what our skin appears to be in the eyes of those who see it.
Though the sun is our saviour, sadly it is also our destroyer. The sun is the single strongest ageing factor of our skin. Around 80 percent of human skin ageing is due to the continuous UV insult by the sun on our skin. The other 20 percent is chronological or simply ageing due to the ticking clock. UV radiation causes both destruction and weakening of the collagen fibres of our skin. Collagen fibres apart from providing strength to our skin also makes up most of the volume of our skin. Knowing this secret of skin ageing enables us to counter it to some extent. Indeed, being forewarned is being forearmed.
The best war strategy is to know our enemy well. Now that we know who the Enemy No.1 of skin ageing is, shall we not counter it with skill, shield and will? Maintaining a youthful skin is thus an art of war – it is largely a war against UV radiation. For this, we must learn from our friends Down Under – the Ozzies.
Truly, adversity is the best university. Australia has the highest incidence of skin cancer in the world. This is due to the depletion of the protective ozone layer at the southern hemisphere creating an ozone-depleted hole in our atmosphere for harmful cancer-causing ultraviolet C radiation to reach the Ozzies. The hole also allows the ageing rays of UV A and burning rays of UV B to reach Down Under in a larger quantity. What a triple insult on the skin!
In face of this adversity, the Ozzies have braced themselves, formulated and educated their public about skin protection against excessive UV radiation. Such a campaign has helped tremendously. Indeed they have won the war to a large extent. Bravo Ozzies! What did they do?
They campaigned actively to increase public awareness about the harmful effects of UV radiation. If we look into the handbag of any Australian woman, we are likely to find a pair of sunglasses and a tube of sunscreen. They often carry an umbrella and wear broad brim hats. Many avoid the midday sun and have stopped using sunbeds. More and more are wearing long sleeved blouses and shirts when going out under the sun.
The No. 2 secret of skin ageing is ‘No Cigarette’. Nicotine suffocates the skin by narrowing the blood vessels on its surface. As a result of this, smokers might find that their skin receives much less oxygen and important nutrients such as vitamin A. Cigarette smoking also weakens the collagen and elastic fibres thus contributing towards skin wrinkling and sagging.
Apart from premature facial wrinkling, smoking also causes wrinkling of skin on other parts of our body including the inner arms. While skin wrinkles may not be reversible, one can prevent worsening of wrinkling by quitting smoking now.
In addition, repeated exposure to the heat from burning cigarettes and the facial expressions one makes when smoking such as pursing one’s lips when inhaling and squinting one’s eyes to keep out smoke may contribute to wrinkles. Such wrinkling are called habit lines.
In summary, ageing of human skin is largely due to ‘seasoning’ of our skin under the sun or ‘smoking’ it with cigarettes over time. Thus the chosen title, ‘Ageing skin – Sun, smoking and seasoning’ is most appropriate.
Ageing is a natural process. People should age gracefully with gentle acceptance of the process of ageing. Nevertheless, not all can accept it as quickly as it happens. Thus, the hollows, folds, furrows, shades and shadows may cause anxiety, social phobia and depression and significantly compensate the quality of life of the sufferers.
Doctors should help those who need help without being too judgmental. Thus, the natural sprouting of aesthetic medicine within the scope of dermatology and family medicine is inevitable. If doctors who are the experts – responsible to care for the wellbeing of the human body and mind – refuse to practice aesthetic medicine such as injecting dermal fillers and botox for those who needed them desperately, then the vacuum would naturally be filled up by non-professionals who possess no ethical consideration and have very little knowledge about the human skin.
The recent natural development of aesthetic medicine as a subspeciality of family medicine, dermatology or plastic surgery over the past 20 years is indeed most appropriate and timely. It is a natural response to the emergence of new needs and demands in modern time.
My next column ‘Aesthetic medicine – Vanity or insanity’ will address this issue.
Dr. Victor Ti, MD, MFAM (Malaysia), FRACGP (Australia), Dip P Dermatology (UK), Dip STDs/AIDS (Thailand), Dip. AARAM (USA), LCP of Aesthetic Med.(Malaysia) is an experienced expat specialist generalist (Family Physician) of BH Clinic, Phnom Penh. As a specialist generalist, he is skillful at diagnosing all general diseases and excluding the sinister ones. Apart from the general diseases, Dr. Victor is also known for his skills in skin diseases, sexually transmitted diseases, minor surgery and aesthetic medicine. He can be contacted via messenger m.me/bhclinic1, Tel: 023900446 or Whatsapp: +60164122977