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What does science say about our aging faces?

posted 2018 May

Brett Kotlus MD 

NYC Cosmetic and Oculofacial Plastic Surgery

The first signs of facial aging are subtle but definite. Aging usually starts around the eyes because your eyelid skin is very thin and constantly moving.  You may notice that the smile lines or “crow’s feet” radiating from the outer corners of your eyes are just barely noticeable even when you’re not smiling, as if they were faintly etched in your skin.

Sun exposure further accelerates these early changes but it also creates increased pigmentation which can be uneven and unwanted.

At some point in your life, you will probably feel there is discordance between the way you want to look and the way you actually look. There is nothing wrong with wanting to hold onto that idealized image of yourself, as long as you maintain a realistic self-image (meaning you shouldn’t expect to look 20 when you are 70).

Fortunately, measures can be taken within the framework of natural senescence that can shift your apparent age to the more youthful side of the spectrum. You can adjust your environment, your behaviors, and even the cellular structure of your body to extend your youthful appearance by many years.

The most important thing you can do right now

The most important anti-aging action you can take is to wear sunscreen every single day.

You should be very diligent about this throughout your life.  If you didn’t  pay much attention to sun protection in your teens and 20’s, you should start now, even if you have a darker skin type. The ultraviolet radiation emitted by the sun leads to a process called solar elastosis. This consists of degradation of collagen and elastin in the deep skin layer called the dermis. Loss of the building blocks of the skin causes acceleration of wrinkles and sagging.

A 2013 Australian study published in the Annals of Internal Medicine followed 900 people from ages 20-55 to test the effects of sunscreen on facial aging. Half of them were asked to wear sunscreen every day and the other half were asked to just follow their usual routine. After 4½ years, the sunscreen users were shown to have halted the appearance of skin aging. UV protection can actually stop your face from aging.

Skin Vitamins

A proven way to reduce the earliest signs of facial aging is to use a topical antioxidant. Vitamin C, a potent enemy of free radicals, has been shown to reduce wrinkles and repair skin damage caused by sun exposure. It is a required factor for collagen synthesis and it protects the skin from UVA and UVB damage. It also inhibits the production of melanin (pigment) in the skin, so it can reduce the visibility of brown spots caused by sun damage.

There are different forms of vitamin C found in skin products and not all are equal. L-ascorbic acid is a potent form of vitamin C. However, l-ascorbic acid is sensitive to heat, air, and light and is subject to degradation. As the product oxidizes or breaks down, it turns brown; a sign that it may no longer be useful. It should be kept in a cool,dark place and once it is turning brown, you should get a replacement.

Another clinically-proven method of wrinkle reduction and prevention is topical vitamin A. Effective forms of this vitamin in skin products are called retinol or tretinoin. It works by increasing glycosaminoglycan production in the skin which acts to retain water and promote hydration and suppleness. Glycosaminoglycans are long chains of sugars that bind water molecules. Vitamin A also increases skin collagen, reducing wrinkles and improving the overall thickness of the skin. Type 1 collagen is the major structural component of the dermis. Generally, having more collagen results in smoother skin.

Beyond your home skincare regimen

If you’re doing everything you should be doing at home with your skin care but you are someone who wants to be vigilant about looking like your youngest self, you should consider botulinum protein injections.  Also known as the trade names Dysport, Botox, and Xeomin, these products are administered in a medical office and they reduce the strength of the facial muscles responsible for expression wrinkles and creases.

If you an expressive person, you may eventually develop “11” lines between your eyebrows or “crow’s feet” at the outer corners of your eyes when you smile.  When performed by an expert, these neuromodulating agents don’t make you look frozen or unnatural, they simply make you look softer and smoother. 

Studies have shown that when your scowl and frown muscles are relaxed you’re less likely to experience the emotions that accompany those expressions.  Just like when you smile and it brightens your mood.

My philosophy

You are never too young to start thinking about wrinkle prevention.  Because your expressive eyelids frame your glimmering eyes and your skin is the beautiful wrapper that packages your beautiful body, why wouldn’t you want to take care of them? I have a lot of patients in their 70’s and I never heard one say they took too much care of their skin. I have heard many of them say they wished they protected themselves better from the sun and maybe they wouldn’t have so many wrinkles or occurrences of skin cancer. The days of slathering baby oil on your face and laying out in the sun with a reflector are over. If you start an effective anti-aging plan today, you may avoid or postpone a surgery or laser procedure many years from now.

A youthful face is attractive. Research shows that attractive people are more successful in business. People who feel attractive tend to have more self-confidence. Now is the best time to look and feel healthy.