We have all heard the fairy tale of a prince who finds the ‘fountain of youth’. But even though our lives aren’t fairy tales, it doesn’t mean that we cannot dream of looking young and youthful for a long long time, even if not for ever. Whoever said that 40 is the new 30 was not lying after all.
That said, modern living has its own perils. One of the significant side effects of our lifestyle, or lack of a healthy one, is premature skin ageing in people as young as in their 20s. One day you wake up, look into the mirror and you see fine lines, wrinkles, and dull, dehydrated skin with a lot of sagging and you start thinking about a facelift. Nightmare isn’t it? But don’t you worry, with this article I shall explain the science of skin ageing and exactly what you can do to delay it and that facelift surgery.
Typically, when someone comes in for an anti-ageing consult, I begin by explaining to them as to what really happens to our skin as we age. Our skin is not just the layer that we see on the outside. That’s just one layer of our skin. From our facial bones to our skin and all the soft tissue, fats and muscles in between, there are up to seven layers. And each of these layers contributes differently to our ageing face.
However, to make matters simpler, there are two critical elements in these layers that are responsible for maintaining the youthful appearance of our face. One of the elements is hyaluronic acid. It is a naturally occurring sugar polymer. Its function is to hold water and add suppleness and internal moisture to the skin. The second is collagen. It is like a scaffolding around which all the layers of the face rest.
So, as we age, there is depletion of these two vital elements. While reduction of hyaluronic acid is visible in terms of poor skin quality, lack of sheen and brightness and overall roughness and wrinkling of skin, it’s the loss of collagen that makes the skin go loose and look saggy and haggard. So most of our skin anti-ageing strategies are based upon preventing the decay of collagen and hyaluronic acid and upon boosting them wherever needed.
Broadly speaking, there are two kinds of factors that cause skin ageing:
Internal factors or Intrinsic factors: These mainly pertain to our genetics which we inherit from our parents. And there isn’t much you can do about it.
External or Extrinsic factors: These are the factors which impact our bodies and also our skin from our environment and our lifestyle. It’s these extrinsic factors we are more focused about because even though you might have great genes that afford you the luxury of looking youthful without much effort, if you don’t take care of your skin and external factors, your skin can still age quite badly and rapidly.
The good news about these extrinsic factors is that most of these are totally modifiable and very much in our own control. Key extrinsic factors include diet, lifestyle, sleeping patterns, stress management, sun and light exposure, and physical activity.
With all of this knowledge, how do we actually go about delaying the ageing of the skin? There are three important pillars to any antiageing strategy. They are:
- Lifestyle modification,
- A good skincare routine, and
- Good skincare treatments. Here we shed some light on each of these pillars.
Lifestyle modification
I get a lot of queries these days from a lot of younger people who drop in for anti-ageing consultation. One of the common questions I hear is: ‘Why is my skin ageing so fast while my mom still has such great skin?’ Well, the answer is fairly straightforward. Lifestyles have changed significantly over the last few decades. There are some common lifestyle issues that I have identified that contribute to faster ageing. Here are the important ones.
Dietary factors: Excessive intake of sugar, fast food and processed food generates a lot of free radicals in our body. These free radicals then attack our cells and cause more breakage of collagen and hyaluronic acid. Therefore, we need more of antioxidants in our diet to combat these free radicals. Cutting down on sugar and junk food is the first step towards delaying skin ageing. Locally grown and available fruits, vegetables and seeds are great sources of antioxidants.
Sleep hygiene: Our body has something called a ‘circadian rhythm’ or the body clock. If we don’t sleep well, this body clock gets disrupted. It affects all the hormones and the body processes and contributes towards skin ageing. Therefore, proper attention should be given to get a good sound sleep for at least six-eight hours in the night.
Mental health: Your skin easily reflects your state of mind. Given how stressful life is, it’s important to counteract stress and mental well-being by engaging in mindfulness and centering yourself. Chronic mental stress triggers skin ageing.
Physical activity: Engaging yourself in physical exercises releases a lot of endorphins or happy hormones. These hormones counteract the damage caused by mental stress as well. Not just that, physical activities boost metabolism and thus help to reduce free radical damage to our skin.
Smoking, alcohol and drugs: Smoking, vaping, excessive alcohol consumption and recreation drugs are easily one of the fastest ways you can cause damage to your skin and make it age faster.
In the same breath, I would encourage everyone to take stock of their physical and mental health periodically and seek professional help from nutritionists, doctors and mental health professionals in order to have a holistic balance.
Lifestyle is an important factor determining how one’s skin will look. Regular physical activity, a proper sleep routine and good mental health help keep the skin in good shape
Good skincare routine
A care routine for your skin health is just how a workout is for your body. It doesn’t have to be excessive, but it has to be right and it has to be consistent, with all my stress being on the word ‘consistent’. Skincare can be confusing, especially with an explosion of information that’s there on social media. What I would recommend is to begin with a basic skincare routine that consists of a good cleanser, moisturiser, sunscreen and just one anti-ageing serum or cream.
While the holy grail of antiageing routines has been retinol, caution must be executed while using any retinol-based products. Retinol is great, it helps to set skin cell turnover time and, therefore, helps skin to renew itself properly. But excessive use of retinol can also cause a lot of dryness, flaking of skin, redness and irritation. Therefore, it is prudent to start retinol slowly, for short contact time, and maybe just once or twice a week. Other anti-ageing skincare ingredients include actives such as vitamin C, glycolic acid, azelaic acid, and so on, which help to exfoliate skin and even help with pigmentation. It is, however, advisable to start with these products only after a thorough consultation with your dermatologist.
It’s needless to say that sunscreen forms the basis of a good skincare routine. If you aren’t protecting your skin from UVA, UVB, visible light and infrared light, any skincare routine becomes useless. Therefore, having a broad spectrum sunscreen and using it frequently throughout the day is most important.
Adding multivitamins, antioxidants and collagen boosting supplements can also aid in delaying skin ageing.
Good treatments
Skincare treatments are in vogue. I mean chances are high that you have heard about things like chemical peels, vampire facials, laser toning, HIFU, Botox and fillers if you have ever googled anti-ageing skin treatments. So let me make them simpler for you. There are various categories of skin treatments. They are as follows.
Treatments for skin exfoliation and skin renewal: Chemical peels, medifacials, laser resurfacing.
Treatments for collagen production: Vampire facials, microneedling, HIFU and RF skin tightening.
Treatments for hyaluronic acid replenishment: Skin boosters.
Treatments for wrinkles: Microneedling RF, anti-wrinkle injections like Botox and Dysport.
Treatments for sagging skin and volume loss: Fillers and threads.
When to start
What’s the right age to begin with anti-ageing treatments? You can begin as early as in your 20s. The first sign of ageing starts as early as in the 20s. But you don’t need everything all at one go. While we do try to give you a customised treatment plan, I would recommend the following age-wise treatment strategies.
20s: Chemical peels, medifacials and skin boosters for hyaluronic acid replenishment.
30s: Chemical peels, medifacials, skin boosters, vampire facials and preventative anti-wrinkle injections like Botox.
40s: All of the above plus skin tightening devices like HIFU and RF (for collagen stimulation), anti-wrinkle injections and fillers.
50s and above: All of the above.
However, not everyone needs the anti-ageing treatments and not everyone needs all the antiageing treatments. Remember, the treatments are not bad, but outcomes and handling of those outcomes depend upon who you choose to do them with. So choose wisely and don’t get fooled by lucrative offers and unrealistic expectations of results. Please discuss the treatments in detail with a trusted dermatologist and plastic surgeon only.
To conclude, if you like what you see in the mirror and you are happy with it, then just stay how you are. However, if that line, that sag bothers you, don’t be shy to start your anti-ageing journey today. The first step is to improve your life and lifestyle, the second step is to fix a good skincare routine and the third step is to start an anti-ageing treatment. You are never too young or too old to start caring for your skin.
Dr Ishad Aggarwal
Dr Ishad Aggarwal, MD, is a consultant dermatologist. He is also a skin, laser and aesthetic medicine expert and a trainer for Botox and fillers. His Instagram handle is @skindoc_ishad