After a period of perfect renewal, in humans between 20-35 years of age, there is a gradual declining ability to respond to stress, increased homeostatic imbalance and increased risk of disease. This irreversible series of changes is inevitable for life. Death is the ultimate consequence. “Old age” is not scientifically recognized as a cause of death because there is always a specific proximal cause, such as cancer, heart disease or liver failure. This is what we call senescence.
Life is about such changes and skin is the proof of aging and is at the mercy of many forces as we age. Intrinsic ageing is due to various factors like genetics, apoptosis, wear and tear, free radicals, hormonal decline, accumulation of waste products etc. Many of the conditions cannot be intervened, though some may be modifiable. But could we expand the lifespan? Maybe or maybe not! But each species has its own prescribed life period too. With modified healthy lifestyle and measures, like modified food habits, carbohydrate restriction, exercise, stress reduction, good sleep, bio-identical hormone corrective measures, antioxidant supplements etc., quality of life can certainly be improved with a low probability of diseases and disability with high cognitive and physical functional capacity.
The ageing of the skin (external) is seen vividly. 80% of the cause is contributed by photodamage. Other important causes are smoking, stress, poor nutrition, environmental pollution etc. Dry skin, fine lines and wrinkles, freckles, skin tags, red spots, pigmentations, telangiectasia, atrophy, laxity, and premalignant cutaneous conditions are the signs of ageing skin. Many of these conditions can be prevented. Many are treatable or at least modifiable.
Management of ageing skin includes measures to prevent UV damage and medications and procedures to reverse existing damages. Sunscreens, topical retinoids, peptides, and vitamin C are used with good results. Systemic and topical antioxidants have variable results. Various rejuvenation procedures like chemical peels, botox, facial fillers, radio frequency, lasers and other light systems are giving excellent results. Perhaps these may be a booming medical industry.
Dr. Karam Lokendro