With time the thickness of our skin gradually reduces to become thinner in the structural dermal layer.
Newer skin care regimes aim to replenish and renew this layer. With the loss of collagen and elastin, the skin becomes less flexible and conforming. Wrinkles result from these age-related changes as well as the repetitive movement of underlying muscles. Sun damage and exposure accelerates these changes and also alters the pigment distribution. Sun spots begin to be pronounced and obvious, ranging in size and colour.
Skin care is a long-term commitment. Daily application of active ingredients is needed to reverse and then maintain age-related changes. It may take three to six months to see these changes as a few skin cycles are required to optimise the results.
There are many active skin care products. Retinol is related to vitamin A. As a stimulating agent, it has been shown to increase collagen and lighten pigmentation. Rebuilding collagen smoothes fine lines.
These exfoliate the skin with smoothing and increased cell turnover. It is an acidic compound and needs to be fairly strong to gain the benefits. Combined with retinols the effect is complementary and additive. Both compounds also increase sun sensitivity so a broad spectrum sunscreen is essential. Some products combine the sunscreen with moisturiser.
These complement a skin care range. Commonly used antioxidants include vitamin C, copper and manganese. These all protect from sun, environmental damage and smoking-induced free radicals. Vitamin C also helps collagen production, a basic skin building block. Copper helps with skin repair and healing.
Niacinamide or vitamin B17 decreases the immunosuppression caused by sun exposure. This may help reduce the risk of skin cancers by allowing skin cells to combat these changes.
Broad spectrum sunscreens and sunblocks are essential in any skin care regime. These should be used on a daily basis. The spectrum of cover must include UVA and UVB. The sun protection factor (SPF) needs to be 15 or greater.
These individual components may be combined in skin care products to allow ease of application and save time. Another advantage is the components are synergistic in their effect.
Many over-the-counter or commercial skin products have the active ingredients listed but are in too low a concentration to have the desired effect. The trends are moving towards stronger, doctor prescribed preparations used under medical supervision. These are used at the maximum concentration tolerated by your skin. Individualised programs are designed on a daily or alternate day basis. Mild tingling or stinging is common at these concentrations but these stronger doses accelerate the results. Reactions can occur but are rare.
An example of a program would be a daily skin cleansing, exfoliation (alpha hydroxyl acids), skin stimulating agent (retinol) with antioxidants (vitamin C, copper or manganese). These are used morning and night. Newer products also contain niacinamide. This is complemented by effective and daily sunscreen. General healthy lifestyle factors of diet, exercise, sleep and avoiding smoking, also help.
Always choose your plastic surgeon carefully, making sure they are Members of The Australian Society of Plastic Surgeons and have full surgical training. This is guaranteed by being Fellows of the Royal Australasian College of Surgeons, the only body recognised for training surgeons, and having the letters ‘FRACS’ after their names.
Dr. John Kippen is a practising Plastic, Cosmetic and Reconstructive Surgeon and a Member of the Australian Society of Plastic Surgeons. Dr. Kippen has surgeries at Mona Vale, Brookvale and Wahroonga.
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