Kathmandu The ageing of skin is a biological process which includes two types —chronological ageing and photo-ageing. Chronological ageing is an intrinsic factor which is an inevitable process, whereas photo-ageing is an extrinsic factor which involves premature aging due to UV rays. Ageing is inevitable and irreversible which occurs as a result of a genetic programme implanted in the genetic make-up of each species. With age the skin’s natural rejuvenation process slows and it becomes thinner, drier and less elastic. Skin ageing is influenced by several factors including genetics, environmental exposure (UV radiation, xenobiotics, and mechanical stress), hormonal changes and metabolic processes (generation of reactive chemical compounds such as activated oxygen species, sugars and aldehydes). The skin is exposed to ultraviolet (UV) irradiation, and to a lesser extent, to other DNA damaging agents such as cigarette smoke, automobile exhaust and professional exposure. All factors together act on the alterations of skin structure, function and appearance. Yet solar UV radiation unquestionably is the single major factor responsible for skin ageing. Collagen is the main structural protein of the skin. In older skin, collagen looks irregular and disorganised and the overall collagen content per unit area of the skin surface is known to decline approximately one per cent per year. Reduced content of collagen type VII (Col-7) may contribute to wrinkles by weakening the bond between dermis and epidermis of extrinsically aged skin. Ageing of the face is associated with gravity impact, muscles action, loss of volume, diminishing and redistribution of superficial and deep fat, loss of bony skeleton support. These lead to face sagging, changes in shape and contour. The desired therapeutic anti-ageeng effect of the skin is continuous, step-by-step process, which combines various methods of the skin bio-revitalisation and rejuvenation, augmentation, restoration of each skin layer individually and in the light of many other factors — from a style of life to the immune, genetic, emotional and health status. The mainspring of any skin anti-ageing therapy is to achieve a healthy, smooth, blemish-free, translucent and resilient skin. Eat healthy Vitamin C is crucial to the formation of collagen because without it amino acids cannot be linked to form the protein. Good sources are red pepper, dark green leafy vegetables like broccoli and sprouts, tomatoes, oranges and kiwi. Skincare that contains Vitamin C is also thought to encourage collagen repair (it’s usually listed on the label as L-Ascorbic acid, ascorbyl palmitate or ascorbyl phosphate). Antioxidants help protect against free radicals that can cause skin ageing. Food rich in antioxidants include grapes, blueberries, nuts, dark green and orange vegetables and green tea. According to Dr Patricia Farris (co-author of The Sugar Detox: Lose Weight, Feel Great and Look Years Younger) eating too much sugar can be a beauty disaster. It causes premature ageing of the skin by a process called glycation. This is where excess sugar in the blood attaches itself to lipids, nucleic acids and proteins (especially your collagen) to form “advanced glycation end products” or AGEs, which accelerate the ageing process hence causing wrinkly skin. Smoking creates enzymes called matrix metalloproteinases (MMPs) which damage the collagen in your skin, hence the tell-tale sagging which many smokers is betrayed by. Don’t stress yourself In many ways, the mind and the skin are intimately intertwined. You name it — acne, eczema, hives, psoriasis, hair loss and many skin disorders like premature ageing take their roots from or place their roots in the psyche. When you are tense, your body releases stress hormones including cortisol, which may increase the skin’s oil production, making you prone to pimples. Additionally your anxiety over ageing could be causing wrinkles, zits and blotchy spots. Sun protection and moisturisers Sun exposure is a prime suspect for hastening collagen loss. UVA rays penetrate deep into the skin and damage the deep collagen. While selecting a sunscreen, select one that offers SPF 30 (or higher), broad spectrum (both UVB and UVA) and water resistant. Be sure to reapply your sunscreen every two hours when you are outdoors. An anti-aging moisturiser helps to minimise fine lines. Purchase anti-ageing night creams with retinoids. Retinoids are the derivative of Vitamin A and have been proven to help boost collagen production. Retinoids reduce substances in the skin that break down collagen after sun exposure and also target receptors in the skin which increase the production of collagen. However, exaggerated promises like look 10 years younger overnight or quickly reduces all signs of aging are too good to be true. It is important to remember that anti-ageing skin care products deliver modest results. If you want your wrinkles and fine lines to disappear, you can always choose Botox. Botox is a medicine which will help you look years younger. In recent years, it has become a popular choice of wrinkle treatment for women between 25-65 years of age. Another treatment you can do to make your skin look healthy and flawless is to exfoliate. Exfoliation is the process of removing the top, dead layers of the skin. It helps speed up the natural process of skin and collagen renewal. One of the best ways to exfoliate is with chemical exfoliants such as glycolic acid and salicylic acid. They dissolve the glue-like substance that bonds dead skin to the surface rather than sloughing it away like scrubs does, and gives a more even result, leaving skin looking healthier and more radiant. (Dr Jebina Lama is a Consultant Dermatologist and Dermato-Laser Surgeon at the Norvic International Hospital, Kathmandu)