Wednesday, April 13, 2011

Growing Old Wrinkle Free


Oh no!  What's that staring you back as you look into the mirror this morning?  It couldn't be yet another tiny crinkle in your forehead determined to push you into senility could it?!  Wrinkles... the one thing that nobody wants more of especially in our modern day culture.  But is there anything we can do about it?  Why don't we find out as we turn you into an expert on the topic of wrinkles and how to prevent them.


The Basic Framework Of Our Skin

Our skin is the largest organ in our body and consists of 3 basic layers - epidermis, dermis, and subcutaneous layer (fatty tissue).

1)  Epidermis - The epidermis is the outer most layer of our skin and is the body's main barrier of
     protection from the environment [1].

2)  Dermis - The dermis is the middle layer of our skin and contains a number of essential items such as
     blood vessels, sweat glands, hair follicles, etc.  It also contains three very important structural
     components known as collagen, elastin, and glycosaminoglycans [1,2].
         -  Collagen is a protein that is responsible for providing support and strength for our skin.
         -  Elastin is a protein that allows our skin to resume its shape after being stretched or contracted
            much like a rubber band returns to its original form after being stretched out.
         -  Glycosaminoglycans (GAGs) are long chains of carbohydrates attached to a protein core.  Water
            loves to latch on to GAGs which is why they keep the skin plump, soft, and hydrated.

3)  Subcutaneous layer (hypodermis) - Underneath the dermis is a layer of fatty tissue called the
     hypodermis or subcutaneous layer.  It supplies our skin with blood vessels and nerves along with
     providing padding and insulation.


How Do Wrinkles Form?

Skin, like many other cells and tissues in the body, tends to break down and even die over time.  This is quite normal.  When this happens our body does what any good mechanic would do when trying to fix a broken or damaged vehicle - it repairs or replaces the older parts with newer ones.  This makes sense right?  This whole process happens on a daily basis without us even knowing it and for the first few decades of life this isn't a problem.  However, over time our body sustains an increasing amount of free radical damage and is less able to effectively carry out this rebuilding process and repair our damaged skin.  Hence, the formation of wrinkles as we enter our middle ages and beyond.

Let's break this down a little further to help you understand exactly how different components of our skin are affected over time and ultimately end up wrinkling:

-  The epidermis is less able to repair itself over time and actually becomes thinner [3,4].
-  Collagen will become more sparse and less soluble which weakens the dermis layer [5,6].  Remember 
   that collagen acts as the building blocks of our skin to provide it with strength and support much like 
   bricks and mortar do when building a home.  So if our "bricks and mortar" start to crumble you can 
   only imagine what that does to our skin.
-  Elastin is degraded slowly over time and also accumulates damage.  In fact, as we age and the body 
   tries to regenerate new elastin it often makes disfigured elastin fibers.  This happens mostly in areas of 
   the body that have had a lot of sun exposure like our face, hands, and feet [6].  Consequently, our skin 
   is less able to return to its original shape after being expanded or contracted.  You may be able to
   better picture this scenario by thinking of what happens to an old, dried out rubber band when you 
   stretch it.  It's not able to spring back to its original form after it's expanded.
-  Glycosaminoglycans are less able to hold onto water which leads to dehydrated skin that doesn't 
   remain soft and plump like it once used to [6].
-  Fatty tissue (subcutaneous layer) tends to decrease with age particularly in the face, hands, and feet 
   while increasing in areas such as the belly and thighs [4,6].  This is part of the reason why our 
   bellies and thighs don't wrinkle as much as we get older and our face and hands do.  If you ask me our 
   face and hands definitely get the raw end of the deal don't you think?

In addition to the above, there are a few other important factors that act to increase wrinkling.  Repeated facial expressions over many years such as squinting, frowning, and smiling will cause permanent creases or folds in your skin.  Smoking and sun exposure also increase the prevalence of wrinkling.  In fact, smoking has been shown to lead to almost a five fold increase in premature wrinkling while excessive sun exposure has shown to triple the incidence of premature wrinkling [7].  Geezz!  Those aren't very good odds.

Postponing Your Date With Wrinkles

Now that you know what causes wrinkles the more important question is how can we prevent them from happening in the first place.  Although wrinkle formation is inevitable there are many things that can be done to prolong your youthful appearance.  I'll focus on three of the most important things you can do to prevent wrinkles.

1)  Reduce Exposure to Ultraviolet (UV) Radiation
     -  UV light exposure is definitely not a friend of collagen fibers.  Not only does it speed up the 
        breakdown of current collagen fibers but it inhibits the formation of new collagen [8].  This is 
        largely due to the formation of free radicals when your skin is exposed to UVA and UVB light 
        which damages your DNA [9].
     -  UVB exposure also decreases a substance called hyaluronic acid which is a key glycosaminoglycan 
        (GAG) responsible for keeping your skin moisturized [10].  Remember that water loves to latch 
        onto GAGs which is how your skin stays both hydrated and soft.  So if UVB exposure is wiping 
        out a good portion of your GAGs then it makes it tough to keep your skin moist, soft, and wrinkle 
        free.
     -  UV exposure also increases your risk of skin cancer which is mainly due to UVB light [11].
     -  Your best bet is obviously to avoid excessive sun exposure if possible.  However, if you do plan on 
         being in the sun then remember to put on your sunscreen.  Also, do not use tanning beds -
         ever!  The short lived tan that you get isn't worth the risk of cancer and shriveled up skin later on in 
         life.

2)  Stop Smoking
     -  Smoking has also been shown to decrease the production of new collagen which once again 
        weakens the cellular support structure of your skin [12].  In addition, smoking was also shown to 
         increase the breakdown of collagen already formed in the skin [13].
     -  The formation of abnormal elastin fibers along with the destruction of current elastin has also been 
         linked to smoking [13].
     -  Smoking also increases the formation of free radicals which cause oxidative damage to the 
        connective tissue found in your skin along with increasing your risk of cancer [13].
     -  Your best bet is to simply quit smoking or never start if you haven't already.  It's never too late to 
        put out that cigarette and your skin will thank you many times over.  If you need help quitting check 
        out the many resources available to you on my smoking cessation page - Butt Out.

3)  Eat a Nutrient-Dense, Plant-Based Diet
     -  Many people may have never considered how beneficial eating healthy, antioxidant rich foods can 
        be for your skin but after learning how they work it will make perfect sense to you.
     -  You've read a lot of information from above about how free radicals can cause all kinds of 
        oxidative stress and damage to your skin.  This damage is a quick ticket to wrinkles, wrinkles, and 
        more wrinkles.  But beneficial compounds called antioxidants are here to save the day!  How is 
        this you ask?  Because antioxidants act like little scavengers going around and gathering up all 
        those free radicals to render them harmless in the body [14].  And the more free radicals you 
        demobilize the less damage and distress to your skin cells which means younger looking skin.
     -  The best way to load up on antioxidants is to adopt a plant-based diet filled with vegetables, fruits, 
        legumes, whole grains, and nuts/seeds.  After all, when is the last time you heard your doctor or 
        dietitian talk about how abundant antioxidants like beta-carotene or vitamin A and C or selenium or 
        even polyphenols are in steak and chicken?  That's because they aren't.  These substances can
        only be found in generous, health promoting amounts in plant-based foods.  That's why it's 
        essential to have a diet based on these foods if you want to promote youthful, wrinkle free skin for 
        many years to come.
     -  A study published in 2010 in the British Journal of Nutrition looked at diet and skin aging.  After 
        the researchers accounted for differences in age, smoking status, BMI, and lifetime sun exposure 
        there was still a clear link between eating low-fat, plant-based foods and a decrease in wrinkling.   
        Those individuals who ate the most green and yellow vegetables had a significant decrease in their 
        wrinkling score as opposed to those who ate a diet high in saturated fat [15].  Saturated fat is found 
        in much larger quantities in animal-based foods (meat and dairy), oils (even olive oil), and 
        processed foods.  Needless to say, it stands to reason why you would want to stick to a plant-based 
        diet and avoid high fat foods if you want to do what's best for your skin.  To learn more about fat 
        content in your diet visit my page on Fat Fundamentals.
     -  Multiple studies have found that dietary antioxidant vitamins, minerals, and phytochemicals such as 
        carotenoids, tocopherols, and flavonoids have demonstrated a protective effect against
        sun exposed skin damage [16,17].  These substances are found in abundance in plant-based foods.
     -  A class of antioxidants known as anthocyanins found in blueberries and other purple fruit has been 
        shown to reduce the breakdown of collagen due to damage cause by UVB sun light exposure [18].
     -  Another powerful fruit, pomegranate, is rich in antioxidants called phenolic compounds.  This 
        health promoting fruit has a number of beneficial effects on aging skin.  First, it actually helps 
        thicken the skins outermost layer (epidermis).  Second, it promotes the growth of new collagen 
        fibers and also prevents current collagen fibers from being broken down [19].
     -  Green tea has also been shown to be protective against ultra-violet radiation induced skin 
        inflammation and damage.  The antioxidant group known as polyphenols are responsible for these 
        beneficial effects in green tea [20].

Conclusion

Wrinkling doesn't seem to be anyone's friend but, unfortunately, is inevitable as we age.  The many different components that make up the multiple layers of skin eventually breakdown and wear out causing those unwanted folds and creases we find staring back at us in the mirror every morning.  While we can't escape this phenomena, we can choose to adopt or break certain behaviors and habits that will accelerate this process.  By reducing our lifetime exposure to UV light, avoiding smoking, and eating a nutrient-dense, plant-based diet we arm our skin with the best defenses available to prevent those pesky, little lines from forming in the first place.  I hope you've found this information helpful and may you have healthy, youthful looking skin for many years to come. 







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Clinical Pharmacist

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References:
1 Marks JG, Miller J. Lookingbill and Marks' Principles of Dermatology (4th ed.). 2006. Elsevier. pp. 1-9.
2 McGrath JA, Eady RA, Pope FM. Rook’s Textbook of Dermatology (7th ed.). 2004. Blackwell Publishing. pp. 3.1–3.6.
3 Balin AK, Pratt LA. Physiological consequences of human skin aging. Cutis. 1989 May;43(5):431-6.
4 Fenske NA, Lober CW. Structural and functional changes of normal aging skin. J Am Acad Dermatol. 1986 Oct;15(4 Pt 1):571-85.
5 Uitto J. The role of elastin and collagen in cutaneous aging: intrinsic aging versus photoexposure. J Drugs Dermatol. 2008 Feb;7(2 Suppl):s12-6.
6 Waller JM, Maibach HI. Age and skin structure and function, a quantitative approach (II): protein, glycosaminoglycan, water, and lipid content and structure. Skin Res Technol. 2006 Aug;12(3):145-54.
7 Kadunce DP, Burr R, Gress R, et al. Cigarette smoking: risk factor for premature facial wrinkling. Ann Intern Med. 1991 May 15;114(10):840-4.
8 Rittié L, Fisher GJ. UV-light-induced signal cascades and skin aging. Ageing Res Rev. 2002 Sep;1(4):705-20.
9 Sanders CS, Chang H, Salzmann S, et al. Photoaging is associated with protein oxidation in human skin in vivo. J Invest Dermatol. 2002 Apr;118(4):618-25.
10 Rock K, Grandoch M, Majora M, et al. Collagen fragments inhibit hyaluronan synthesis in skin fibroblasts in response to UVB: New insights into mechanisms of matrix remodelling. J Biol Chem. 2011 Mar 17. [Epub ahead of print]
11 Emri G, Horkay I, Remenyik E. The role of free radicals in the UV-induced skin damage. Photo-aging. Orv Hetil. 2006 Apr 23;147(16):731-5.
12 Morita A, Torii K, Maeda A, et al. Molecular basis of tobacco smoke-induced premature skin aging. J Investig Dermatol Symp Proc. 2009 Aug;14(1):53-5.
13 Morita A. Tobacco smoke causes premature skin aging. J Dermatol Sci. 2007 Dec;48(3):169-75.
14 Bonnefoy M, Drai J, Kostka T. Antioxidants to slow aging, facts and perspectives. Presse Med. 2002 Jul 27;31(25):1174-84.
15 Nagata C, Nakamura K, Wada K, et al. Association of dietary fat, vegetables and antioxidant micronutrients with skin ageing in Japanese women. Br J Nutr. 2010 May;103(10):1493-8.
16 Shapira N. Nutritional approach to sun protection: a suggested complement to external strategies. Nutr Rev. 2010 Feb;68(2):75-86.
17 Sies H, Stahl W. Nutritional protection against skin damage from sunlight. Annu Rev Nutr. 2004;24:173-200.
18 Bae JY, Lim SS, Kim SJ, et al. Bog blueberry anthocyanins alleviate photoaging in ultraviolet-B irradiation-induced human dermal fibroblasts. Mol Nutr Food Res. 2009 Jun;53(6):726-38.
19 Aslam MN, Lansky EP, Varani J. Pomegranate as a cosmeceutical source: pomegranate fractions promote proliferation and procollagen synthesis and inhibit matrix metalloproteinase-1 production in human skin cells. J Ethnopharmacol. 2006 Feb 20;103(3):311-8.
20 Katiyar SK, Elmets CA. Green tea polyphenolic antioxidants and skin photoprotection (Review). Int J Oncol. 2001 Jun;18(6):1307-13.

2 comments:

  1. I also eat foods that contain PQQ antioxidant that helps prevent wrinkles as well and maybe a little dab of Mary Kay under eye wrinkle cream :)

    ReplyDelete
  2. I am trying to grow old gracefully and wrinkle free. I'm losing, obviously, but I am trying. I've cracked one and two - I will try the third one but I am not sure that it is something I will be able to stick with.

    ReplyDelete