Much of ageing is actually skin deep — it happens most visibly in your skin and surface layers. A surgical and cosmetic dermatologist, Dr Ann-Maree Kurzydlo gives her secrets on slowing the ageing of your skin.
In my medical practice, one of the most common questions I’m asked is how to look younger and reverse the signs of ageing.
To answer that question, let’s take a step back and examine what actually makes us look older. As it happens, it’s mostly skin deep. Changes occur in our skin and underlying fat layer that show the sum of years on our face. Skin changes that we equate with ageing include wrinkling (breakdown of the scaffolding of the skin — collagen and elastin), pigmentation or brown spots, increase in pore size and open or broken blood vessels. We also gradually lose the underlying plump, youthful facial fat that pads the skin and fills in all the hollows and shadows.
Why does all this happen?
A number of factors drive the changes; some inevitable (age), some the genetic hand we are dealt (ethnicity and skin type), but some are within our control. Sun exposure easily tops that list and the ultraviolet (UV) radiation that kisses our skin in summer also secretly steals away our youth. Other lifestyle behaviours like diet, sleep and exercise routines also matter.
It seems everyone wants to look younger, and in Australia a 4 billion dollar a year cosmetic and beauty industry has blossomed to supply that desire. The magician’s box of techniques and tricks to rejuvenate the face includes lifestyle changes, creams, injectables like botox or fillers and laser or light energy, carrying through to the scalpel and surgery.
What we can do:
1. Wear sunscreen
The adage that prevention is always better than the cure is especially true when it comes to sun protection and the skin. Research shows that up to 90 percent of the changes we interpret as aged skin can be accounted for by chronic sun exposure, while genetics make a smaller contribution.
Wearing sunscreen daily (ideally 50+ broad spectrum) prevents the energy in UVB and longer spectrum UVA rays from creating uneven pigmentation and damaging collagen and blood vessels. While avoiding a worn, leathery skin, you also get protection from skin cancers and melanomas.
2. Eat well
What we eat is very important for keeping us looking our best, since our appearance reflects general health and wellbeing. A balanced diet should include plenty of fresh fruit and vegetables (the more colours the better), packed full of antioxidants, vitamins, trace elements and beneficial compounds like lycopene, anthocyanins, carotene and bioflavonoids. Fish, nuts and legumes offer omega-3 and -6 oils, which in the right balance are anti-inflammatory, mopping up damaging free radicals in our body. And limiting alcohol and drinking plenty of water keeps the skin well hydrated.
Maintaining a healthy body weight also helps, as it controls hormone levels. Oestrogen is stored in fat and benefits collagen synthesis and production of hyaluronic acid, a natural skin moisturiser. Excessive weight loss reduces the fat stores and oestrogen levels, which may make us look older.
3. Beauty sleep
A good night’s sleep makes us look fresher, but did you know that skin renewal is faster at night, peaking between 11pm and 4am? Quality sleep encourages cell repair and collagen regeneration, so be sure to get your 8 hours.
4. Regular exercise
We know exercise is great for your heart, lungs and mental outlook, but it’s also a key to healthy and vibrant skin. Exercise improves circulation and increases blood flow, carrying oxygen and nutrients to the skin while flushing away free radicals and waste from around skin cells. Sebaceous glands are activated, producing natural moisturising skin oils.
It will come as no surprise that stress ages us. Stress leads to increased cortisol levels and impairs the immune system, also generating internal inflammation. While meditation and relaxation are great at reducing stress levels, regular aerobic exercise is shown to be an excellent way to shake off all that tension, and your natural endorphins promote feelings of wellbeing.
5. Skin Care
Environmental pollutants, smog and dirt absorbed into our skin create free radicals that damage cells. Cleanse your face at the end of the day with gentle products suited to your skin type.
There is some evidence that using creams containing antioxidants may protect the skin from these ageing free radicals. Typically vitamin A, C, E and B3 (niacinamide) are recommended, along with beta-carotene and green tea extract.
Using a moisturiser improves the appearance of skin, especially as we age and oil production and skin hydration fall. For younger or more oily skin types, oil-free moisturisers may be better. Daytime moisturisers should contain sunscreen.
6. Age-defying creams
There are a dazzling variety of creams that promise eternal youth, but the best evidence exists for retinoids (retinoic acid). They’re clinically proven to reduce fine lines, pigmentation and improve skin appearance by stimulating collagen production. However, they can also cause sun sensitivity and mild irritation.
Older skin sheds dead cells and keratin more slowly, so gentle exfoliation with alpha or beta hydroxy acids (glycolic or salicylic acid) in the form of chemical peels can temporarily improve skin appearance.
7. Never smoke
It’s no news that smoking is bad for you. While heart disease and lung cancer is lurking on the inside, the effects on skin show up early and clearly. Research shows that every 10 years of smoking adds about 2-3 years to your visible age.
Nicotine reduces blood flow, oxygen supply and nutrients to the living skin, affecting cell renewal. There are over 4,000 chemicals in tobacco smoke that attack collagen and elastin, causing sagging and wrinkles. Think crows feet, puckered and lined lips and hollow cheeks. Add dry, flaky, sallow and dull-looking skin and you’ll be able to picture any long-term smoker.
The good news is that within six weeks of giving up smoking, the skin will benefit from increased oxygen and antioxidants, and looks visibly better.
8. Needles and light
Lines, folds and dynamic wrinkles (created by facial muscles) are best treated with a combination of Botox (botulinum toxin) and fillers. Injecting Botox into facial muscles relaxes them and smoothes out the wrinkles they create. Fillers can correct deeper lines and the facial volume loss that accompanies age. Lips thin with age and can be filled.
Intense Pulsed Light (IPL) and lasers target pigmentation, redness and prominent blood vessels. Fractionated laser resurfacing such as the Fraxel Laser Skin Resurfacing generates collagen and can improve wrinkling and pigmentation.
Ageing is natural, and written proudly on our faces is the story of our lives. The ghost of Ponce de Leon might still be searching for the fountain of youth, but the reality is that we can’t turn back the clock. But, with a little effort and some simple lifestyle changes, we might just be able to slow ageing down.
Dr Ann-Maree Kurzydlo is a Consultant Dermatologist and a Fellow of the Australasian College of Dermatologists. She has a degree in Nuclear Medicine and studied medicine at Newcastle University, graduating with Honours. She has had trained in areas such as emergency medicine, psychiatry and sexual health. Dr Kurzydlo specialises in general, paediatric, surgical and cosmetic Dermatology. She is an expert in all things health and beauty, and advocates a holistic approach to health care.