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Saving face

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Skin changes such as wrinkles and sagging are among the most visible signs of ageing. To an extent, such changes are an inevitable part of growing old-the result of ‘intrinsic’ (internal) factors beyond our control that include genes and changes in hormone levels over time.

However, research shows that the vast majority of skin ageing is due to ‘extrinsic’ (external) factors, such as sun exposure, smoking, poor nutrition, environmental pollution and stress. These are factors that we can do something about and, ultimately, our understanding of them is the key to keeping our skin young- and healthy-looking for longer.

Sun exposure

Although sunlight is undoubtedly good for us, when it comes to our skin, overexposure to the sun is its number-one enemy. Ultraviolet (UV) radiation from the sun is by far the most important factor in skin ageing, especially its premature ageing. In fact, ‘photoageing’, as it’s known, is estimated to account for up to 90 per cent of all visible skin-ageing (Int J Cosmet Sci, 2008; 30: 87-95).

Both ultraviolet A (UVA) and B (UVB) radiation are responsible, but UVA penetrates more deeply into the skin and, thus, is able to damage both the epidermis-the outermost layer, made up of skin cells, pigment and proteins-and the dermis-the next layer in, made up of collagen and elastin fibres (Acta Dermatovenerol Alp Panonica Adriat, 2008; 17: 47-54).

The tell-tale signs of photoageing include wrinkles, sagging, dry or rough skin, age spots, spider veins and actinic keratoses-thickened wart-like, rough, reddish-brown to blackish patches of skin (Coll Antropol, 2008; 32 Suppl 2: 177-80). Most at risk are those of us who live in sunny climates, spend a lot of time outdoors and have fair skin (Arch Dermatol, 2002; 138: 1462-70).

The most obvious plan of action is to protect the skin with a sunscreen. Indeed, UV filters are now found in numerous everyday cosmetic products such as makeup, moisturizers and hand creams. However, several sun-screen chemicals are linked to adverse effects, such as hormone disruption and allergic reactions (see WDDTY vol 19 no 3).
A safer option is to use products that contain physical filters, such as zinc oxide and titanium dioxide, rather that chemical filters. These agents are capable of reflecting both UVA and UVB rays and, as they don’t penetrate into the skin, they are unlikely to have toxic/allergic effects (Acta Dermatovenerol Alp Panonica Adriat, 2008; 17: 47-54).

Even better, look for products that contain antioxidants such as vitamins C and E, and coenzyme Q10, as these natural free-radical fighters play an important role in protecting the skin against UV-induced damage (Curr Probl Dermatol, 2001; 29: 157-64). One 16-week study found that twice-daily application of a cream containing antioxidants provided protection against UVB-induced oxidative stress in the epidermis, a crucial factor in skin ageing (Photodermatol Photoimmunol Photo-med, 1999; 15: 115-9). Another revealed that the topical application of coenzyme Q10 was effective against UVA-induced oxidative stress in the skin, concluding that “CoQ10 has the efficacy to prevent many of the detrimental effects of photoaging” (Biofactors, 1999; 9: 371-8).

Antioxidants taken internally may also be beneficial. Taking supplements, or including plenty of antioxidant-rich foods in your diet, can bolster the skin’s natural defences against sunlight (see below).

Other ways to protect yourself against the sun include avoiding exposure between 11am and 3pm, when the sun’s rays are strongest, and wearing protective clothing, such as a wide-brimmed hat and long sleeves, when you’re outdoors during the day. Also, be sure to avoid indoor tanning devices, which are another source of UV radiation.

Dietary factors

Nutrition is one of the most important factors involved in skin health and its condition. If the skin is not sufficiently nourished, it won’t be able to defend itself against external insults, such as the sun’s rays, that contribute to the signs of ageing (Dermatoendocrinol, 2009; 1: 271-4).

Indeed, an international study conducted in 2001 confirmed that the foods we eat can have a significant impact on the state of our skin (J Am Coll Nutr, 2001; 20: 71-80). Researchers at Melbourne’s Monash University studied 453 people living in Australia, Greece and Sweden to determine whether or not food and nutrient intakes were related to wrinkling of the skin in sun-exposed areas.

What they discovered was that a high intake of vegetables, legumes and olive oil appeared to be protective against developing wrinkles, while a high intake of meat, dairy and butter had the opposite effect. In particular, full-fat milk (rather than skimmed milk, cheese and yoghurt), red meat (especially processed meat), potatoes, soft drinks/cordials and cakes/pastries were all associated with extensive skin-wrinkling. Protective foods included leafy green vegetables, broad beans, lima beans, nuts, olives, dried fruit/prunes, cherries, grapes, apples and tea.

According to the researchers, these protective foods may have contributed to less skin-wrinkling because of their high contents of antioxidant vitamins and phytochemicals. Indeed, previous studies found that certain antioxidants and plant ingredients can protect the skin against UV radiation when taken as supplements, so high intakes of these nutrients would tend to lead to less wrinkling at sun-exposed sites.

The antioxidant vitamins C and E, the carotenoids beta-carotene and lycopene, and the proanthocyanidins, a group of flavonoids found in grape seeds and other plant sources, are just some of the nutrients that appear to have photoprotective effects (see WDDTY vol 19 no 3).

The Monash researchers also noted that sugar and sugar products can contribute to poor skin health through the ‘glycosylation of proteins’-when a sugar molecule attaches itself to a protein molecule-in the skin. This, in turn, can contribute to skin-wrinkling and photoageing, and might explain why foods such as soft drinks and cakes/pastries are associated with more wrinkling of the skin (J Am Coll Nutr, 2001; 20: 71-80).

A more recent study also reported

a link between diet and skin-ageing. Using data from the first National Health and Nutrition Examination Survey, UK researchers examined the associations between nutrient intakes and ‘skin-ageing appearance’ in more than 4000 American women aged 40-74 years. They found that having higher dietary intakes of vitamin C (from orange juice, citrus fruits, fruit juices and tomatoes) and linoleic acid (found in oils such as rapeseed and soybean oils, and in foods such as green leafy vegetables and nuts), and lower intakes of fats and carbohydrates, were associated with better skin-ageing appearances.
In fact, higher vitamin C intakes were associated with fewer wrinkles and less senile dryness (dry skin as a result of ageing); higher linoleic-acid intakes were associated with less of a likelihood of senile dryness and thinning skin; and higher fat and carbohydrate intakes were linked with a more wrinkled and thinning skin. These associations were independent of age, race, education, sunlight exposure, income, menopausal status, body mass index, supplement use, physical activity and energy intake (Am J Clin Nutr, 2007; 86: 1225-31).

In general, the evidence suggests that including plenty of antioxidant-rich fruit and vegetables in your diet is one of the best things you can do to save your skin.

Smoking and pollution

Cigarette-smoking is another important causal factor in skin ageing; so, if you need yet another reason to quit the habit, think of your skin. Smoking increases the quantities of matrix metalloproteinases (MMPs)-enzymes that break down the collagen, elastin fibres and connective tissue in the skin (J Dermatol Sci, 2007; 48: 169-75). These enzymes also cause oxidative stress, which impairs collagen production (J Investig Dermatol Symp Proc, 2009; 14: 53-5). The result of this double whammy is skin that’s old before it’s time.
Indeed, studies show that the longer you continue to smoke, the older you’ll look (Plast Reconstr Surg, 2009; 123: 1321-31).
Fortunately, just stopping smoking can have a rejuvenating effect on the skin. In a study of 64 women who took part in a nine-month stop-smoking programme, the results suggested that kicking the habit can dramatically reduce the biological age of your skin.
The women’s skin was assessed before and after the programme in terms of lines, pigmentation, elasticity, brightness and texture to establish its biological age. At the end of the programme, an average reduction of about 13 years in the biological age of the women’s skin was found whereas, at the beginning of the study, their skin had an average biological age of nine years older than their actual, chronological age (Skinmed, 2010; 8: 23-9). These results suggest that stopping smoking is an important way to prevent and even reverse the signs of skin-ageing.

Besides tobacco smoke, the air pollution from road traffic and other sources can also have a negative impact on the skin. A recent German study of 400 elderly women found that air-pollution exposure was significantly linked to extrinsic signs of skin ageing and, in particular, pigment spots. An increased exposure to soot and particles from traffic was associated with 20-per-cent more pigment spots on the forehead and cheeks. Back-ground particle pollution that was not directly attributable to traffic was also positively associated with pigment spots on the face (J Invest Dermatol, 2010 Jul 22; Epub ahead of print).

While it’s impossible to completely avoid air pollution, increasing antioxidant intake can boost the skin’s natural defences. Also, keep tabs on the air pollution in your area by contacting your local air-quality monitoring service (in the UK:; in the US: When pollution levels are high, avoid spending a lot of time outdoors if possible. For further advice on how to minimize your exposure to air pollution, see WDDTY vol 18 no 5.
Other face-saving factors. Clearly, wrinkles, sagging and the other signs of skin ageing are not simply the inevitable consequence of getting old. The sun, tobacco smoke and outdoor air pollution can all have a negative impact on our skin, and what we eat can determine how well our skin responds to these insults.

In addition, severe physical and psychological stress can both take their toll on the appearance of your skin (Acta Dermatovenerol Alp Panonica Adriat, 2008; 17: 47-54), so consider stress management techniques such as meditation and yoga as part of your anti-ageing regime.

Also, it may help to get into the habit of sleeping on your back rather than on your side, as years of resting your face on the pillow in the same way every night can lead to wrinkles known as ‘sleep lines’ (Scand J Plast Reconstr Surg Hand Surg, 2004; 38: 244-7).
Finally, don’t forget to drink plenty of water to keep your skin hydrated and smooth-looking.

Joanna Evans

Natural wrinkle fighters

Coenzyme Q10. Topical application of this antioxidant not only protects against sun damage, but also appears to improve the appearance of wrinkles. A clinical trial showed that the use of a 1-per-cent CoQ10 cream for five months significantly reduced wrinkles, as rated by a dermatologist (Biofactors, 2008; 32: 237-43).

Vitamin C. In one placebo-controlled trial, a topically applied cream containing 5-per-cent vitamin C led to a “clinically apparent improvement” of sun-damaged skin after six months. In particular, deep furrows and skin elasticity were improved (Exp Dermatol, 2003; 12: 237-44).

Niacinamide. According to clinical testing, applying 5-per-cent niacinamide (vitamin B3) in a moisturizer to the face can improve various signs of ageing, including hyperpigmentation, fine lines and wrinkles, redness/ blotchiness, yellowing (sallowness) and elasticity (Int J Cosmet Sci, 2004; 26: 231-8; Dermatol Surg, 2005; 31: 860-5).

Alpha-lipoic acid (ALA). In a trial of 33 women, aged 40-75 years, each treated half her face with a cream containing 5-per-cent ALA, and the other half of her face with a placebo cream, twice daily for 12 weeks.

The results showed significant improvement in the signs of photoageing on the ALA-treated side of the face. Specifically, laser profilometry-which measures the surface of the skin with extreme accuracy-revealed an average decrease in skin roughness of 51 per cent compared with 41 per cent on the placebo-treated side (Br J Dermatol, 2003; 149: 841-9).

Hope in a jar?

Of the countless creams on the market claiming to erase wrinkles and stop sagging, few have undergone rigorous scientific trials to prove their effectiveness. One exception is No 7 Protect & Perfect Intense Beauty Serum, made by Boots, which was tested last year in a double-blind, randomized controlled trial. After one year, the researchers found “significant clinical improvement in facial wrinkles”, which they believed was due to the increased production of fibrillin-1 in the skin, a protein that promotes skin elasticity. Bear in mind, however, that the study was funded by Boots (Br J Dermatol, 2009; 161: 419-26).

Nevertheless, for those who might be looking for a more natural solution (the Boots serum contains a raft of harsh chemicals), your best bet is to look for products with high levels of antioxidants such as vitamin C and E, and co-enzyme Q10.

Weleda’s new Pomegranate Firming Face Serum, for example, contains antioxidant-rich pomegranate juice and, according to the website, dermatological tests have shown that, after 28 days of use, the depth of wrinkles was reduced by 29 per cent while skin moisture levels increased by 39 per cent (


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