Decoding the Skin Ageing – A dermatologist’s perspective

My conversations with Dr Divya Sharma

Q- What is skin ageing?

Dr Divya– Intrinsic ageing is an inevitable process which is natural and no one can escape that while extrinsic ageing results from exposure to environmental factors such as air pollution, smoking, poor nutrition, and sun exposure. Intrinsic ageing is visible as thin, dry skin while extrinsic ageing manifests as coarse wrinkles and uneven textured skin. Sun exposure perhaps is the most important factor in preventing extrinsic ageing.

Q- What is the microscopic difference between intrinsically aged skin and prematurely aged skin?

Dr Divya– The intrinsically aged skin shows a decrease in the size of the basal layer (mother cells which continue to replicate and skin regrows) and this reduces the contact between the epidermis and dermis. This leads to a decrease in nutrition supply and hence, cellular ageing or natural ageing. There is a decrease in the ability to retain water as collagen and certain natural humectants decrease in size and quantity.

In skin which is ageing faster or prematurely due to environmental exposure, there is a thickening of the epidermis and this leads to the uneven texture of the skin. There is a decreased contact between the epidermis and dermis leading to wrinkles and an increase in elastotic tissue which leads to a waxy appearance. Prematurely aged skin will look coarse, and uneven and may show more prominent open pores.

Q) Which is the single most important factor deciding extrinsic ageing?

Dr Divya– Sun exposure or UV exposure contributes to 80% of extrinsic ageing and hence sunscreen is a must for every skin type to delay ageing. Even if you are indoors, sunscreen application is a must. Chase the right formulation but never give up on sunscreens!

Q) What kind of daily routine helps prevent or delay skin ageing?

Dr Divya– Skin is a dynamic organ – Like any other organ your skin is subject to continuous internal and external assaults. Hence. it may change its type and characteristics as your body changes. Gaining weight is one of the easiest slides to go down in your skin health. Weight gain not only ages you faster but increases pigmentation.

Refined sugars and processed foods increase oxidative stress and hence, cause premature ageing. Avoid high carbohydrates in your diet every day to keep your liver healthy and hence skin happy.

Sleep is essential for skin to regenerate itself and hence is a must for delaying ageing

Q) What skin products are most essential for delaying skin ageing?

Dr Divya– Gently cleanse daily but avoid exfoliation and over-scrubbing. You should use a cleanser best suited to your skin type and outside weather.

Sunscreen- The quintessential anti-ageing skincare routine. One has to test various formulations prescribed by his/her Dermatologist before one gets the most aesthetically pleasing sunscreen that one likes to wear every day. Do that effort to delay skin ageing.

Hydration- It is a must to delay skin ageing. Apart from using moisturisers that improve the barrier like ceramides to hyaluronic acid-containing moisturisers in mature skin, all tend to compensate for the loss of natural hydration that takes place in dry skin.

Retinoids- As a molecule, it increases skin cell replication and helps in collagen remodelling to some extent. Very dry and sensitive skin may not be the best candidate for a retinoid-based routine. There are certain alternative options available for retinol-sensitive skin like bakuchiol or retinol-hyaluronic acid combinations.

Vitamin C- Along with vitamin E and ferulic acid, does work as a topical antioxidant and delays oxidative stress. Although there are many options available, very few are stable and actually deliver what they promise. Choose a stable formulation and always a small bottle, as Vitamin C tends to oxidise very fast once the bottle is open. It causes a mild stinging sensation in sensitive skin sometimes.

Dr Divya Sharma is a renowned dermatologist and trichologist based out of Bengaluru. She is on the scientific committee of various national regional dermatology congresses and is often invited as faculty to the Indian Academy of Dermatologists, Venereologists and Leprologists (IADVL), Association of Cutaneous Surgeons of India (ACSICON) national conferences. A member of IADVL special interest group (SIG)- Aesthetics. She runs her own practice, Dr Divya’s Skin and Hair solutions in Bengaluru and may be reached through her website can connect with her on Twitter @divya_sharmaMD

April 3, 2023

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