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Combating Facial Volume Loss With Cosmeceuticals

By: Jennifer Linder, MD
Posted: May 1, 2014, from the May 2014 issue of Skin Inc. magazine.
Combating Facial Volume Loss With Cosmeceuticals

The loss of facial volume is a key contributor to an aged facial appearance. Although some of the visible loss of facial volume is due to reduced facial fat and the resorption of bones, you may be able to help clients potentially avoid resorting to a face lift, which simply stretches and removes excess tissue, by implementing topical cosmeceuticals that work to protect existing volume, and replace epidermal and dermal matrix volume that has already been lost. Although minimally invasive injectables are the gold standard once adipose tissue and bone mass have been lost, there are many proven ingredients and product categories that can be added to a client’s daily regimen to help preserve, maintain and increase the facial volume of the skin—and your clients’ youthful appearance.

The physiology of facial volume loss

The primary cause of visible facial aging of the skin is matrix degradation. The extracellular matrix (ECM) is a complex framework of biomolecules that support and protect dermal cells. The ECM is made up of structural proteins (collagen and elastin), adhesive proteins (laminins and fibronectin), glycosaminoglycans (GAGs) and proteoglycans. These components are all vitally important for a full, youthful appearance that is free of laxity, wrinkling and poor surface texture. The breakdown of these all-important structures is a result of both intrinsic aging that happens due to time and genetics, and extrinsic aging, which is largely avoidable.

The offending extrinsic factors

Although ECM-breakdown occurs naturally with the passage of time, it is accelerated by external factors, primarily UV exposure. The oxidative stress instigated by UV rays increases matrix metalloproteinase (MMP) production—the enzymes that breakdown the ECM. These enzymes are increased with as little as 0.1 minimal erythema dose (MED), which is one-tenth of the UV exposure it takes for skin to become red. This demonstrates the critical nature of the daily, year-round use of broad-spectrum sun protection; you don’t need to tan to begin the cascade of facial volume loss. (Editor’s note: See the article “Sunscreens: What You (and Your Clients) Must Know” in the May 2014 issue.)

Free radical formation is also increased with UV exposure. It is well-documented that UVB rays specifically instigate a cascade that leads to the creation of highly reactive radicals that have unpaired electrons in their outer shell. There are a variety of types of free radicals, yet reactive oxygen species (ROS) are widely studied, due to their proven damaging effects on the skin.

The aged appearance that occurs due to the loss of facial volume is compounded by the atrophy of both the epidermis and the dermis. It has been demonstrated that the drop in estrogen levels during perimenopause and menopause slows the production of matrix components. In addition to the degradation of mature collagen already mentioned due to UV exposure, it has also been demonstrated that UV rays compound facial volume loss by inhibiting the expression of the genes responsible for the formation of new collagen—both type I and type II procollagen. This dermal atrophy contributes substantially to visible facial aging.

Ingredients for fighting facial volume loss

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