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A Deeper Look at Extrinsic Aging

By: Jennifer Linder, MD
Posted: October 31, 2012, from the November 2012 issue of Skin Inc. magazine.
professional skin care client getting a healthy amount of sleep

Fighting the visible signs of aging is a lifelong pursuit for many. Others have given up, assuming that it’s a pointless effort because it’s based on genetics. But only 10–15% of cutaneous aging is actually driven by genetics or the passage of time. This intrinsic, inevitable aging is not where your focus should rest. The true culprit is extrinsic aging, caused by external influences, as 85–90% of all cutaneous aging is a direct result of these avoidable factors.1

The anatomy

The majority of a healthy dermis is the extracellular matrix (ECM), a complex framework of biomolecules designed to support and protect the dermal cells. The structural proteins (collagen and elastin), adhesive proteins (laminins and fibronectin), glycosaminoglycans (GAG) and proteoglycans that comprise the ECM do degrade naturally due to intrinsic aging, but this breakdown is dramatically accelerated by external offenders—primarily UV exposure and the resultant oxidative stress, and the increase in matrix metalloproteinase (MMP) activity.2 Study after study confirms the fact that unnecessary sun exposure is the No. 1 culprit in extrinsic aging.

Broad-spectrum UV protection

Sun exposure is the worst of the exogenous causes of skin aging. As little as 0.1 minimal erythema dose—the minimum dose of radiation that produces skin redness—will increase the expression of MMP.3 These MMP accelerate matrix breakdown, leading to varying degrees of visible sagging and laxity, wrinkles, epidermal and dermal atrophy, and enlargement of pores.

Because sunscreens can limit UV-induced skin damage and MMP production, they are accepted as the most beneficial anti-aging products available today.4 It is important to understand the variety of ingredients available to make informed client recommendations regarding the effective use of sunscreen. Sunscreen can have either chemical or physical ingredients, or a combination of both. It is critical for skin health and anti-aging benefits that the sunscreen product protects against both UVB and UVA wavelengths. UVA rays have a longer wavelength, giving them the ability to penetrate into the dermis and break down the ECM. Currently, only four of the ingredients approved by the U.S. Food and Drug Administration (FDA) provide true broad UVA spectrum protection: zinc oxide, titanium dioxide, avobenzone and ecamsule. For this reason, a true broad-spectrum sunscreen should include one of those four components, in addition to UVB-protecting ingredients. Typically, a blend of multiple ingredients is necessary to provide truly efficacious sunscreen protection. Encourage use of an SPF of at least 30, and remind clients to reapply every two hours when outdoors to maximize prevention.

To provide protection against the UV-induced oxidative stress put on the skin, topical antioxidants should also be used regularly in all client regimens. Look for sunscreens that also include antioxidants or other topical agents that can deliver several multifunctional antioxidants. Some important antioxidants to include are epigallocatechin gallate (EGCG) and other green tea components, resveratrol, ergothioneine, caffeine, silymarin and genestein. Also consider adding an antioxidant serum to clients’ morning regimen with ingredients such as vitamins C and E.

Smoking and the skin

Secrets to staying young: Live honestly, avoid too much sun, moisturize like crazy and lie about your age.

Aging Skin: Current and Therapeutic Strategies, a reference book by Linda D. Rhein, PhD and Joachim W. Fluhr, MD is aimed at providing the latest information and directions of future strategies to treat and prevent skin aging.

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