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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

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Another important lifestyle consideration that dramatically affects the skin is smoking. In a study compiled by the Campaign for Tobacco-Free Kids during the fourth quarter of 2010, 46.6 million U.S. adults and 3.4 million high school students regularly smoke cigarettes. Despite efforts to educate children about the health hazards linked to smoking, 1,000 children become regular smokers each and every day. The negative effects on the cardiovascular system and the lungs are widely recognized, but many who choose to smoke have little or no awareness of what smoking does to healthy skin. Smoking is a major contributor to many skin conditions and complications, such as skin discoloration, ECM breakdown, deep wrinkling, premature skin aging, poor wound-healing and the formation of abnormal skin growths.

The nicotine in cigarette smoke causes vasoconstriction (blood vessel contraction). In addition, the carbon monoxide in cigarette smoke bonds with oxygen in the blood, restricting the amount of oxygen delivered to the body. This deadly combination of nicotine and carbon monoxide not only constricts capillaries trying to carry oxygen, but also reduces the availability of oxygen to flow through them.

Smoking just one cigarette restricts blood flow for up to 90 minutes. During this 90-minute period, the amount of oxygen that is available to pass through the skin is dramatically reduced. If a person smokes more than one cigarette during this 90 minutes, then the time the skin goes without proper oxygenation is multiplied exponentially. The telangiectasias—small, dilated blood vessels near the skin’s surface—that are characteristic of a smoker’s skin are a result of the body attempting to get more blood to the skin by producing more vessels. In addition to the vascular effects on the skin, exposure to the pollutants present in cigarettes accelerates the degradation of the ECM by increasing MMP—specifically MMP-1—production, causing the unwanted breakdown of healthy and necessary matrix components, such as collagen and elastin, leading to wrinkling and laxity.

Before treating clients who smoke, it is important to be certain they are educated on the realities of what you can achieve with their skin if they continue with their habit. Similar to the client you are treating for hyperpigmentation who insists on continuing to lie in the sun, treating clients for sallow, deoxygenated, telagiectatic skin when they continue to smoke is futile. Any forward progress that you make will be sabotaged by the nicotine and carbon monoxide that continue to barrage the skin. Once someone has quit smoking, professional detoxifying and oxygenating treatments can promote increased circulation and oxygenation of the skin cells. These types of treatments, as well as superficial chemical peels, can make an impressive visible improvement in a client’s skin tone. In addition, consider adding L-ascorbic acid, retinoids and peptides to a past smoker’s regimen to increase collagen deposition and help reduce wrinkling. Some ingredients, such as capparenols from caper bud and certain types of algae, can support and strengthen capillaries to reduce their hyperpermeability.

A good night’s sleep

Another contributing factor in extrinsic aging is based on sleep. Although proper sleep, or the lack thereof, has been cited as the cause of many health issues, it is rarely discussed as an important part of keeping skin healthy and youthful. During sleep, the nervous system shifts from the sympathetic system that is dominant during waking hours to the parasympathetic system. The parasympathetic system increases blood flow to the skin, allowing it to repair and restore itself more effectively.5 It has also been noted that those who have a high rate of alcohol intake have disturbed parasympathetic activity and poor sleep quality.6 So, excessive alcohol consumption not only dehydrates the skin, but also reduces the amount of oxygenation and restoration the skin can perform during quality hours of sleep.

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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