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Glycation and the Skin

By: Kris Campbell
Posted: October 31, 2013, from the November 2013 issue of Skin Inc. magazine.

“Glycation” is a buzzword that is gaining more momentum in the consumer and retail sectors. Although most skin care professionals know the term, glycation is being discussed in consumer magazines, as well. It is always to your professional advantage to know what clients are reading in order to reduce the chance of being caught off guard.

The glycation process

It is already known that excess sugar can lead to a variety of health concerns, but what most forget is that too much sugar can also affect the skin. Sugar can be digested in many forms, including the consumption of carbohydrates and can even be formed via meal preparation. If there is too much sugar in the body, protein molecules can cross-link with sugar molecules.1 Once this cross-linking process has occurred, the new sugar proteins are called advanced glycation end products (AGEs). The human body does not recognize AGEs as normal, and will produce antibodies that cause inflammation in the skin. Once formed, AGEs tend to gravitate toward dermal collagen and elastin.

As people age, proteins in the body can become damaged through the introduction of AGEs—one of the key factors in aging of the skin. The more sugar you eat, whether processed or natural, the more AGEs are produced. When the body is overwhelmed with AGEs, collagen becomes compromised. Effects of the glycation process at the cellular level of the skin’s structure may result in wrinkling, loss of elasticity, stiffness, accelerated aging and compromised barrier function. Other conditions that appear when microcirculation is damaged and cell turnover slows is a loss of volume in the face due to redistribution of fat. Although the development of lines and wrinkles is normal as clients age, it is difficult to see clients in their 20s resemble a person in their 40s, which is more frequently being witnessed in treatment rooms.

AGEs have been connected to several different health challenges. The oxidative conditions that arise from the formation of AGEs can lead to Alzheimer’s2, cardiovascular disease3 and renal failure4. The amount of AGEs present increases in certain situations involving hyperglycemia and oxidative stress, such as diabetes.5 Diabetics—whose ability to process glucose is at the root of the disease—have an especially difficult time with glycated sensitive skin issues, including neuropathy and scleroderma. The number of people being diagnosed with diabetes and or pre-diabetes is increasing year by year. Intake forms are extremely valuable when dealing with health-challenged skin. Questions about other health challenges can be added in order to potentially determine why glycation issues can vary, especially if diabetes or other conditions are in the picture.

There are several types of AGEs that are autofluorescent at certain wavelengths of light. Skin autofluorescence is a noninvasive measure of the level of tissue accumulation of AGEs, representing cumulative glycemic and oxidative stress. The noninvasive autofluorescence reader (AFR) that measures skin AGE concentrations uses a sample area of unblemished skin and hair to test. The unit then shines a variety of light wavelengths on the sample area. The light that is reflected from the fluorescing AGEs is analyzed to measure the percentage of AGE concentration in the client’s skin. The use of the AFR has led to predicting potential diabetes and cardiovascular issues. Many pieces of equipment such as this started in the hands of physicians and have been reconstructed to be utilized in the skin care industry, so skin care professionals may have access to AFR in the future.