Could glycation be causing your client’s skin to age prematurely? Researchers have been studying what ages the skin for the better part of a century, but it has only been in the past decade or so that the attention has been turned to advanced glycation end products (AGEs).
AGEs have been implicated in numerous age-related, degenerative diseases in the body and the skin, and tend to form in higher amounts in individuals with diabetes as well as during the aging process. While everyone is susceptible to glycation regardless of age, individuals approaching their golden years need more support in counteracting the damaging effects of it.
Understanding how glycation forms, and how it appears and impacts the skin at the cellular level will help you better support clients who may be in their 60s and beyond. With the right home care, lifestyle and intelligent ingredients, it is possible to help counteract the damage.
A Look At Glycation
Glycation is the result of a sugar molecule (fructose or glucose) bonding to a protein or lipid molecule—a haphazard process that impairs the function of biomolecules. When these sugar molecules react in a non-enzymatic way with amino-acids in proteins and other macromolecules, AGEs form.
It is a complex, multi-step process that primarily starts with the Maillard reaction. First, glucose attaches to a free amino acid (mainly lysine and arginine) of a protein, lipid or DNA, in a non–enzymatic way to form a Schiff base. A Schiff base is a compound that is dependent on glucose. If the glucose concentration decreases, the reaction is reversible. During the second phase, the Schiff base undergoes chemical rearrangement to form an Amadori reaction (also known as early glycation products). At this point, the reaction is still reversible. However, if there is accumulation of Amadori reactions, they will undergo chemical rearrangements and form cross-linked proteins. This process is irreversible, with the final result being AGEs and interference with protein function.1
In the last two decades, increased evidence has linked AGEs to a number of degenerative diseases of aging1 as well as aging in the skin. AGEs have been shown to adversely affect virtually all cells, tissues and organ systems. In the skin, AGEs cause protein fibers, or collagen, to become stiff and malformed. There is also a correlation between AGEs and skin disorders, such as acne, eczema, psoriasis, rosacea, hyperpigmentation and skin cancer. Like chronic inflammation, AGEs often make the skin (and body) more vulnerable to the assailants that contribute to skin diseases and disorders.
We’re exposed to two main sources of AGEs: exogenously, mainly by the foods we consume; and endogenously, those that form in the body. The latter tend to occur with greater concentrations in older adults.2 Diet, excess exposure to UV rays and smoking have all been linked to higher levels of AGEs as well as inflammatory markers. Thus, in addition to proper skin care and nutrition, it is important to talk to clients about better lifestyle choices, for improved health and skin.
Glycation in the Golden Years
Research has shown an interrelated dependence between AGE accumulation and protein turnover rate. Collagen types I and IV exhibit slow turnover, as well as proteins like fibronectin primarily suffer from glycation during intrinsic aging.
Glycation collagen first appears as early as age 20 and accumulates annually.3 Some research has indicated glycated collagen accumulates at a rate of 3.7% annually, reaching a 30-50% increase by the time humans reach 80 years old.
How does all if this affect the appearance of skin? Collagen is one of the skin’s strongest proteins, responsible for buoyancy, plumpness and a firm structure. Collagen glycation impairs these functions in various ways. For instance, it leads to stiffness and decreased flexibility, increasing susceptibility to line and wrinkle formation, as well as sagging skin and vulnerability to sun damage.
Since AGEs tend to start accumulating as early as age 20, it is important to get younger clients thinking about overall health and prevention. Simple adjustments to diet, getting adequate sleep and using skin-building and protective ingredients, as well as those that support cell turnover will help younger skin delay the damaging effects of glycation. For clients in their 60s and beyond, it will be important to address lifestyle and ensure they are protecting the skin; however, the primary focus will be on counteracting existing damage.
Reducing AGEs in the Diet
Since AGEs can be exogenously or be endogenously produced, talk to clients about medical history to better understand if there are any genetic factors, illnesses, chronic stress or use of medications that may be impacting the skin’s health. When diagnosing a client’s skin, you’ll want to find out about:
- Use of medications,
- Diet and overall nutrition,
- Possible hormonal imbalances,
- UV exposure,
- Smoking and
- Current skin routine.
Removing any potential exogenous contributors to AGEs will help support anything you do in the treatment room. Additionally, a healthy diet will also support the skin in rebounding from damages caused by glycation and help prevent future damage from occurring. Low-inflammatory ingredients, omega-3 fatty acids and antioxidants are good sources for rebuilding skin strength (see Anti-Glycation Recommended Foods).
A primary contributor to glycation in the body is food. All food has a certain amount of AGEs; however, some are definitely higher even in their raw, uncooked state. Cooking methods can increase the amount of AGEs. Ultimately it is best to consume fruits, vegetables and nuts in a raw form and meats prepared with lower heat temperatures.4 Some ideas to reduce the amount of AGEs when preparing food are provided below.
- Using medium to low heat (slow cookers are ideal).
- Avoid excessive browning.
- Boil, poach, stew and steam food rather than frying, broiling, grilling and roasting.
- Marinate meats in acidic ingredients, such as lemon juice or vinegar to help reduce the formation of AGEs during cooking.
- Increase consumption of fish, legumes, low-fat milk products, vegetables, fruits and whole grains.
- Limit the intake of solid fats, fatty meats, full-fat dairy products and highly processed foods.
Reducing AGEs in the Treatment Room
In the treatment room, this age group will require highly customized treatments focused on removing aged collagen, stimulating the formation of new collagen and rebuilding and strengthening the skin. Enzymes with ingredients such as goat milk, papain, and kojic, L-lactic, L-tartaric, L-malic and salicylic acid will provide anti-inflammatory support, exfoliate away dead cells and stimulate cell turnover.
Phytic and pyruvic acid are also great for stimulating rejuvenation without irritating the skin, and when blended with L-arginine, an essential amino acid, healing and collagen synthesis are accelerated.
Peels will further deepen the exfoliation, helping to eliminate years of damage from the skin. For this, turn to next-generation AHAs like flower acids or wine extracts blended with L-ascorbic and L-malic acids. These will lift away damage while firming, toning and delivering potent antioxidant support. Flower acids are particularly beneficial for individuals who may be sensitive to AHAs. They still provide potent exfoliation, but with less skin irritation.
For home care, ingredients that inhibit matrix metalloproteinases (MMPs), reactive oxygen species (ROS), and promote all around healthy skin, will also protect against glycation, as provided here.
Albizia julibrissin bark extract. This plant is known for its ability to protect skin cells by producing melatonin. It works by improving respiration, ridding the skin of toxic glycogens, increasing cellular energy and reducing the formation of AGE pigments.
Kombucha. This comes from the process of fermenting black tea. The powerhouse culture contains organic acetic, lactic, malic, gluconic and butyric acids, as well as active enzymes, polyphenols and B vitamins. It works to smooth the skin, provide and is being used as a natural, non-invasive wrinkle filler.
Encapsulated retinaldehyde. This vitamin A is similar to retinol but less irritating to the skin.
Glycine soja. An antioxidant and MMP inhibitor, this ingredient also has amino acids to promote collagen and elastin synthesis.
Epidermal growth factor (EGF). Composed of 53 amino acids, it is a protein that heals skin injuries and stimulates cell proliferation.
Omega-6 essential fatty acids (linoleic and oleic acid). These fatty acids provide anti-inflammatory skin-building benefits.
Peptides. These proteins work to activate tissue growth factor (TGF) and collagen production.
Turmeric. One of the most powerful and natural antioxidants, it contains compounds called curcuminoids that provide UV protection, minimize free-radical damage and provide anti-inflammatory support.
Keep in mind, it is also the quality of the ingredient or overall formulation that will make all the difference. Chirally correct, dye-free, fragrance-free, “intelligent” ingredients that are sophisticated in their delivery and have balanced actives, will support anti-glycation and skin healing processes. Formulations that contain ingredients like dyes and fragrances or those derived from impure sources may actually proliferate the glycation process.
Bring Skin Back
While bringing glycated skin back to optimal health will require a customized approach following deep exploration of your client’s skin and his or her lifestyle habits, it is possible with the right mix of professional treatments and home care ingredients.
Keep in mind, clients in their golden years will just require a deeper focus on removing preexisting damage while stimulating the formation of new cells and collagen.
A healthy diet will also play a critical role in reducing AGEs in the body. Talk to clients about ways they may reduce their intake through the foods they consume and the cooking methods used in preparation, as well as proper sleep and stress-reducing activities—lifestyle choices will deeply impact the outcome of any anti-AGE treatment program.