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Ageing Skin: The Changes, Challenges & Management (Part Three)

Ageing Skin: The Changes, Challenges & Management (Part Three)

WHY SKINCARE MATTERS

    Let me begin by saying that despite what has been discussed, ageing can still be a very positive journey and l for one see it as a privilege as unfortunately there are not many people who make it to their ‘golden years’.

    However, when it comes to skincare we do need to stop looking at it as just purely an aesthetic concern and begin to see it as a health issue.  Our skin that is vital and fragile will age, and its roles of protection and regeneration will diminish over time.

    Due to our ever-growing ageing population, we are realizing how ageing skin can in fact be a real health problem that can complicate and due to co-morbidities can be made complicated.

    As health care professionals in a clinical setting, knowledge of skin health is vital to ensure that it is being protected, maintained and if need be treated accordingly.

    As individuals, we can help ourselves to ensure that skin health is maintained for as long as possible.

    How can this be achieved?

    From a clinical perspective, there are evidence-based interventions available to help promote and maintain skin health as individuals age by incorporating a prevention network.  This network combines elements of education such as the importance of using sun protection, interventions for early diagnosis and treatment of skin problems such as skin cancer as well as protection against wounds and lesions such as skin tears.  

    Within this prevention network, there is also the element of providing therapeutic and rehabilitative interventions when skin issues are established such as providing emollient therapy for dry skin to control symptoms and maintain the integrity of the skin.

    Fortunately, as individuals, we can incorporate this prevention network into our everyday lives, and it does not need to be made up of an array of complicated or elaborate routines.  We need to maintain focus on preventing dry skin in ways such as bathing ourselves in lukewarm water and not hot as this can lead to skin sensitivity.  Avoid vigorous rubbing when drying ourselves as this can create friction leading to a possible breakdown in skin integrity and ongoing issues.

    Our skin is best protected by washing with pH balanced body and face washers.  Daily application of emollient based creams or lighter based if preferred is important to not only alleviate skin dryness but also improve the barrier of the skin and microbial defences.  Furthermore, daily sun protection with a broad-spectrum sunscreen is important to prevent skin cancers but also incorporating self-skin assessment is key to ensure early intervention.

    Finally, when we talk about skin health it is about approaching it holistically so, therefore, incorporating a well-balanced diet is just as important as what we topically put onto our skin.

   What hopefully has been highlighted, albeit only briefly, is not only how wonderful our skin is in all that it does for us, but also the importance of why it must be taken care of and maintained to help achieve the quality of life. This can be achieved in both clinical settings but also as individuals on a day-to-day basis.

   The care of ageing skin must change focus from looking at it just from an aesthetic perspective to how the breakdown of structure and function affects the quality of one’s life.  And this must start from an early age because if we are to take note of what the World Health Organisation has stated…prevention is far more effective and costs far less than treatment.


This blog post is written by Dora Erdossy, Dermal Educator & Dermal Clinician. With over 25 years’ experience in the Skin Care Industry, Dora Erdossy has worked as a Dermal Clinician and Educator for some of the industry’s largest brands across Australia, USA and Europe. Dora’s passion for education saw her become an educator for dermalogica and The International Dermal Institute in 2001 where she taught in Australia, Vietnam, Fiji and New Zealand. In 2005, Dora moved to the United States where for the next 3 years, she championed the role of Senior Educator at dermalogica’s Los Angeles HQ.⠀

Ageing Skin: The Changes, Challenges & Management (Part Two)

Ageing Skin: The Changes, Challenges & Management (Part Two)

CONTRIBUTING FACTORS

    There are two contributing factors when we talk about ageing skin.  

  1. Intrinsic ageing – this is genetically determined meaning it’s what happens as we naturally age.  We don’t have control over this.
  2. Extrinsic ageing – this type of ageing is due to internal and external influences such as UV exposure, air pollution, stress, smoking, sleep and medication.  The good news is that we do have control over this.

    In a nutshell, the ageing process of the skin is genetically determined but is largely influenced by environmental factors so we in fact can play a big role in how well our skin ages.  For most of us only about 10-15% of our ageing is influenced by genetics which means that 85-90% is extrinsic ageing and controllable.  Lifestyle choices greatly affect not only the appearance of the skin but the function of it as well as these factors can lead to the skin weakening which can lead to skin tears, potential difficulties in wound healing and then possible lengthy stays in hospital.

   What we must keep in mind is the skin ageing process does not begin from the age of 70 but in fact the protective skin qualities begin to decline much earlier…as early as 50 years old!

    What does this mean?  Preventive skin care intervention must be introduced at an earlier age to not only enhance the protective qualities of the skin but also maintain its integrity along with protecting our skin from the extrinsic factors such as UV exposure.

    There is a greater awareness of how the health care system is being impacted due to our ageing population and this in turn has increased the degree of research into understanding how not only ageing can affect the skin but the changes that can be expected to be seen.  

    This research has led to the coining of a new term – Dermatoporosis.

DERMATOPOROSIS

    This is described as a loss of function that ultimately leads to a breakdown in the protective mechanisms of the skin.  As individuals age, skin cells are also biologically ageing.

   There are a number of age-related skin changes of which l will highlight a couple.  We see an increase in moisture loss and susceptibility to microbial invasion due to a breakdown in barrier function.  This increase in moisture loss can make the skin appear flaky, rough, dry and dehydrated.  Collagen and elastin fibres are reduced decreasing skin strength and potentially slower wound remodelling.

   Furthermore, the sensation of touch is decreasing, which reduces or alters sensation leading to an increased risk of pressure damage.  I have only touched on some of the changes that take place and much of this is natural ageing however as mentioned earlier, extrinsic factors can also influence and perhaps make matters worse.

Image: Dermatoporosis with multiple lesions, old & recent (lesions begin to form as a result of skin breakdown and due to poor wound healing, new lesions form before old lesions have had a chance to heal completely)

So as we age the skin changes but what does this mean if the skin is injured?

INJURED SKIN

    When one is injured, the wound healing process kicks in.  This is a physiological process whereby an elaborate sequence of events occurs with the aim to end with a successful closure and bring back function to the tissues that were damaged.

    The typical stages of wound healing are inflammation, proliferation and maturation/remodelling.  These stages do not follow a specific timeline of days as the stages do overlap but these stages ideally are a progression of wound healing in a normal, orderly and co-ordinated sequence of events.

    However, for this to happen effectively, there needs to be a sufficient supply of oxygen, nutrients, hormones and the necessary cells required for this process.  The wound healing process can be delayed significantly due to many factors that are either intrinsic or extrinsic factors.

FACTORS AFFECTING HEALING

  1. Intrinsic Factors such as an individual’s health status.  The general health & wellbeing of a person can influence their ability to heal normally.  The nutritional status is also important and in fact malnutrition is common amongst the elderly population.  For example, a diet low in protein can lead to the epidermis thinning, reduce epidermal cell proliferation and decrease skin hydration.
  2. Extrinsic Factors include lifestyle choices such as smoking can decrease skin strength due to impaired connective tissue remodelling and also slow down the regeneration of the epidermis.  Mechanical stress such as scratching one’s skin due to the skin being dry and itchy or friction against bedsheets can create wounds.  The simple removal of a wound dressing can affect the integrity of the epidermis and lead to trans-epidermal water loss.

    And of course, Skin Health.  A common feature in older skins is dry skin.  When there is a loss of water from the epidermis, the skin is more likely to crack and lead to itching and bleeding.  When skin is excessively dry it can often become scaly or cracked, frequently seen on the legs of older people.

     Potentially, all wounds if not managed, can become chronic wounds.  An example is a skin tear which can be caused by mechanical stress.  A skin tear is an acute wound that has a high probability of becoming a chronic wound if not managed properly.

Image: Skin Tear

Image: Chronic Wound

With all this be seeing said, in Part 3 of Ageing Skin: The Changes, Challenges & Management we will discuss Why Skin Care Matters…


This blog post is written by Dora Erdossy, Dermal Educator & Dermal Clinician. With over 25 years’ experience in the Skin Care Industry, Dora Erdossy has worked as a Dermal Clinician and Educator for some of the industry’s largest brands across Australia, USA and Europe. Dora’s passion for education saw her become an educator for dermalogica and The International Dermal Institute in 2001 where she taught in Australia, Vietnam, Fiji and New Zealand. In 2005, Dora moved to the United States where for the next 3 years, she championed the role of Senior Educator at dermalogica’s Los Angeles HQ.⠀

Your Nutritional Guide to Improving Wound Healing

Your Nutritional Guide to Improving Wound Healing

Let’s be factual, whenever an average person gets a wound, they think about taking medications and applying healing lotions. What they do not know (or remember) is that diet is equally, if not more, important in helping the body heal. While most wounds will heal quickly on healthy people, especially when they are kept clean, others like ulcer and pressure injury are more serious and require extra attention and intervention. 

Thankfully, things become so much easier when you eat the right food. This nutrition guide is a call to pay attention to your diet, not just for maintaining a healthy weight but also for wound healing.

Nutrients That Aid Healing

  • Protein

When the skin is traumatized it goes through different phases of healing. Protein has proven to be vital to this healing process. It helps with fibroblast proliferation, wound remodelling, collagen production, and formation of new blood vessels. The more traumatic your wound is, the more protein you’ll need.

  • Carbohydrates

Carbohydrate, especially refined ones, is not something you want to consume a whole lot. Having said that, your body does need a portion of this nutrient to heal properly. Carbohydrate eventually gets converted into glucose. Meanwhile, glucose provides energy, helps to repair tissue, and assists in tissue regeneration. 

  • Healthy Fats

Too much fat can be damaging to your health. But that is not to say that it is entirely bad. Fats are “essential components for healthy cell membranes,” says Fiona Tuck, Nutritional Medicine Practitioner, and founder of Vita-sol. In fact, healthy fats like avocado and olive oil can also minimize your risk of heart disease.

Of course, you would need to cut down on certain fats like Omega 3 because they tend to cause blood clotting.

  •  Vitamins

Vitamins are also incredibly beneficial for wound healing. Vitamin B helps to moderate local wound metabolism while Vitamin C helps to stabilize collagen. It also increases the strength of wound tissue. Other vitamins like Vitamin D and K are necessary for healing too.

  • Zinc 

Zinc is involved in a lot of enzyme reactions. It helps achieve a healthy immune system and breaks down protein. However, if it is too much, Zinc can inhibit copper and thus affect wound healing negatively. You must take these nutrients moderately so these nutrients do not backfire.

  • Iron 

Iron is so important that when your body is deficient in it, it can affect how oxygen is delivered to the tissue. There’ll be a problem with the transfer of iron to the tissue and this slows down wound healing. It also affects energy generation from the cell.

  • Copper

Copper is good for rebuilding the traumatized tissue.

What You Should Eat

  • Protein-rich foods 

Foods such as fish, eggs, yogurt legumes, and poultry are great sources of protein and amino acid.

  • Whole grains 

These are a great source of good quality carbohydrates which is the kind of carbohydrate that’s good for the body.

  • Fresh fruits and vegetables

You can never go wrong with fruits and veggies. Fiona says to consume fruits and veggies of different colours as they tend to supply different nutrients and different vital chemicals

  • Polyphenols 

Polyphenols improve gut and skin health while also boosting immune functions. Fiona explains that polyphenols are good for “not only our skin and for our capillaries but also good for our gut health as well”

  • Water

Water also does great for healing. Your healing can be impaired if you’re dehydrated so drink as much water as you can. 

What You Shouldn’t Eat

  • Avoid junk foods, especially those with lots of sugar.
  • Highly processed foods are also bad because they have additives, emulsifiers. These can lead to gut issues, inflammation and affect the immune system
  • You also should avoid alcohol as it affects the immune system and causes your nutrient requirement to go up. 
  • Avoid smoking. It impairs wound healing. Smoking before a surgery depletes important nutrients like vitamin C and causes sluggishness and fatigue.

Conclusion

Eating healthy simply saves you a lot of hassle. If you fail to make healthy food choices or take the right nutrients when you have an injury, you’ll experience slower wound healing, scarring complications, infections, and inflammation.