Our skin is a pretty incredible organ. It’s the largest in our bodies and its primary jobs are to protect our bodies from impacts, changes in pressure and temperature and to keep out “bad” things like harmful chemicals, radiation, micro-organisms and other foreign bodies. And while it is performing its job as our very own armour and raincoat, it also lets waste out which helps with regulating the temperature of the body. Not only that, but it’s pretty great at sensing things like heat, cold, touch and pain And all the while renewing itself!!!
But it does age. Its ability to renew itself reduces. That results in the skin’s barrier function becoming less effective, a loss in strength and resilience of the skin and reduced ability to repair itself. The skin also often starts to show uneven pigmentation and reduced elasticity and bulk.
There are two factors that result in skin ageing. The first is simply the ticking of the clock or chronological ageing. The second, often called premature ageing, is caused by external factors like air pollution, smoking and diet but is primarily caused by cumulative exposure to the sun. While many of the impacts of chronological and premature skin ageing are similar, chronologically aged skin tends to look dry, thin and finely wrinkled. On the other hand, prematurely (sun) aged skin tends to look leathery, with bigger (coarse) wrinkles and uneven pigmentation.
We have some pretty good evidence about things we can do to reduce and reverse some of the signs of premature skin ageing, but when it comes to chronological ageing the evidence is less clear and so most of what we focus on is premature ageing.
What you CAN do:
Lifestyle and sun protection
I hate to say this, but skin health is just one more thing that is adversely affected by lifestyle. To be the bearer of bad news, this means it will be improved by cutting out the sugary snacks, fried food, alcohol and cigarettes. However, the single most important thing we can do to limit and reverse skin ageing, is limit our sun exposure. And it is never too early or late to start! Sun avoidance, shade, and protective clothing are the best forms of protection. Though, perhaps the easiest thing we can do is use broad-spectrum sunscreen every day. The concern about skin cancer has led us to a focus on UVB protection and the measure which describes UVB protection in skin care – its SPF. But the primary concern for premature ageing (and increasingly we are aware of an increased risk of skin cancer) is exposure to the sun’s UVA rays. On a skin care product, the words “broad-spectrum” indicates that the product protects from UVA as well as UVB (which the “SPF” describes). Just a side note, we see an intense focus online for higher SPF products. Without taking away from the importance of reducing our UVA and UVB exposure, insufficient UV exposure can increase the risk of Vitamin D deficiency (according to a 2016 study, 32% of Americans were deficient in Vitamin D) and the risk of a number of cancers, Alzheimer disease, dementia, macular degeneration and cardiovascular disease. So this is a case of where more sun protection is better… to a point.
There are three main groups of ingredients that have evidence for anti-ageing. The first are:
1) Cell regulators.
Vitamin A is by far the best studied and the most effective ingredient not just in this group, but across all skin ageing ingredients. A common problem with the most frequently used forms of Vitamin A (retinoic acid and Retinol) is their irritation and in the case of Retinol, lower effectiveness and evidence. Of all the forms of Vitamin A Retinaldehyde is both highly effective and non-irritating (it is even suitable for sensitive skin) and has good evidence. In fact, the lack of products on the market that use Retinal (and even then are often not formulated using the best evidence), is one of the main reasons that we started ESK, and it is included in Ultimate A and Ultimate A+ – our two night creams. The other ingredients in this group are Peptides, but the evidence for Peptides remains weak.
The two with the best evidence are Vitamins B3 and C. Vitamin B3 (Niacinamide) is stable, well-tolerated and is helpful for many skin types and conditions and is found in ESK’s B Calm, B Quenched and Enlighten. Vitamin C (L-Ascorbic Acid) which is great for helping with the classical signs of sun related skin ageing, is unstable, occasionally results in sensitivity and anecdotally may exacerbate acne. As a result, most skincare brands bond Ascorbic Acid with another ingredient (eg. Magnesium Ascorbyl Phosphate). But while we have good evidence for L-Ascorbic Acid, there is just no evidence that these other bonded ingredients (usually called Vitamin C by the manufacturer) actually work. And this was the second reason we started ESK, to provide an evidence based, stable and effective Vitamin C which is in our Reverse C Serum and C Serum Lite products.
3) Chemical peeling/exfoliation.
The ingredients with the best evidence in this group are Glycolic and Lactic acid like those included in ESK’s Smooth Serum.
After sun protection and skincare, there are a number of clinical or invasive procedures. These include (deeper) Chemical peels, Laser (many different types), Fillers (including Hyaluronic acid). And while Botulinim Toxin (Botox) injections don’t change the underlying nature of the skin or impact the ageing process, they can temporarily reduce wrinkles and frown lines. And finally, there is Hormone Replacement Therapy, the oestrogen version of which is included in our recent blog on Menopause and also Ginni’s book on Menopause (The M Word).