Firstly, the main cause of aging is sun damage. Even more so than biological aging. The signs of photoaging include redness, age spots and fine lines, loss of fat around the cheek area, loss of symmetry of face, skin dryness and wrinkles. The Glogau classification is used to diagnose the severity of photo damage to the skin. It ranges from I-IV.
Group I is mild and the skin has mild pigment changes. It occurs between 28-35 years. For group II the wrinkles are in motion. The skin will have brown spots and laugh lines begin to appear. The damage is usually moderate and happens between 35-50 years. Group III and IV are advanced and severe respectively. In both, the skin has wrinkles, discoloration, hyperpigmentation and there is visible keratosis.
Let’s be honest, we all want to look young. And the first signs of aging can damper our body image. Luckily, it does not have to be that way. There are many solutions to tap into to reverse photo aging. The treatment will depend on skin type, severity of damage, age and the desired outcome.
The three main treatments for photoaging skin are: alpha-hydroxy acid (chemical peels), retinoids (tretinoin acid) and antioxidants.
1) Chemical peeling
These work by removing the damaged outer layer of the skin. There are 3 types of chemical peels: mild, medium and deep. In the case of mild photoaging, a mild peel is used. The easiest treatment would be to start using a cleanser containing alpha hydroxy acid (AHA). You may be worried when you hear acid. Actually, AHA are natural acids found mainly in fruits.
Glycolic acid, which is derived from sugar cane, is the most commonly used AHA. However, there are others like, citric acid in citrus fruits, malic acid found in apple fruits, tartaric acid in grape fruits among others.
A cleanser with AHA like glycolic acid will exfoliate the damaged skin and rejuvenate it. Eventually, a new layer of skin which is smooth and healthy will appear. It is best to use a cleanser with 5% to 7% AHA. 10% is the tipping point. It is best not to exceed this percentage. Always use a sunscreen because the skin is more sensitive when using AHA.
For moderate sun damage, trichloroacetic acid TCA peels are used. It usually treats fine wrinkles, blemishes and pigmentation. It is preferable for dark skin patients. Furthermore, it can be used on the face, neck and other body parts. A 15% TCA peel is recommended. While using it, take antibiotics to prevent infection, apply a heavy moisturizer to prevent the skin from drying and avoid the sun until fully healed.
Finally, for a deep peel you will need to visit a dermatologist. This treatment uses phenol acid. It treats course facial wrinkles, severe sun damage and precancerous growth. Importantly, it is used only on the face. The common side effects are redness and stinging. Unfortunately, with this treatment you would have to take 2 weeks off work to get the procedure. For good results, you may need repeat visits and use it together with cosmetic surgery. Also full healing may take several months.
Retinoids are a class of compounds that promote cell growth. The main topical retinoids for treating photodamaged skin are tretinoin, isotretinoin, and tazarotene. They not only repair photoaged skin but also prevent photoaging.
The most commonly used and recommended retinoid by dermatologists is tretinoin. Also called retinoic acid, it is a naturally occurring acidic form of vitamin A. It is usually sold under the brand name Retin –A.
Retin-A has three prescriptions: 0.025%, 0.05%, and 0.1%. Dermatologists recommend starting with low prescription strengths of 0.025% and working it up to 0.1%. When starting to use it, the skin may experience itching, redness, peeling and dryness. The time that the skin takes to acclimatize will vary from person to person.
While starting, it is best to use twice a week. Slowly but surely, work it up into a nightly routine. In case of itching, mix with a moisturizer and it will maintain its efficacy. On the other hand, people with thin skin should use it less frequently. And while using it, it should be mixed with a skin strengthening moisturizer.
Ultimately, consistent use or Retin-A will reverse the signs of photoaging like wrinkles, age spots, crowfeet, sagging, hyper pigmentation and dullness. It stimulates the production of collagen and consequently regenerates the skin. Since it thins out the outer layer of the skin it goes without saying that it is to be used with a sunscreen daily.
Picture this, you cut an apple into two and leave it on the kitchen counter. What will happen after an hour? You guessed it right. The apple will turn brown. That same effect happens on our skin when exposed to the sun. It is called oxidation.
The sun damages the skins cells and forms free radicals. These radicals are dangerous because they “steal” electrons from healthy cells. As a result, it sets up a chain reaction of “stealing”. To reverse the process antioxidants are needed to neutralize the free radicals.
Though the body has its own enzyme systems to fight free radicals, the main “fighters” are micronutrients. These are vitamin E, beta-carotene and vitamin C. However, since the body cannot manufacture these micronutrients they are gained through nutrition.
Firstly, vitamin E (d-alpha tocopherol) is a fat soluble vitamin present in nuts, seeds, leafy green vegetable, fish oils and whole grains. On the other hand, vitamin C (ascorbic acid) which is a water soluble vitamin is present in citrus fruits, green peppers, cabbage, spinach, broccoli, kale, cantaloupe, kiwi, and strawberries. The recommended daily allowance is 60 mg per day. As for beta-carotene, it is a precursor to vitamin A (retinol).It is found in liver, egg yolk, milk, butter, spinach, carrots, squash and grains. Note that beta-carotene is converted to vitamin A by the body. Hence, there is no set requirement.
These three dietary antioxidants can be supplemented with topical application. Vitamin E and Coenzyme Q10 (a fat-soluble natural antioxidant) topical application can protect the skins from oxidation and loss of fat. Consistent use of these treatments will reduce fine lines, wrinkles, crow’s feet and also protect against sun damage.
Finally, while treating photoaging skin, these three methods should be the starting point. They are readily available and easy to use. However, if there is no improvement, surgical treatments may be considered. Some of these procedures include face-lift, botox injections, collagen injection, dermabrasion and laser re-surfacing. Above all, whichever method you choose, always consult your dermatologist.