Anti-ageing tips for every age
Age before beauty
When it come to anti-ageing there is so much information out there that sometimes it can be a bit confusing as to what exactly are the right steps, treatments and products that we should be using. While biological age is not always the best indicator of the condition of your skin — factors like smoking and sun exposure can prematurely age it — this is a general guide to follow. Below are the kinds of ageing I would generally see in my practice, and some of the most effective treatments.
IN YOUR 20s
For most of us, signs of ageing start to declare themselves when we enter our late twenties. Although they can be subtle, very early signs of ageing such as pigmentation and fine lines start to appear on our faces. Hyperpigmentation such as freckles is almost always related to sun exposure and UV rays from the sun have been found to accelerate the appearance of signs of ageing due to damage to the skin's DNA, collagen, proteins and cell structures.
Adult onset acne is another problem that can show up in this decade even for people who did not have teenage acne. The cause of adult onset acne is multifactorial; with factors such as hormones and our innate immunity playing a key role in the development of adult onset acne. Adult onset acne tends to develop in the lower third of the face and the neck with a cyclical premenstrual worsening. Acne can be extremely frustrating for sufferers and can also leave behind scars as a sequela.
Get started on a sunscreen daily as early as you can. Besides causing sunburns and skin cancers, UV rays from the sun are the most important factor other than genetics that causes ageing of the skin and pigmentation. For additional protection against UV rays and free radicals in the environment that also cause skin ageing and collagen loss, get started on a topical antioxidant like topical vitamin C to neutralise free radical damage.
Adult onset acne should be treated as soon as possible to avoid scars and post inflammatory hyperpigmentation from resulting. Adult onset acne can be treated and depending on the severity of the condition, medications and a combination of lasers and chemical peels may be required.
Your 20s is a good age to get started on Q-switched lasers and chemical peels; which accelerate the lightening of pigmentation, the treatment of acne, shrinking of pores and the brightening of skin without incurring any recovery time. Most patients will start to notice lighter pigmentation, more even skin tones, brighter skin, less acne and less blackheads and whiteheads in 1-2 weeks after their Q-switched laser and chemical peel treatments.
IN YOUR 30s
The 30s is a decade when the signs of ageing start to become more obvious. This is due to physiological changes in the behaviour of skin with the skin's ability to repair itself steadily decreasing and collagen levels in our skin getting depleted faster than collagen can be replaced.
In our 30s, levels of collagen, elastin and hyaluronic acid begin to decline. Collagen, elastin and hyaluronic acid have many functions in the skin, including maintenance of the skin's hydration; structural support of the face (to prevent sagging); skin texture and thickness. As the levels of collagen, elastin and hyaluronic acid decrease in our 30's, wrinkles; fine lines; sagging; and sallow and rough complexions start to appear.
One of the first signs of ageing is sagging due to loss of structural support and stability of our facial structures from depleting collagen levels. In our 30's, sagging first appears in the midface and this accounts for the appearance of nasolabial folds; marionette lines; and hollow, sagging cheeks. In the later half of our 30s, the lower third of the face also starts to show signs of sagging such as marionette lines; jowl lines and loss of jaw line definition.
Another sign of aging that appears in our 30s is the appearance of wrinkles. Wrinkles can appear as fine lines throughout the face. This is due to our skin becoming thinner and the decreased levels of collagen and hyaluronic acid which normally plump up the skin.
Deeper wrinkles in the upper part of the face — crows' feet; forehead lines and glabella lines — also start to show up in our 30s. In the early stages, wrinkles are dynamic; meaning that they only appear when we smile, laugh or frown. If left untreated, these dynamic wrinkles can evolve to form static wrinkles. Static wrinkles are wrinkles that remain even though our face is at rest, without using any muscles of facial expression. Static wrinkles are also the biggest cause of the 'resting angry face'.
Adding a retinoid to your daily skincare routine at night can help to increase collagen levels in the skin to mitigate these signs of ageing. Consistent use of retinoids can increase collagen formation in the skin and increase cell turnover to smoothen out fine wrinkles, lighten pigmentation and increase skin thickness.
One of the latest breakthroughs to reverse the signs of ageing and increase collagen levels in the skin is a development from South Korea called Rejuran Healer. Rejuran Healer uses polynucleotides or PDRN which are DNA fragments to repair skin damage from ageing and sun exposure; reduce inflammation and increase collagen levels in the skin. Besides the reversal of signs of ageing (e.g. enhanced skin elasticity and reduction of fine wrinkles); smoother skin texture; faster skin recovery from injuries; increased skin hydration and plumper skin are some of the expected benefits of Rejuran Healer.
To treat the deeper wrinkles that are seen during our facial expressions, the only solution is Botulinum toxin, also known as Botox, which is a brand of this toxin. Botulinum toxin acts on the muscles of facial expressions where they have been injected into to relax these muscles so that these wrinkles do not appear when we laugh, smile or frown. Botulinum toxin can last four to six months before its effects wear off and the wrinkles appear again. A lot of people worry that Botulinum toxin can cause an expressionless face that looks 'frozen'. This frozen appearance should not be an intended outcome. When injected by an experienced doctor, Botulinum toxin should erase your wrinkles while preserving your facial expressions so that you can still laugh and frown naturally.
In the early stages of sagging, non-invasive dermatological treatments that lift that skin can give good results. Examples of such treatments include High Intensity Focused Ultrasound (HIFU) (e.g. Ulthera, Lifthera and Symalift) and radiofrequency (e.g. Thermage). These two modalities remodel the existing collagen in our skin to result in a lifting and tightening effect and stimulate formation of new collagen fibres to enhance the lifting effect. With HIFU and radiofrequency, results can take one to two months to be seen.
IN YOUR 40s
In our 40s, the subcutaneous fats that gave our faces its distinctive fullness, shape and contour is gradually lost, and this results in the face looking more angular, gaunter and 'hollow'. This is typically seen first in the temples and cheeks. In the temples, as the fats are lost, change from a convex to a concave shape. In the cheeks, loss of fats gives to a deflated appearance of the cheeks. Loss of cheek volume also leads more obvious appearance of dark eye circles.
Sagging continues to become pronounced in the face, with more obvious jowls and sagging in the midface and lower face. Together with deflated appearance of the face, this makes the face look more tired and old looking.
To restore loss of volume in the face and recreate facial contours, dermal fillers are a safe and effective treatment. When injected into the temples and cheeks, dermal fillers can restore the natural convexity and contours of the temples and cheeks. Dermal fillers are used to soften folds and lines of the face such as the nasolabial fold and marionette lines. Most commonly, dermal fillers consist of hyaluronic acid, which is a water loving molecule. This allows dermal fillers to instantly volumise the parts of the face that have been injected.
For sagging in the face and neck in your 40's, the liquid facelift and threadlifts offer a greater 'lift' and longer lasting results than HIFU and radiofrequency. The liquid facelift consists of a combination of Botulinum toxin and dermal fillers placed in strategic areas of the face to erase wrinkles and lift the skin. More severe sagging in the face and neck would benefit better from a face or neck threadlift. Threadlifts consist of fine threads placed under the skin of the face and neck to mechanically lift saggy tissues. Threadlifts also offer an additional advantage of stimulating collagen formation along the threads for continuous improvement in lifting.
IN YOUR 50s AND BEYOND
The 50s is the decade when all the signs of ageing in the face — pigmentation, coarsened skin, drier skin, wrinkles and sagging — are seen and continue to become more pronounced.
Dynamic wrinkles that have not been adequately treated can become deeper and static by now. The face also has a characteristic triangular shape (as compared to the 'inverted triangle of youth' associated with a youthful face in the 20s) due to more prominent sagging of the tissues sinking lower in the face and loose skin from loss of subcutaneous fat. Pigmentation related to sun exposure and aging such as solar lentigos also usually appear in this decade.
The fifth decade onwards is when combination therapy would be more suitable to achieve obvious benefits to the skin. For example, severe sagging in the face and neck can be treated with threadlifts and HIFU to achieve greater lifting and skin tightening. Static wrinkles can be treated with Botulinum toxin and fractional CO2 laser to resurface the skin.
Fractional CO2 laser is a good modality to treat wrinkles, fine lines, coarse skin and pigmentation. By increasing the collagen levels in the skin, fractional CO2 laser resurfaces the skin so that it is firmer, softer and has less signs of ageing.