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Is Surgery the Answer?

By Dr Vivian Oputa

It’s great to know that aging skin is not inevitable. Modern science has merged with beauty and there is so much  available to improve the appearance of skin and give it a healthier, fresher look. Your skin is capable of glowing  for life! You don’t have to go under the knife to look 10 years younger.

The Epidermis is the outermost layer of skin and aging concerns of this layer include dullness, dryness, blotchiness  and fine lines. By age thirty, the epidermis typically becomes drier because there is a reduction in sebum (oil)  production. This aging characteristic escalates during the menopausal years and increased sensitivity may occur as a  result of this dryness. The basal layer of the epidermis contains the pigment producing cells responsible for skin  colour known as melanocytes. The cumulative effect of repeated sun exposure over the years makes the melanocytes more  active leading to an overproduction of the pigment melanin causing blotchy discolouration and large freckles known as  lentigos which often appear with age. The superficial epidermal cells of the stratum corneum known as corneocytes are  not shed as efficiently with age leading to accumulation and thus epidermal thickening which results in a dull,  lifeless and sallow complexion. Exfoliation helps to rid the skin’s surface of this build up of dead cells.

The Dermis lies just below the epidermis and it contains a network of blood vessels known as capillaries, sweat  glands, hair bulbs, nerve endings and collagen and elastin fibres which provide support and strength to the skin.  With age the dermis also undergoes major changes. After the age of forty, 1% of the skin’s collagen is lost every  year. The collagen and elastin fibres break down leading to sagging (also known as “crepiness”) and the collagen  producing cells known as fibroblasts diminish in number and become less active. Exposure to sunlight also affects the  dermis by damaging cellular DNA. This damage may lead to an increased formation of blood vessels (showing up as  spider veins), increased fragility and hence bruising of the skin, thinning of the glycosaminoglycans (GAGs) which  surround cells, and thinning of the extracellular cement which holds the cells together. Sometimes age related  pigmentation or freckles may be lodged in the dermis which makes it difficult to correct.

There are ingredients available that work in a complementary or synergistic manner on the epidermis and dermis that  should be incorporated into a skincare regimen. Making a good decision to rejuvenate the skin does not mean you  should go overboard and try every available cosmetic product on the market. It is advisable to incorporate at least  two ingredients appropriate for your skin type that work on the epidermis and dermis.

There are seven primary active ingredients that have given excellent results in skin rejuvenation. There are also  various antioxidants that play a supportive role in the rejuvenation process. The top seven ingredients that you  should check cosmetic labels for are Vitamin C (L-ascorbic acid), Retinoids, Glycolic acid, Idebenone, N-6  furfuryladenine, amino acid peptides and GHK copper peptides. Multivitamin and mineral supplements essential for  healthy skin should also be added to a rejuvenation regimen.

Antioxidants are capable of neutralizing free radicals and some of them have the added property of stimulating  fibroblasts to produce collagen in the dermis. Oxidants or free radicals are responsible for turning apples brown  after they are cut, bananas brown when peeled, and for iron rusting when exposed to the elements. They cause similar  harm to body cells. Potentially harmful free radicals which damage cellular DNA are generated in the body each time  you breathe, digest food, exercise or sleep. Toxic substances in air pollution, cigarette smoke, ultraviolet light  and emotional stress also generate free radicals that may be harmful to health. Antioxidants work to combat these  free radicals.

A proper skin rejuvenation regimen should incorporate a potent antioxidant to help reduce the rate of dermal  degeneration and repair/prevent free-radical damage. Examples of some antioxidants include Alpha lipoic acid,  Beta-carotene, Blueberry extract, Blackberry extract, Bioflavinoids, Coenzyme Q-10 (CoQ10 or ubiquinone), GHK copper  peptides, Green tea extract, White tea extract, Grape seed extract, Idebenone (a CoQ10 variant), Lycopene,  Pomegranate extract, Marine complexes or algae, Vitamins C and E and Superoxide dismutase, an enzyme that occurs  naturally in the skin which helps protect against free radical damage so is technically not an antioxidant.

Retinoids are Vitamin A derivatives which help improve the appearance of fine wrinkles and skin discolouration by  providing effective exfoliation. This restores a healthier, more vibrant and glowing complexion. Retinoids also  minimize the appearance of pores, treat acne, reduce oiliness and firm the skin be stimulating fibroblastic activity.  Retinoids include prescription Retin-A (tretinoin), Renova and Avage (Tazarotene). Retinol and Retinyl palmitate are  over-the-counter Vitamin A derivatives seen in several cosmetic preparations. It is advisable to use Vitamin A  derivatives on alternate nights and always wear a sunscreen during the day as Vitamin A creams increase the skin’s  sensitivity to the sun.

Glycolic Acid is the smallest molecularly of all the AHA’s (alpha hydroxyl acids) and penetrates the skin better  making it the most beneficial for facial and cosmetic use. It works by loosening the bonds that hold skin cells  together, helping to shed the sheath of dead cells (exfoliation) and by dilating capillaries thus bringing more blood  and hence oxygen and nutrients to nourish the skin. It is also capable of reducing surface oils, removing blackheads  and other skin impurities, stimulating collagen production and moisturizing the skin. The result is a fresh, glowing  complexion with an improvement in the appearance of fine lines, blotchy discolouration and pore appearance.
N-6 Furfuryladenine is a naturally derived botanical growth hormone capable of increasing moisture retention and  reducing the appearance of fine lines and blotchy skin pigmentation. It helps keep plants green and healthy, is not  as irritating to the skin as AHAs and Retinoids, does not cause sun sensitivity and is good for delicate and  sensitive skin types.

GHK Copper Peptide helps firm the skin, reduce inflammation and promote healing. GHK (glycyl-L-histidyl-L-lysine) is  a peptide normally found in human skin and tissue that binds copper molecules to allow them to arrive at target sites  in their active state. The chemically synthesized form known as prezatide copper acetate is added to cosmetic  preparations for use on the skin. This acts by stimulating collagen and elastin production, the formation of  extracellular cement between cells improving strength and the formation of GAGs (glycosaminoglycans) which thicken  the dermis. It also increases blood vessel formation leading to increased oxygenation of the skin and acts as an  antioxidant by stimulating the enzyme superoxide dismutase.

Vitamin C in its active form (L-ascorbic acid) firms the skin, reduces under-eye bagginess and improves blotchy skin  pigmentation. It works as an antioxidant and also stimulates fibroblastic activity. Amino acid peptides used in skin  rejuvenation stimulate fibroblasts to produce collagen leading to firmer skin

Idebenone, a variant of coenzyme Q-10, is the newest antioxidant available for cosmetic use and it is capable of  firming the skin and improving its texture, correcting skin discolouration and improving the appearance of fine  lines. It is promoted as the most potent and effective antioxidant ever used in the history of skin care. It reduces  mitochondrial DNA free radical damage and helps prevent cellular DNA damage caused by the harmful rays of the sun but  is not a sunscreen. Studies have shown idebenone to be more potent than Vitamin C, N-6 furfuryladenine and alpha  lipoic acid.


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