The skin is our principal organ of beauty, touch, pleasure and sensuality. It is the largest organ of the human body, accounting for about 14% of total body weight and covering 1,2 to 1,9 square meter. Unfortunately it is also the one organ that is most exposed to the ravages of the environment.
Healthy skin contains 70% water, 25% proteins, 2% lipids and 3% trace minerals and other substances.
Technically the skin is composed of three layers: the epidermis (the top layer), the dermis (the middle layer) and the subcutaneous (bottom layer).
The epidermis is the thinnest skin layer with a maximum thickness of 1 mm. It is composed of 4 distinct layers of about 0,25 mm each. The top outer layer called "corneal layer" is made from dead, hard, tough cells that form the hard skin surface. The 3 lower layers produce millions of new cells every day, at the bottom of the epidermis. These new cells start as soft cells and then undergo a differentiation process and are transformed into the hard, flat cells of the outermost layers as they are pushed upwards to the surface while the dead cells are continuously sloughed off and replaced by new ones from below. In this way the epidermis is replaced about once a month.
The dermis is a thick, supple and sturdy layer of connective tissue and makes up about 90 percent of the skin's thickness. The dermis is a dense meshwork of collagen and elastin fibres, two connecting proteins. This meshwork supports tiny lymph and blood vessels that allow the skin to breathe and be nourished as well as the nerves, muscle cells, sweat and sebaceous glands and hair follicles. This layer contains special cells that repair the skin, such as fibroblasts.
The subcutis and subcutaneous adipose tissues
The subcutis is the deepest layer of the skin, composed primarily of fat. The subcutaneous layer manages the skin's functions of feeding, excreting and heat exchange. The key cells are fat cells or adipocytes that provide energy, serve as a heat insulator for the body and act as a shock absorber to protect underlying tissue against mechanical trauma and help give the skin its resilience.
Major skin molecules: collagen, elastin, GAG's and proteoglycans
Collagen forms the structural network of the skin and is the most abundant protein in the human body. It is one of the strongest proteins in nature and gives the skin its strength and durability.
Elastin is similar to collagen but it is a more stretchable protein that maintains the skin's elasticity. It provides the matrix that holds indvidual skin cells in place.
GAG's contain special sugars that have high water holding properties. These sugars are built into larger water holding chains of sugar such as hyaluronic acid.
Proteoglycans are larger molecules with many attached GAG's.
As the body ages, the appearance and characteristics of the skin change. Visible ageing of the skin starts around the age of 25, as the natural regenerative processes begin to slow down.
The skin replaces old cells more slowly and there is a lower turnover of the surface skin and slower wound healing.
After the age of 45, a thinning of the skin begins, partially due to hormonal changes. The thinning makes the skin more fragile and vulnerable to damage by abrasion and more sensitive to irritating environmental factors and allergens.
The coils of collagen and elastin suffer cuts and cross linking damage and as a result the skin loses much of its strength and elasticity.
The moisture holding proteoglycans and GAG's decrease in abundance, making the skin become dryer and looser.
The skin loses fat, so it looks less plump and smooth. The number of blood vessels decreases and the skin loses its youthful colour and glow.
While all these changes are taking place, gravity is also at work, pulling the skin, causing it so sag. Wrinkles around the eyes are a characteristic sign of skin damage. The skin tends to heal more slowly and minor blemishes develop.
In addition this ageing process can be accelerated by factors such as extremes of cold or heat, excessive sun, psychological stress, smoking and improper nutrition. The effects of photo damage caused by UV radiation can be seen by comparing skin in areas exposed to the sun to areas usually covered.
During ageing the oil producing glands become less active and the skin becomes dryer. It becomes more sensitive to the use of harsh soaps and disinfectants which more easily damage the skin. We have natural oil covering our skin, named sebum, which is produced by glands in the skin. When the oil is removed by frequent use of drying agents, such as soap, the skin becomes dry which can lead to cracking and flaking.
Part of the ageing process is genetic. Just as our genetic make-up determines our eye colour and whether our hair is curly or straight, genes also have some say in whether our skin retains a firm texture into our sixties and seventies, or begins to wrinkle and sag during our forties. It goes without saying that on the other hand the ageing process and the speed of it are largely affected by environmental factors and by our lifestyle and by the care we take (or do not take) about our skin.
There are many ways to reverse or diminish the ageing process and keep our skin looking radiant, smooth and healthy.
Prevention should start from the earliest possible age. This means that even as a teenager a person should begin doing the things that will prevent the onset of skin ageing. Using moisterizing skin creams, for example, should begin in the teenage years.
If you have never smoked: don't. And if you do: reduce it or just quit entirely.
Try to engage in intense physical exercise including cardiovascular activity at least 2 or 3 times a week. Not smoking and getting enough exercise will allow you to breathe much more deeply, supplying your cells with more oxygen and removing more toxins from your body, both of which result in healthier skin.
Stay out of the sun as much as possible and especially between 11:00 and 15:00 h. Sunbathing on a beach or next to a swimming pool may be fun, but even the strongest sun protecting creams can not eliminate the devastating effect of the sun's UV radiation on your skin. Never use a tanning bed or a spray tan.
Eat and drink plenty of foods that contain anti-oxydants, such as pure fruit drinks, green tea, fresh vegetables and fruits and nuts. Cut back on refined sugars and fried food. Take dietary supplements that are known for promoting healthy skin and hair.
Stay hydrated. Drink plenty of water, especially if you drink alcohol or coffee.
And if you are still bothered about visible signs of ageing, a number of medical treatments are available.
Injectable fillers and Botulinum toxin are suitable for people with busy lifestyles who do not want the inconvenience of a long recovery.
Thermage uses a unique radiofrequency technology to safely heat the deep layers of the skin and stimulate the body's natural renewal of collagen.
Chemical Peelings improve the skin's appearance by applying a chemical solution, causing the top layer of the skin to separate and peel off. The new skin is smoother, less wrinkled and may be more even in colour.
Mesotherapy delivers vitamins, minerals, amino acids and other ingredients directly into the skin to nourish and rejuvenate, promote production of collagen and elastin and stimulate metabolism.
Scientific research in the field of anti-ageing continues to give rise to new and promising treatment options.
We can help you to sort through these numerous options. During a (free) consultation our doctor will examine your skin, discuss your expectations and recommend the suitable treatment options.