International Academy of Cosmetic Dermatology
The “aging face” is basically determined by five factors:
1. Intrinsic aging factor (or chronological aging)
2. Sleep lines factor
3. Expression lines factor
4. Gravity factor
5. Photoaging factor
This last factor is responsible for most of the skin alterations: loss of skin elasticity, fine lines, mottled pigmentation, broken blood vessels, enlarged pores, skin texture alterations, and yellow color. Photo aging also leads to actinic keratoses and skin cancer. Contributing factors include smoking, hormonal imbalance (more notable after menopause), nutritional excesses or omissions, and excessive weight gains and losses.
Prevention is fundamental and is based upon the continuous use of protections against the sun’s rays, not only against UVB but also against UVA, as well.
Nowadays, dermatologists have many tools to prevent and fight the signs of skin aging. These may be used together in various combinations: sunscreens and antioxidant molecules, cosmeceuticals (retinoic acid and tazarotene), chemical peelings (alpha hydroxy acids and trichloracetic acid), microdermabrasion, botulinum toxin (Botox®), dermal fillers (collagen, hyaluronic acid), dermal “sculptors” (poly-l-lactic acid), and other treatments, including photodynamic therapy (PDT), IPL (pulsed light). Also, available are ablative and non-ablative laser surgery and fat transfer.
Riccarda Serri, MD