Ageing
skin in the new millennium
What we can do about looking old?
A couple of months ago, The Royal Society of Medicine met in Liverpool for
their regional conference on The Ageing of Skin. Laterlife.com is bringing to a wider -
and highly interested audience - the issues discussed and conclusions drawn by expert
members of the medical profession who are not part of
the cosmetic industry.
What really
works:
avoid the sun
no cigarettes
use the right creams
Professor Chris Griffiths, of the Hope Hospital, Manchester, pointed to the increasing evidence which suggests that
too much exposure to the sun (photodamage), and tobacco smoking are the key factors that
cause wrinkles and other symptoms of prematurely ageing skin. He recommends skin creams with vitamin A
derivatives which, if they are in the right formulation, have been found to be effective
in repairing skin that has aged naturally, as well as photodamaged skin.
NB Most over the counter creams with vitamin A derivatives contain too small amounts to be
effective. More effective creams are obtainable
from beauty salons and skin clinics. Some people
find these creams cause skin irritation.
Cosmetic
surgery - a modern addiction?
Dr Eileen Bradbury, Cheshire, talked of
the ‘Permayouth’ generation and reported that increasing numbers of people are
looking to surgery to delay the ageing process, not just with one-off operations but
multiple procedures. These cosmetic treatments can be genuinely empowering, but if used as
substitutes for developing real strategies for happiness, they risk doing psychological
harm: “the more remarkable the treatment the greater the psychological risk to
vulnerable individuals”, is how she summed it up.
There is nothing new about the anxieties surrounding ageing in the 21st
century, she said. Youth has always been
strongly associated with attractiveness, energy, health and, above all, a future. Over the centuries, people have sought the elixir of
eternal youth. And signs of ageing lie in the shape
of the face, the proportion of the features and the surface texture of the face – the
skin and underlying muscle tone. What has changed
is the social and economic context of ageing and the means available of looking youthful.
 Divorce rates increase and people in their 40s, 50s and 60s find themselves
back in the world of dating. Styles of being older
have changed and old certainties about how people are meant to look, dress and behave as
they get older have disappeared. Age is not a
valuable economic commodity in the world of international business and unemployment rates
for those over 40 have rapidly increased. There has
been an increase in depressive disorders and anxiety symptoms amongst the “worried
well” in their middle and later years.
If the problem is looking older, then the solution is to look younger, or at
least to halt the clock. And now what is on offer
can seem like magic.
This is not just the province of women, men are just as prone to the
insecurities of ageing although they have traditionally been judged less harshly on their
ageing appearance. However, in a culture dominated
by youthful men and women, gender differences are not so great and men also seek ways of
looking younger. Research has found that whilst younger men have a more positive body
image than women, this is not the case for older men. They
are perhaps more vulnerable as they need to attract a partner – studies show that
single women do better psychologically than single men.
For those who have a measured approach, who are functioning well in terms of
their own internal sense of self and in relationships with others, then surgery and other
treatments can be of psychological benefit. Those
who are self-conscious can lose that preoccupation and sense of shame. The problem lies with those for whom such treatments are
a substitute for developing their own strategies for happiness and well-being. The more remarkable the treatment the greater the
psychological risk to vulnerable individuals.
Laser treatments
Over the last ten years, lasers have become established
as a refining tool alongside and after conventional “cutting” aesthetic surgery,
said Mr David Gault, professor at Bishops Wood Hospital, Northwood,
Middlesex. Many patients who have had standard surgical rejuvenation find that
freckles, lentigos and keratoses, commonly known as “age spots” and “liver
spots” let down the overall improvement, and pigment and cutting lasers can now be
used to remove these. Vascular lasers are useful to treat scars which stay red overlong.
The most common laser accompaniment to cosmetic surgery is resurfacing. It
is often now used along with other treatment for lower eyelid bags and wrinkling. Lasers
are very useful to treat wrinkles elsewhere too, particularly those around the mouth in
smokers, but should be avoided on the neck. They are also useful for acne scarring..
New
combination treatments
These have revolutionized anti-ageing therapy says Dr
Nick Lowe, UCL Hospitals, London & UCLA School of Medicine, USA. Modern skin
rejuvenation techniques often involve the patient undergoing a combination of treatments:
skin fillers, lasers and muscle inactivants like botox. Dr Lowe warned that these very
specialist procedures should only be undertaken by a qualified doctor. He presented
results of new trials comparing the effectiveness of different botulinum toxins in
combination with other treatments, such as laser rejuvenation and topical therapy.
Botulinum has revolutionised cosmetic procedures and is
one of the most straightforward additions to clinical practice. Botulinum toxin is the only treatment that
improves facial lines by targeting the underlying muscles. It acts by chemically freezing
the nerves, though the effect is reversible and muscle function is restored. The duration
of action of botulinum toxin varies between individuals and according to the type of
toxin, the dose, the muscle injected.
There are seven types of botulinum toxin (A-G); of
these, only types A and B are licensed for therapeutic use. Most clinical experience has
been obtained with botulinum toxin Type A.
Statistics from the American Society for Plastic
Surgery show that the use of Botox in cosmetic procedures doubled between 1999 and 2000
whereas the use of other therapies changed
little. This reflects the advantages botulinum toxin offers patients. Treatment is
administered as a minimally invasive outpatient procedure that allows patients to return
to work immediately. It has a high margin of safety because the effects of the toxin are
reversible. The duration of action is consistent for individual patients and the effects
of subsequent injections last longer than those of the first. Botox has also been widely
used in combination with resurfacing laser therapy, topical treatments, chemical peels and
fillers; it is also an adjunct to surgery.
Cosmetic surgery and the ‘natural’ look
Recent advances in cosmetic surgery have not just been about new techniques but also a
refinement in how those techniques are used. Mr Clive Orton, President, British
Association of Aesthetic Plastic Surgeons, Manchester,
explained how modern surgeons are concentrating on how to correct the ageing face
with a natural look, working on muscle and shape correction rather than the old-fashioned
‘tightening’ of the facial skin. He said public demand has driven improvements
in treatment, as people become increasingly aware of what a bad facelift looks like.
Chemical
peels
These have been used
successfully for more than a century and are regaining popularity says Dr Richard J.
Barlow, Consultant and Honorary Senior
Lecturer at St John’s Institute of Dermatology of the University of London..
The process
involves application of one or more exfoliating agents, depending on the depth of the
peel. One or more type may be used in a single
treatment. Peels are used successfully for warts,
acne and scarring as well as for rejuvenation.
If you want to know more about the procedures above,
plus cost, you can contact LASERCARE CLINICS, who work with the NHS and offer private
consultations as well: their website is: www.lasercare-clinics.co.uk
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A vast industry is out there to help with all and every beauty concern. In
this column every month laterlife.com will report on ideas and products, old and
new. The practical results of everything from creamy cleansers to mud baths will be
brought to you. All with the focus on maturity of course.
