Tag Archive: Sun damage

Comprehensive Guide to Skin Ageing

June 13, 2018
Skin Ageing Treatments by Singapore Dermatologist

What causes skin ageing?

We know that skin ageing is a natural process that cannot be changed. Fine lines, wrinkles, sagging and dark spots are some changes in the skin as we grow older. While some of these changes are unavoidable, certain signs of ageing are actually caused by sun damage and can be avoided. Some knowledge of the mechanism of the human ageing process can allow you to be more adept at ways to slow down such effects.

The process of skin aging can be classified into 2 groups: extrinsic ageing and intrinsic ageing. The two processes are biologically different.

Extrinsic skin ageing

This factor includes physical, chemical or environmental factors that the skin is exposed to. A major contributor to extrinsic ageing is UV radiation. Cumulative exposure to the sun in an individual’s lifetime can add up to cause significant damage to the skin.

Other external factors are cigarette smoking, air pollution, and exposure to cold, heat, dust and smog. Our lifestyle choices can also take a toll on our skin e.g. exercise, sleeping habits, diet or stress. Varying circumstances through all these factors can cause oxidative stress. This leads to some extent of dysfunction across our cells, mitochondria, DNA and could manifest as inflammation, cellular membrane damage or even immune dysfunction for instance.

UVA and UVB radiation causes photoageing. As UVA can penetrate deeper into the skin (greater penetration depth) and generate unwanted radicals, it is said to be more responsible for photoageing. UVB rays are mostly absorbed by the outer skin layers and causes DNA damage within the outer skin cells.

Photoageing

Photoageing is a slow process resulting from chronic exposure to UV radiation. Skin type and accumulative lifetime exposure to the sun can determine the degree of photoageing. When UV light penetrates the skin, cells produce melanin to form as a protective barrier (this is also how a tan is developed!). The melanin pigment helps to reflect some of the rays. The rest of the radiation that is not reflected will be absorbed by the skin cells. This can damage the cells that function to develop tissue fibers for the skin’s structure.

In photoaged skin, the epidermis (outermost skin layer) becomes more fragile and less elastic. There is greater damage of elastic tissue and a decrease in cellularity. It can cause elastosis, where there is an overgrowth of elastic fibers. Rough spots called actinic keratoses can also be caused by excessive UV exposure, which can be precancerous skin lesions.

Antioxidant and skin ageing

UV radiation causes oxidative damage. This means it produces excessive free radicals within the skin cells. Free radicals are formed when atoms or molecules loose electrons. They are generated by our own bodies during normal metabolic process, but external sources such as from UV radiation may cause excessive amounts. Excessive free radicals can lead to human skin disorders and premature skin ageing for example. Exposure to air pollutants can also trigger the release of free radicals.

The human skin has antioxidant enzymes to help protect against free radicals, such as superoxide dismutase (SOD) and glutathione (GSH) biosynthesizing enzymes. Other antioxidant molecules you may be familiar with are vitamins A, C and E. Antioxidants protect cells by interacting with the free radicals and neutralizing them by “donating” electrons to prevent unwanted damage.

You can think of the antioxidants as the ‘good’ molecules in your fight against ageing. However, these antioxidants reduce in number over time, thus a weaker ability to combat against free radicals and against ageing. With weaker defence against free radicals, the skin begins to show signs of photoageing.

Intrinsic skin ageing

Intrinsic ageing can also be understood as genetically programmed ageing. Structural proteins such as collagen and elastin, a major component of the dermis, and organelles such as mitochondria are produced less over the course of time. DNA functions and repair abilities decline with time. Thinning and loss of the skin’s elasticity happens as visible manifestations of these changes. Chronologic ageing can also be caused by hormonal changes.

Preventing the ageing process

To improve skin quality, there are various treatments available.

  • Sunscreens have been long perceived as a vital prevention measure to reduce UV damage. Look for a dermatologist tested sunscreen with minimum SPF30. Apply and reapply religiously (every 3 hours for optimal protection).
  • Retinoids have shown to reverse sun damage and can improve the skin’s extracellular matrix (which provides structural and biochemical support to cells).
  • Cosmeceuticals may serve as a ready consistent supply of antioxidants
  • Dermal fillers can restore volume loss and remove skin wrinkles
  • Chemical peels use acids to regenerate and improve the appearance of aged skin

On your own, certain lifestyle habits can be changed to slow down the process of skin ageing. Adequate exercise and sleep are vital in general regulation of bodily functions which combat aging. Quitting smoking can cut out exposure to unwanted chemicals and pollutants. A diet rich in antioxidants can also be helpful. Keep hydrated and cleanse your skin regularly to remove dirt and pollutants / chemicals (which may cause oxidative stress) from the skin.

© 2018 TWL Specialist Skin and Laser Centre. All rights reserved.

—–

Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

Dermatologist’s Best Guide to Alpha Hydroxyl Acid (AHA) Facial Treatments

May 31, 2018
AHA Alpha Hydroxyl Acid Facial Treatments by Dermatologist

Alpha Hydroxyl Acid (AHA) Facial Treatments

Alpha hydroxy acids (AHA) are naturally-occurring compounds possessing unparalleled benefits to the skin and extensively used in a dermatologist’s office. Most AHAs are non-toxic and are often present in food and fruits, thus also known as fruit acids.

The types of AHA used commonly for cosmetic purposes are glycolic acid and lactic acid. Glycolic acid, found in sugar cane, has the smallest molecule of all the AHAs and is the most widely used acid in skincare. Lactic acid is present in sour milk and tomato juice and can be found in our bodies as a byproduct of metabolic processes.

Certain types of AHA have lipophilic (ability to dissolve in lipids/fats) side groups in its chemical structure such as mandelic acid and benzylic acid. Such acids are more soluble in lipids over the conventional water-soluble AHAs, thus are often used for oily and acne-prone skin.

Uses as a peeling agent

AHAs are commonly used in peeling procedures as a short intense exposure to the acid produces benefits to the skin. A chemical peel is the application of one or more chemical exfoliating agents to the skin, and by exerting a controlled epidermal injury, it allows regeneration of new epidermal and dermal tissue. Such treatments are often used to treat skin disorders and conditions for aesthetic improvement.

Using controlled higher concentrations of AHAs, application to the skin for short times can achieve substantial desquamation (skin peeling). This renewal of skin cells is useful in anti-ageing, reducing hyperpigmentation and improving radiance. It is important to have a chemical peel conducted by an accredited dermatologist, to prevent uneven peeling and dermal wounding.

In contrast to other peeling agents, such as phenol or salicylic acid, most of the AHAs are nutritive and physiologic.

Pre-peeling preparation

According to Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin and Laser Centre, to prepare the skin for a regeneration phase, pre-treatment is necessary. The cosmetic conditions most suitable for a chemical peel would be features of photo ageing, such as solar lentigines, sallowed complexions, rough and textured skin, fine lines or wrinkles, acne scarring or hyperpigmentation.

Whilst most skin types can opt for an AHA chemical peel, it is imperative to first seek assessment by an accredited dermatologist who will cater the peel, such as the acid type, strength, frequency and duration, for variability of individual skin conditions. Performed properly by a trained dermatologist, risk of scarring from a chemical peel is drastically reduced. The level of expertise in administering peels ensures a good outcome.

Prior to the actual application of the chemical peel substance, the skin will need to be thoroughly cleansed to remove oil and debris before being rinsed and dried.

Treatment with Chemical Peel

The peeling agent (AHAs) will be applied on the skin using an applicator or a brush. The duration of allowing the peeling agent to be in contact with the skin varies according to the skin’s conditions as assessed by the dermatologist. With superficial peels, some sensation of heat and stinging may be experienced, before the peeling agent is neutralized (where applicable) and thoroughly cleansed off after the duration of contact recommended by the dermatologist.

The chemical peel treatment is completed at our clinic with application of a hydrating Amino Acid Masque to soothe and calm the skin post-peel. Additional post peel care requires the use of sunscreens and other photoprotective agents, due to sun sensitivity post-treatment. It should be noted that regular application of sunscreen is advocated as it can reduce sun damage and aggravating of skin conditions.

How does a chemical peel work?

For superficial peels, the acid causes breakdown and decreases cohesiveness of corneocytes, that are found at the outermost part of the epidermis. Desquamation occurs, allowing renewal from lower epidermal layers. By weakening and ‘ungluing’ the cells in the inner stratum layer, it leads to uniform exfoliation of the outermost stratum layers.

With a low PH, most acid peels need to be properly neutralized to prevent acidification of the skin. To avoid burning, AHA peels are neutralized with basic salts such as sodium bicarbonate or sodium hydroxide.

A chemical peel does not compromise the barrier structure or integrity of the skin, as the mechanism of action of AHAs on the skin is a more targeted action for epidermal skin renewal.

Conclusion

As a treatment that improves skin texture and counters the effects of ageing, chemical peels continue to be relied on for various skin conditions. It is also safe for the skin and human health in general, as extensively tried and tested by dermatologist’s. A range of AHA formulations and concentrations are available for the dermatologist to administer therapy according to the patient’s requirements.

Speak to your dermatologist today for a tailored experience.

© 2018 TWL Specialist Skin and Laser Centre. All rights reserved.

—–

Meet with Dr. Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

To book an appointment with Dr. Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.