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THE AGEING SKIN – ::A BROAD VIEW::
For more presentations and information visit THE AGEING SKIN – ::A BROAD VIEW:: BY: MALVI PATEL UNDER THE GUIDANCE OF: DR. ABHA DOSHI
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WHAT IS AGEING? Ageing is the process of growing old.
For more presentations and information visit WHAT IS AGEING? Ageing is the process of growing old.
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THE ANATOMY OF SKIN
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Cells of Epidermis Keratinocytes Melanocytes Langerhans cells
For more presentations and information visit Cells of Epidermis Keratinocytes They produce keratin in the skin Melanocytes Produce melanin pigment in the skin Langerhans cells Participate in immune response Merkel cells Touch sensation
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Cells of Dermis Fibroblasts Macrophages Adipocytes
For more presentations and information visit Cells of Dermis Fibroblasts Provides structural framework Synthesizes extracellular dermal constituents Macrophages Phagocytosis of cellular debris and pathogens Adipocytes Fat storage cells
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THE CHEMICAL CONSTITUENTS OF DERMIS
For more presentations and information visit THE CHEMICAL CONSTITUENTS OF DERMIS COLLAGEN most abundant Provides strength and support ELASTIN Imparts elasticity to the skin GLCOSAMINOGLYCANS High water retaining capacity Most important of them is HYALURONIC ACID
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AGEING SKIN INRINSIC AGEING Telomere Shortening Mitochondrial Damage Endocrine Dysfunction EXTRINSIC AGEING Photo-ageing Smoking Lifestyle
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Telomere Theory of Ageing
For more presentations and information visit Telomere Theory of Ageing What are telomeres? Its relation to ageing? Telomere shortening = ageing Telomerase – the savior Helps stabilize and replenish the telomere length
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Mitochondrial Damage The mitochondria generates reactive oxygen species during ETC. What are Reactive Oxygen Species? The bad effects of these Reactive Oxygen Species? Lipid Peroxidation Alteration of gene expression pathways causing: Degradation of collagen Accumulation of elastin
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Endocrine Dysfunction
For more presentations and information visit Endocrine Dysfunction Ageing causes reduced hormone production. Estrogen reduces with age. Lower Estrogen level is associated with skin ageing and telomere shortening. Reduced Estrogen causes Loss of Elasticity Reduced Water holding capacity Increased Pigmentation Decreased vascularity
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Photo-ageing Ultraviolet (UV) rays from the sun cause skin damage and accelerate ageing of the skin. Two mechanisms by which UV rays act are: Mechanism 1 (Induction of Matrix Metalloproteinases) Mechanism II (Mitochondrial Damage) DNA damage Production of ROS
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Smoking Smokers look older than non-smokers of the same age.
For more presentations and information visit Smoking Smokers look older than non-smokers of the same age. Tobacco smoke induces Matrix metalloproteinases.
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Lifestyle Lifestyle of a person can also contribute to ageing.
For more presentations and information visit Lifestyle Lifestyle of a person can also contribute to ageing. Factors such as: Lack of sleep Intake of alcohol Improper diet Stress Can have ill effects on the skin and accelerate ageing.
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CHANGES THAT OCCUR IN AGED SKIN
For more presentations and information visit CHANGES THAT OCCUR IN AGED SKIN YOUNGER SKIN OLDER SKIN
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PHARMACEUTICAL PRODUCTS AND PROCEDURES FOR THE ELDERLY
For more presentations and information visit PHARMACEUTICAL PRODUCTS AND PROCEDURES FOR THE ELDERLY SUNSCREENS MOISTURIZERS ANTIOXIDANTS FILLERS CHEMICAL PEELS BOTULINUM TOXIN (BOTOX) ESTROGENS PLASTIC SURGERY MAKE-UP
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Approx Rs 100 to 150 SUNSCREENS Most of the damage during ageing is due to the harmful UV radiations blocking these rays are the primary step to prevent skin ageing. We will take a closer look at HOW SUNSCREENS ACT? TYPES OF SUNSCREENS
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How Sunscreens Act? = SUNSCREEN SUBSTANCE
For more presentations and information visit How Sunscreens Act? PHYSICAL SUNSCREENS CHEMICAL SUNSCREENS ACT BY REFLECTING THE LIGHT ACTS BY ABSORBING THE LIGHT = SUNSCREEN SUBSTANCE
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Common Examples of Sunscreen agents
For more presentations and information visit Common Examples of Sunscreen agents PHYSICAL SUNSCREENS CHEMICAL SUNSCREENS Zinc Oxide Titanium Dioxide Salicylates Cinnamates Anthranalites NOTE – It has even been observed that use of sunscreens helps in reversing the effects of ageing. Hence incorporation of sunscreens into your daily skin care regimen is of primary importance.
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An example of a sunscreen formulation
For more presentations and information visit An example of a sunscreen formulation A sunscreen formulation in a vanishing cream base Ingredient Quantity Role Stearic acid 18% Forms primary emulsion with NaOH and also forms an occlusive film Sodium hydroxide 0.5% Reacts with a portion of the stearic acid insitu to form the emulsifying agent sodium stearate Cetyl aclcohol Emollient , occlusive Menthyl anthranilate 5% Chemical sunscreen agent Glycerin 10% Humectant Water To make 100% Aqueous phase of the cream Perfume q.s. Gives pleasant odour
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Approx: Rs 100 + MOISTURIZERS In old age, it is observed that there is a dryness and dehydration of skin. Moisturizers help the skin retain the moisture and this helps to make the skin soft and supple.
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An example of a skin moisturizer
For more presentations and information visit An example of a skin moisturizer Ingredient Quantity Role Stearic acid 4.0% Reacts with triethanolamine to form primary emulsion. Triethanolamine 0.2% Mineral oil 8.0% Emolient and occlusive Lanolin 1.0% Isopropyl Myristate 2.0% Glyceryl monostearate 3.0% Helps form secondary emulsion Glycerin Humectant Propylene Glycol Water 100.0 Vehicle Perfume q.s. Gives a pleasant odour
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ANTIOXIDANTS Free radicals or reactive oxygen species are the major cause of ageing and damage in cells over time. Antioxidants act by neutralizing the free radicals and thus prevent them from causing damage to the cells. Most commonly used are Vitamin A Vitamin C Vitamin E X
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FILLERS Substitutes for lost dermal components.
For more presentations and information visit Approx Rs 1700 to 2000/ crease FILLERS Substitutes for lost dermal components. Over age, the dermis loses many components which are responsible for elasticity such as collagen. This loss of elastic constituent of the skin leads to wrinkles and furrows in the skin. Replenishing the dermal constituents by artificially injecting it helps the skin to reduce the visible ageing.
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List of dermal fillers Dermal filler type Product Collagen Bovine collagen human collagen Zyderm, and Zyplast Cosmoderm, Cosmoplast Hyaluronic acid Restylane, Hyalaform, Captique and Juvederm Biologic combination fillers Alloderm Autogenous fat Poly-L-Lactic Acid Sculptra Radiesse Polymethylmethacrylate microspheres Artefill Injectable liquid silicone
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Injection site of dermal fillers
For more presentations and information visit Injection site of dermal fillers Zyderm I Zyderm II (mid dermis) Zyplast (deep dermis)
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Around 400 to depending on depth CHEMICAL PEELS Treatment to improve skin condition using a chemical solution which would cause the old skin to blister and eventually peel off exposing new smoother skin.
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Types of chemical solutions
For more presentations and information visit Types of chemical solutions Alphahydroxy acids (AHAs) – eg. Glycolic acid and lactic acid. Betahydroxy acids (BHAs) – eg. Salicylic acid Jessner’s Peel – combo of resorcinol, salicylic acid and lactic acid. Trichloroacetic acid (TCA) Phenol peels
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Classification of chemical peels
For more presentations and information visit Classification of chemical peels Chemical Peels Superficial Very Light eg. Glycolic acid 10 to 50% Light eg. Glycolic acid 50 to 70% Medium depth eg. Combo of TCA 35% and 70% Glycolic acid Deep eg. Baker-Gordon Formula
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Procedure to apply chemical peels
For more presentations and information visit Procedure to apply chemical peels Choosing a chemical peel Patient counselling and consent Washing and defatting of skin Protection of delicate areas Premedication given Peeling agent is applied using a gauze/cotton swabs Application of peel is done from forehead to chin Allow the peel to stay on till frost formation Stop the peeling process using neutralization when necessary
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BOTULINUM TOXIN (BOTOX)
For more presentations and information visit Approx Rs 1700 – 2000/ crease BOTULINUM TOXIN (BOTOX) Botulinum toxin type A is a toxin obtained by the process of fermentation using Clostridium botulinum species of bacteria. Botulinum toxin is a highly toxic substance which when used in lower concentrations can be beneficial to reduce wrinkles by causing flaccid paralysis. The toxin is injected in quantity of 5-10 units intramuscularly.
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ESTROGENS Estrogen and its derivatives can be given
For more presentations and information visit ESTROGENS Estrogen and its derivatives can be given Orally Topically Newer Selective Estrogen Receptor Modulators (SERMs) can also be used for its specific action on skin.
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Rhitidectomy (face lift)
For more presentations and information visit Rs 20,000 + PLASTIC SURGERY The word ‘plastikos’ means to mold or to shape. Many surgical techniques to enhance skin appearance exist. Of which the most common used are: Blepharoplasty Rhitidectomy (face lift) Dermabrasion Laser resurfacing
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Eye liners and mascaras–
For more presentations and information visit Price Varies MAKE-UP Commonly used make-up Lip-liner Lip balms Eye liners and mascaras– Face powders Foundation make up
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“Youth has no age” Pablo Picasso
For more presentations and information visit CONCLUSION “Youth has no age” Pablo Picasso
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REFERENCES Journal Articles Skin ageing and its treatment, L Baumann* Journal of Pathology J Pathol 2007; 211: 241–251 Elderly skin and its rejuvenation: products and procedures for the aging skin, Marcia Ramos-e-Silva et. al., Journal of Cosmetic Dermatology, 6, 40–50 Dermal filler agents: a practical review, Sukhjit S. Johl and Richard A. Burgett, Current Opinion in Ophthalmology 2006, 17:471–479 Effect of estrogens on skin aging and the potential role of selective estrogen receptor modulators. S Verdier-Sévrain Climacteric; Aug 2007; 10, 4; Health Module pg. 289 Facial skin rejuvenation, David E. E. Holck and John D. Ng, Current Opinion in Ophthalmology 2003, 14:246–252 Nutritional and Botanical Approaches to Antiaging, Chris D. Meletis, N.D., with Nieske Zabriskie, N.D. ALTERNATIVE & COMPLEMENTARY THERAPIES—DECEMBER 2006, Textbooks : Principles of Anatomy and Physiology, Gerard J Tortora, Chapter 5– The Integumentary System (pg 139 – 145) Harrys cosmeticology, J. D. Wilkinson and R. J. Moore, Longman Singapore publishers te ltd. Pg (sunscreens and suntan oils) Cosmetics Formulation Manufacturing and Quality Control, P P Sharma, Vandana Publications pvt. Ltd. Pg 195 – 198, 183 – 185. Web References: Wikipedia: ( E- Medicine ( Chemical Peels by Raymond T Kuwahara - )
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THANK YOU
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