In This Issue:
Building Blocks of the Dermis
Collagen, the main component of the dermis, gives it durability. You probably already know that this protein is crucial to your skin – it's hard to pick up a magazine or browse the moisturizer aisle without seeing mention of it! What you may not realize, though, is that there are actually eighteen types of collagen, eleven of which are present in the dermis.
Elastin gives skin (and other organs like the lungs and blood vessels) resilience and bounce. Until recently, it had been the subject of far less research than collagen, but dermatologists are increasingly interested in elastin loss. Damage to elastin fibers, from sun exposure, age, or disease, leads to a loss of elasticity and, consequently, wrinkles.
Hyaluronic Acid holds water and gives skin volume. In young skin, it is present around and between collagen and elastin cells. As skin ages, though, hyaluronic acid does not play that connective role – which explains the popularity of anti-aging treatments that inject it into the dermis.
The Science of Dermis
Look down at your hand. Now, instead of seeing mere skin, consider the fact that you're actually staring at a complex organ! The surface layer of skin ? what you see right now ? is called the epidermis. Most skin care products operate at this level because very few ingredients penetrate deeper than the epidermis. Moisturizers, for example, are designed to replenish and protect the lipids at the center of the epidermis.
But just below the epidermis, in the dermis, things really get interesting. This lower layer of your skin, although harder to target than the epidermis, is where wrinkle-causing changes take place. And when it comes to wrinkle-prevention, a little knowledge can go a long way!
Fibroblasts, the primary cell type of the dermis, generate three main structural components: collagen, elastin, and hyaluronic acid – remember those three, because keeping (and replacing) them is the goal of almost every anti-aging product and treatment. The dermis is also full of nerves, blood vessels, sweat glands, and immune cells. Just below it lies a layer of subcutaneous fat, which also tends to shift and diminish with age.
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"Thin Skin" Isn't Just an Expression!
The thickness of the dermis, in fact, has a very real – and changeable – impact on skin's appearance. Skin thickness varies over different parts of the body, and throughout a person's lifetime. Generally, it doubles between the ages of three and seven, and again at puberty; from there on out, it decreases. What we may simply describe as skin "aging" is more specifically this gradual process of thinning as the dermis loses collagen, elastin, and hyaluronic acid.
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Skin Care Myth:
The Myth: You can replace collagen, elastin, or hyaluronic acid with topical treatments.
The Truth: There is no way to replace collagen, elastin, or hyaluronic acid with topical treatments. Contrary to the claims of some skin care products, the molecules of all three are too large to pass through the epidermis. The only exception to this is that hyaluronic acid can sometimes help hydrate the skin when applied topically.
Treat Your Dermis Right ... It'll Repay the Favor
Aging gracefully isn't a matter of luck. Sure, good genes give some people a head start. But taking care of your skin, particularly at the level of the dermis, can have a far more lasting impact. Consider which of the following ingredients and treatments are right for you (and note those preventative measures – they're right for everyone!):
Skin Care Ingredients
Although you can't replenish collagen, elastin, and hyaluronic acid topically, certain topical products can help stimulate dermal activity.
As I mentioned earlier, few skin care ingredients penetrate deeper than the epidermis. There are a few exceptions, though: Retinol and prescription-strength retinoids (such as Retin-A) are perhaps the most effective method for reducing collagen damage. When shopping for over-the-counter options, be sure to choose products in packaging that blocks light, which makes retinol inactive. (Please note, however, that retinoids are not suitable for women who are or plan to become pregnant, or for women who are breast-feeding.)
Vitamin C (in the form of ascorbic acid) and copper peptide have been shown to increase collagen production.
Alpha-hydroxy acids, such as glycolic acid and lactic acid, have also been shown to stimulate collagen production. Better yet, they remove the top layer of dead skin cells to help the other beneficial ingredients in your skin care regimen penetrate.
Antioxidants (such as vitamins C and E, lycopene, green tea, and coenzyme Q10) help eliminate free radicals, renegade molecules that attack the collagen, elastin, and hyaluronic acid in your skin. Many moisturizers and serums contain these ingredients.
Treatments
If your skin is already noticeably wrinkled, or if topical products simply aren't enough for your resistant skin type, I highly recommend consulting a professional. In many cases, opting for a professional-strength retinoid or one of the following treatments is also the most cost-effective decision. Please note, though, that these treatments can't help – and can possibly hurt – if they are not performed by qualified, experienced dermatologists.
Dermal fillers: I prefer dermal fillers that use collagen (i.e. CosmoPlast) or hyaluronic acid (i.e. Restylane, Hylaform, or Juvéderm), as they simply replace substances that your skin naturally produces. The results are instantaneous and feel particularly natural.
Mesotherapy: This treatment uses superficial-level injections of vitamins, amino acids, and other ingredients to stimulate the production of collagen and elastin.
Resurfacing treatments: CO2 laser treatments and dermabrasion (not to be confused with microdermabrasion, which is more superficial) aim to improve the texture of skin and minimize stubborn wrinkles.
An Ounce of Prevention…
The harsh truth is that once wrinkles and fine lines exist, they are hard to minimize. Consequently, no product or treatment is as effective as preventing the loss of collagen, elastin, and hyaluronic acid in the first place.
Sun exposure is the quickest way to degrade the dermis and break down collagen, elastin, and hyaluronic acid. Always wear at least SPF 15 (in your moisturizer, your foundation, or a separate sunscreen) and don't neglect your neck, chest, or hands – aging doesn't just happen on your face.
Smoking has been shown to stimulate the breakdown of collagen, while decreasing collagen production by up to 40%. Another good reason to quit!
Nutrition is crucial to protecting your body inside
and out. Those antioxidants I mentioned earlier? Don't stop at moisturizers and serums – be sure to eat lots of fruits and veggies, or add an antioxidant supplement to your diet.
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The Numbers Game:
- In a study of Egyptian subjects, the amount of elastin in sun-protected skin
went from about 49% in the first decade of life to about 30% in the ninth.
- A similar study conducted on Caucasian subjects showed an elastin
decrease of about 51%.
- During the first five years after menopause, skin's collagen content decreases
by 30%. The average decline per year thereafter is 2.1%.
No, I'm not trying to scare you! The bottom line is that collagen, elastin, and hyaluronic acid decrease with age, causing increased wrinkling and decreased skin elasticity. But awareness of that process – and of the ways you can diminish its effects – can make a world of difference.
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As more dermal fillers make it to the market, I am confident that they will become increasingly affordable. Moreover, advances in this area of dermatology are already producing longer-lasting treatments. Juvéderm, for example, which was approved by the FDA in June 2006 and became widely available in early 2007, has been shown to last for up to six months, significantly longer than collagen-based injections.
You may have noticed, though, that while I discussed collagen- and hyaluronic acid-based dermal fillers, I didn't mention elastin. Replacing elastin has long proven more challenging, but recent studies have shown that zinc-based products by the brand name Relastin may be effective in stimulating elastin production. More research is required, but I'm optimistic that these findings will eventually allow us to slow the loss of elasticity that comes with aging.
One thing's for sure: We've only seen the beginning of what dermatology can do to repair and protect the dermis.
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Wishing you great skin!
Dr. Leslie Baumann
Do you have a question? Come visit me at www.SkinTypeSolutions.com or
read my Yahoo blog at www.TheSkinGuru.com
