Cosmetic aspects of cutaneous aging

The ageing process is noticeable within all organs of the body and manifests itself visibly in the skin. Skin ageing is influenced by several factors including genetics, environmental exposure, hormonal changes and metabolic processes. Together these factors lead to cumulative alterations of skin structure, function and appearance. So, ageing of the skin involves the intrinsic process of senescence and extrinsic damage induced by chronic exposure to UV radiation. Oxidative stress is considered of primary importance in driving the ageing process. The original free radical theory of ageing purported that the molecular basis of ageing was derived from a lifetime accumulation of oxidative damage to cells resulting from excess reactive oxygen species (ROS) produced as a consequence of aerobic metabolism. Although the skin possesses extremely efficient anti-oxidant activities, during ageing, ROS levels rise and anti-oxidant activities decline. Chronologically, aged skin is thin, dry and unblemished, with some loss of elasticity. General atrophy is reflected by a decrease in the number of fibroblasts, reduced levels of collagen and elastin. Clinically photoageing is characterized by coarseness, wrinkling, mottled pigmentation, laxity, telangiectasia, and premalignant and malignant neoplasms. The non-surgical treatment options available today (Intense Pulse Light, Fractional Laser, chemical peels, fillers …), are clinically proven to dramatically improve these visible signs of aging. The different treatments should be integrated and customized for each individual to maximize skin correction.