Ageing skin is a gradual process that begins around the age of 25 and tends to accelerate in the 40’s, and again in the 70’s. While it is an inevitable part of life, understanding the mechanisms and causes of ageing skin are just as important as addressing it—because the right knowledge paired with targeted ageing skin treatment can turn back the clock on your complexion.
Overview
The visible signs of ageing skin—fine lines and wrinkles, thinning and fragility, dull skin, and dry skin—affect different parts of the body in unique ways.
The face shows the most significant impact, accounting for 50% of visible ageing symptoms. The neck follows, displaying 25% of the effects, while hands exhibit 15%, often presenting signs such as thinning and dry skin. Knees account for 10% of ageing changes, commonly manifesting as sagging skin.
Ageing skin occurs through two mechanisms: intrinsic and extrinsic ageing. Both contribute to visible changes, but are driven by different causes.
| Subtype | Description | Common Areas |
| Intrinsic Ageing (Chronological) | The normal course of ageing, closely linked to the biological clock and passage of time. It occurs gradually, irrespective of external factors. | Affects the entire body, including less exposed areas like the torso, back, and buttocks. |
| Extrinsic Ageing (Photoageing) | Premature ageing caused by external factors, which accelerate intrinsic ageing. It involves preventable damage to the structural components of the skin, impeding its natural repair mechanisms. | Impacts exposed areas such as the face, neck, arms, and legs. |
When it comes to gender, biological and environmental factors intersect differently for men and women. Women’s skin intrinsically ages faster than men’s, though men are often more affected by extrinsic factors, such as lifestyle choices.
Skin tone also plays a role in how ageing manifests. Lighter skin tones tend to show wrinkles more visibly, while darker skin tones often retain a smoother appearance for longer. However, darker skin tones may experience more pigmentation changes as they age.
While intrinsic ageing cannot be mitigated, it is becoming increasingly possible to reduce extrinsic ageing.
Causes
The primary cause of ageing skin is the loss of the skin’s ability to regenerate two essential proteins: collagen and elastin. These proteins are crucial for maintaining skin strength and mobility.
Collagen is a protein that provides structure and elasticity to the skin. From around the age of 25, production begins to declines by about 1% per year.
Elastin is the fibres that help the skin return to its original shape after stretching. As elastin depletes, it causes the skin to become less resilient and more prone to sagging.
Intrinsic ageing is driven by biological processes:
| Cause | Description |
| Genetics | Genetics influence the rate at which cells replicate, repair, and respond to environmental stressors. Mutations or variations in specific genes can cause faster cellular breakdown, leading to fine lines and wrinkles. |
| Cellular | Cells replicate about 50 times before they can no longer accurately copy genetic material. As cells become senescent and accumulate, the skin thins, loses elasticity, and becomes fragile. |
| Hormones | Hormones, particularly oestrogen and testosterone, decline over time, reducing skin elasticity, hydration, and overall resilience. |
The extrinsic factors that accelerate ageing include:
| Contributor | Description |
| Photoageing | Photoageing is caused by UV radiation, particularly sun exposure between 11am and 3pm, and the use of tanning beds, which trigger thousands of DNA alterations in skin cells every day, breaking down collagen and elastin. This leads to age spots and rough texture. |
| Nutrition | Nutrition, including diets high in sugar and processed foods cause glycation, which binds sugar molecules to proteins like collagen, reducing skin flexibility. Conversely, antioxidant-rich foods, like fruit and vegetables, help to combat oxidative stress. Additionally, lack of hydration can increase the risk of skin thinning. |
| Medications | Medications, such as immunosuppressive agents, along with immune deficiency diseases and the psychological stress they treat, can accelerate cellular damage and reduce skin resilience. |
| Smoking | Smoking, particularly due to nicotine, narrows blood vessels and reduces blood flow, limiting the amount of oxygen and nutrients that reach skin cells. This results in a sallow complexion. |
| Alcohol | Alcohol, when consumed excessively, dehydrates, and damages the skin, diminishing its natural glow. |
| Skincare | Skincare becomes increasingly important as the natural exfoliation process slows with age. Not cleansing properly can cause a buildup of dead skin cells, oil, and dirt, resulting in a dull complexion. |
| Environment | The environment, and pollution, such as particulate matter and smoke, can clog pores, lead to inflammation, and leave the skin looking dull. Harsh working conditions and chronic stress can have an adverse effect on hormonal levels, worsening skin health. |
Diagnosis
Monderma determines the extent of premature ageing by examining exposed areas of the skin to identify its underlying causes.
The normal course of ageing includes predictable symptoms that develop over time:
| Age | Symptoms | Description |
| 25-30 | Fine lines on the forehead and around the eyes. | The skin begins to thin, reducing its barrier function and natural UV protection. Collagen mass and flexibility starts to deplete by about 1% per year. |
| 30’s | Fine lines on the cheeks, around the mouth, and on the neck, with mild hyperpigmentation. | The skin’s barrier function weakens, cell metabolism slows, and hyaluronic acid production declines, increasing moisture loss, and the first effects of sun damage from teenage years and the 20’s start to appear. |
| 40’s | Moderate wrinkles on the forehead, around the eyes, cheeks, and mouth, as well as dull, and dry skin, and reduced volume in the cheeks and neck. | Outer skin layers no longer lie in their proper order, resulting in a more pronounced dull appearance. Existing skin cells shrink, and fewer new cells are formed, reducing skin volume. |
| 50’s | Thinner, less elastic skin, with moderate hyperpigmentation. | Connective tissues in the skin’s middle layer lose their fibrous structure and ability to retain water. Fat tissue in the lower layer thins. |
| 60’s | Deep wrinkles, sagging, and significantly dry skin. | The skin’s natural lipid production declines, as does the production of collagen and hyaluronic acid, resulting in deeper wrinkles and slower skin regeneration. The skin becomes more fragile and prone to dry skin. |
| Over 70 | Impaired wound healing and severe hyperpigmentation. | The skin’s immune function weakens significantly, making it more vulnerable to infection. Wound healing slows, and hyperpigmentation becomes more severe due to prolonged exposure to environmental factors. |
Treatment
While intrinsic ageing cannot be prevented, extrinsic ageing can be addressed through skincare treatment. Monderma’s custom formula includes up to 3 of the following types of active ingredients:
| Topical Ingredient | Properties |
| Retinoids | Retinoids, such as tretinoin and adapalene, promote skin cell turnover to reduce pore size, clear spots, and smooth fine lines. |
| Lightening Agents | Lightening agents, in particular hydroquinone, reduce the production of melanin to lighten patches of darker skin. |
| Anti-Inflammatories | Anti-inflammatories, including azelaic acid, inhibit inflammation-causing molecules to reduce redness, calm inflammation, and lighten patches of darker skin. |
| Antioxidants | Antioxidants, like niacinamide, repair and strengthen the barrier function of the skin to lock in moisture and improve suppleness. |
Daily use of broad-spectrum sunscreen with SPF30 or higher is essential for ageing skin treatment. Lasting results typically take at least 8 weeks to appear, so it is important to follow a treatment plan.
Complications
As the skin ages, cumulative damage from both intrinsic and extrinsic factors result in a series of changes that affect its appearance and function. These changes are visible in several forms:
| Complication | Description |
| Fine Lines And Wrinkles | Dynamic wrinkles, such as frown lines, crow’s feet, and laugh lines, are most noticeable when the muscles beneath them are active due to repeated facial movements. Static wrinkles, like forehead lines, cheek wrinkles, and marionette lines, are present even when the face is at rest. Gravitational wrinkles, including jowls and neck wrinkles, appear where the skin begins to sag as it loses elasticity. Atrophic wrinkles are fine lines resulting from decreased skin thickness and elasticity. Compression wrinkles, such as sleep lines, form due to external pressure on the face. |
| Thinning And Fragility | Thinning skin becomes more fragile and prone to injury as it loses its protective cushioning. This increases the risk of wounds, tears, and bruising, while slower healing from impaired cell regeneration and a weakened vascular network, further increasing the risk of infection. Loss of fat tissue beneath the skin leads to a hollowed appearance, especially around the temples and cheeks. |
| Dull Skin | Dull skin is often the first visible symptom of ageing skin. Reduced ability to shed dead skin cells and generate new ones leads to a buildup of cells on the surface and a lacklustre complexion. Limited blood flow reduces oxygen and nutrient delivery, further diminishing vibrancy. Without the ability to reflect light effectively, ageing skin appears matte and flat, making pores and pigmentation more noticeable. |
| Dry Skin | Dry skin becomes more common with age as the skin’s ability to retain moisture and produce natural oils declines. Sebaceous gland activity decreases, weakening the protective lipid barrier and increasing dry skin. Reduced hyaluronic acid production leads to moisture loss from deeper layers of the skin, resulting in a rough, flaky texture that can cause irritation and itching. |
| Hyperpigmentation | Hyperpigmentation is often caused by slower cell turnover, hormonal changes, inflammation, and cumulative sun damage. Dark spots and uneven pigmentation become more pronounced as the skin’s ability to renew itself diminishes with age. |
| Rosacea | Rosacea becomes more common as the skin ages. Blood vessels near the surface become more visible and susceptible to dilation and damage. The skin’s reduced ability to repair itself and control inflammation increases the likelihood of developing or exacerbating redness and sensitivity. |
| Psychosocial | Psychosocial factors related to early physical changes in appearance and societal attitudes toward ageing skin can negatively affect self-esteem, particularly in those in their 30’s and 40’s. |
Understanding and managing these complications is essential for treating ageing skin and promoting overall wellbeing as one ages.
In Conclusion
Ageing skin is the result of a combination of intrinsic and extrinsic factors. While it is a natural part of life, advances in prescription skincare offer effective ways to manage and mitigate its effects to great effect.
By understanding the mechanisms of ageing skin and adopting effective treatment, you can improve both overall skin appearance and function. Take control today by completing Monderma’s short, free online skin consultation to see if prescription skincare would be right for you.
