Skin Conditions

Skin ageing is a result of biological changes in the epidermis, dermis & hypodermis, extending right down to muscular & skeletal components as natural degradation occurs. In the epidermis, barrier function is reduced causing an increase in transepidermal water loss (TEWL). TEWL is the diffusion of water from the dermis & epidermis which eventually evaporates from the skin, causing dehydration & sensitivies. Skin cell turnover slows, causing rough, uneven texture & pigment changes, exacerbated by the sun's harmful UV rays.

 

In the dermis, collagen, elastin, & hyaluronic acid levels decrease leading to reduced firmness, elasticity & hydration. This results in fine lines, wrinkles, dullness & uneven skin tone. Hypodermis ageing is marked by the loss of fat in the face, which leads to decreased fullness, as well as more prominent wrinkles & jowling.

 

Ageing of the skin can be classified into two categories: intrinsic & extrinsic:

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Intrinsic ageing, known as natural or chronological ageing, normally begins in our mid-20s & is determined by genetics & certain internal factors that are uncontrollable.

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Extrinsic ageing accounts for up to 90% of skin ageing & is largely controllable. The most common causes are:

• Sun exposure - the major cause, often referred to as 'photoageing'

• Pollution & environmental stressors

• Lifestyle choices, such as insufficient sleep patterns, smoking & alcohol consumption

• Stress

 

The good news is that you can reverse some of this damage & prevent future negative effects on the skin by treating it with a carefully selected, at home, skincare regime & in-clinic skin treatments.

 

WHAT DOES AGEING SKIN LOOK LIKE?

While the ageing process varies from person to person, some common skin changes include:

• Dehydration

• Loss of elasticity

• Dull appearance

• Discolouration/uneven skin tone

• Rough texture

• Fine lines & wrinkles

• Lack suppleness & fullness

Blemish-prone skin represents a condition that consists of excess oil production, comedones, papules, pustules, & sometimes, cysts. It commonly presents on areas of the body that contains many sebaceous glands like the face, neck, chest, back & shoulders. Blemishes typically present themselves (& is most common) in puberty, but many adults also develop the condition.

 

TYPES OF BLEMISHES

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Non-inflammatory

Blackheads & whiteheads (open & closed comedones) occur when a plug made up of sebum & dead skin cells can be seen inside a follicle (pore), but does not cause any inflammation or redness.

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Blackheads: If the plug enlarges & stretches the pore, it is referred to as a blackhead. Blackheads are filled with excess debris, dead skin cells & oil that often oxidizes &/or reflects light differently, causing it to appear darker.

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Whiteheads: When a thin cover of skin traps the plug, it prevents the oil from oxidizing. This keeps the colour light, hense the name, "whitehead".

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Inflammatory

When follicles are blocked by sebum, debris & dead skin cells, the follicular wall experiences pressure. If the pressure is great enough, the follicle wall will break & the contents will spread into the surrounding skin.

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When your immune system responds to this bacteria & sebum, inflamed blemishes present. The degree of inflammation determines the size & severity of the blemish.

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Papules: Pink or red bumps without a white or yellow centre (pus).

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Pustules: Red bumps with a white or yellow centre, indicating the presence of pus.

Pustules are formed when the plug inside a pore traps oil & bacteria, which draws white blood cells to the area to fight infection. Pus is made up of dead white blood cells.

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Cysts and nodules: Larger (& often painful) lesions that extend into the deeper skin layers. Cysts & nodules can last for months, destroy the follicle & lead to permanent scars. 

Rosacea is a chronic skin condition characterised by facial flushing, redness, telangiectasias (visible blood vessels) & sometimes, blemishes. The first sign of rosacea may be the onset of visible redness that comes and goes, and varies in intensity.

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Redness-prone skin is most often seen in fair-skinned individuals, typically between the ages of 30 and 50, & generally affects the cheeks, nose, forehead & chin. While it is more common in women, it can be more aggressive for men. The cause of redness-prone skin can be due to a number of genetic & environmental factors. Some of these factors include small intestine bacterial overgrowth, an immune reaction to a natural mite (demodex mite) that lives in our skin, unstable vessels, genetics & sun exposure. What we do know, is that the skin is easily triggered & irritated, which leads to chronic redness with intermittent flare-ups.

 

If skin is sensitive or damaged, it will not optimally defend itself from common daily aggressors. Sun, wind & pollution can signal an inflammatory response within the skin. Since the skin is compromised & unable to properly protect itself, the body sends blood to the triggered areas as a defence mechanism. Blood brings oxygen via the red blood cells & immunity through white blood cells to try & defend against the effects of these aggressors. In doing this, it may also introduce heat, redness & inflammation, which is easily detected on the skin's surface. If this flushing reaction occurs regularly over time, the blood vessels just under the skin will become dilated & the redness will be more permanent.

As a result, the skin will become more vulnerable to external triggers, & visible symptoms may worsen over time.

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While it can be very difficult to completely correct this condition, there are various ways to manage the associated symptoms. These can include both lifestyle & diet changes as well as in-clinic & at home treatments to target & ease the symptoms.

Hyperpigmentation occurs when excess melanin causes a darkened appearance to the skin in either small or large areas. Pigmentation is the natural colour of a person's skin & is related to melanin production. Melanin protects skin cells & their DNA by absorbing the sun's ultraviolet rays (UVR). Darker skin types, in general, are more susceptible to hyperpigmentation than lighter skin types because their skin can naturally produce melanin more efficiently, as a natural defense mechanism.

 

 Hyperpigmentation Types & Triggers:

1. Melasma (chloasma): Appears as symmetrical patches most often on the cheeks, chin, upper lip & forehead. It can be related to genetics, pregnancy, certain medications, &/or hormone imbalances.

2. Post-Inflammatory Hyperpigmentation (PIH): Found in areas of the skin that have been subjected to inflammation due to trauma, inflamed blemishes or irritation (eg. fragrances). Inflammation stimulates Langerhans cells (immune cells), which alter the activity of melanocytes (cells that produce melanin), causing increased melanin (pigment) production.

3. Photodamage: This type of discolouration can present in the form of freckles, age spots & uneven skin tone. It is caused by prolonged/repeated exposure to UV rays (UVR), whether from the sun or sun beds.

The Hyperpigmentation Process:

1. External aggressors trigger an inflammatory response that activate the cells that produce melanin.

2. Melanin production is executed within the melanocytes.

3. Melanin is transferred from melanocytes to skin cells.

4. Skin cells are in a constant state of upward motion to the surface.

5. Melanin accumulates on the surface presenting as dark spots, patches or becomes uniformly darker (tan).

Home & in-clinic treatments can target discolouration & uneven skin tone.