There’s a sweet saying that goes, “Wrinkles are engraved smiles.” Aging points to increased wisdom, memories, and experiences of long life. Although ‘youth is wasted on the young’, our society has a fear of aging and the physical characteristics associated with it. For instance, women as young as 20 are now getting Botox regularly and over 200,000 people get facelifts in the US each year, and this number is only projected to rise.
In short, we have a cultural obsession with youth, especially when it comes to our skin—particularly the skin on our face. Wrinkles, instead of being seen as “engraved smiles” or markers of wisdom, are seen as something to avoid and mask. When caught in the cultural pressure to look young, it can be helpful to flip the narrative and focus on the health, rather than the youth, of your skin.
There are two main factors to consider when thinking about the health of your skin: the molecules supporting skin strength, and the integrity of the skin’s bilayer (the skin barrier). Collagen and elastin are two important molecules that contribute to healthy, durable skin. Collagen provides the structure and support to your skin, while elastin creates flexibility so that your skin can stretch – but return to its natural place afterwards. Your skin’s protective barrier consists of a lipid bilayer (sheets that form a continuous barrier around the cells); it functions to keep moisture IN and harmful chemicals, bacterium, and irritants OUT.
In this blog, we’ll cover the internal and external factors that can modify your skin as you age, affecting its health, protective barrier, and molecules like elastin and collagen with time. To start, internal factors are endogenous, meaning they come from within your body. When considering internal factors, three main players are inflammation, glycation, and hormones.
Inflammatory skin aging can occur for a variety of reasons including poor sleep, high stress, inflammatory (highly processed, sugary) diet, and more. Interestingly, when it comes to inflammation in the skin, we also need to consider senescent cells. All cells in your body have a certain lifetime; the majority of skin cells, for instance, die off in two to four weeks. Senescent cells, however, stop multiplying but don’t die off when they should. They stick around and continue to release chemicals that can trigger inflammation. Similar to a moldy banana that corrupts the whole bunch, a relatively small number of senescent cells can promote inflammation that can damage neighboring cells. Which, in turn, leads to increased aging, and the power of these senescent cells is exacerbated by exogenous factors like UV light.
Aging by glycation occurs due to a normal, daily chemical reaction in our bodies: when we ingest sugar from any source—fruits, cookies, bread—the sugar molecules bind to various protein and fat molecules across the body. The binding of these two leads to synthesis of advanced glycation end products, or AGEs. Glycation can occur with the elastin and collagen muscles that support the durability and health of our skin; when elastin and collagen are degraded by AGEs, we see increased wrinkles, elevated inflammation, and decreased barrier function in the skin. Ever notice a cigarette smoker’s skin? Cigarette smoke generates AGEs which create deep wrinkles, especially around their mouths – another reason to NOT smoke!
Hormonal skin aging has similar effects in men and women, though it arises from different causes. In men, androgen (often called “male” sex hormones, like testosterone) levels are believed to peak around age 30, and decrease by 1-2% every year thereafter (Ketchem et al., 2023). When men get into their 50s, 60s, 70s, and beyond, the decrease in testosterone can be seen in increased wrinkles and generally looser skin. Similarly, women see changes in skin thickness, firmness, and integrity when hormones like estrogen drop during menopause.
In men and women, these hormonal changes decrease the rate at which our bodies synthesize new collagen fibers, and our skin begins to become looser because of it. Moreover, hormonal changes can lead to decreased skin hydration and thickness, which is why in older people, you can see extremely thin skin, especially on their arms and hands.
It’s a good idea to get your hormone levels checked regularly, especially if you are in the pre-menopause/menopause/andropause age group. Your functional medicine doctor or endocrinologist can help you decide the right source of action.
As for me, I’ve been working with my integrative MD and have been on bioidentical hormone therapy for over a decade – it’s been a phenomenal help with my transition into menopause. I don’t have hot flashes, mood swings and my skin has aged more slowly compared to those in my age group.
External factors are exogenous, meaning they come from the outside world, apart from your body. There are a few to be mindful of: UV light and chemical exposure.
Photoaging is the term for the negative skin aging effects of sun exposure. You are likely familiar with the poor effects of UV light on the skin: more UV light might lead to a nice tan, but it also damages our skin’s DNA. UV rays can damage the collagen and elastin molecules in our skin, while also triggering processes which release inflammatory molecules that further undermine the integrity of skin. With a high level of sun exposure sans protection, we can see increased wrinkles, as well as the malignant cells which turn to melanoma, or skin cancer, over time. Moreover, research has shown that UVA and UVB radiation can turn regular skin cells into the senescent cells mentioned earlier. So make sure to protect with sunscreen!
Lastly, chemical exposure can affect the skin in a variety of different ways: makeup and skincare products (check the blog here for ingredients to look out for), air pollutants, and even the food we eat can affect our skin. Many of these toxins affect the skin via free radicals which cause oxidative stress. At low levels, free radicals can be easily managed by the body; they’re a natural and normal byproduct of various biological processes. However, exposure to cigarette smoke, industrial toxins, chemicals in food, and air pollution can cause these free radicals to build up in the body. The heightened amount of free radicals begin to damage skin cells, degrading their integrity and causing oxidative stress. As a result, the collagen and elastin weakens, skin begins to sag, and wrinkles and fine lines appear more readily.
The first step to cultivating healthy skin is understanding what can cause its damage via these internal and external sources. And remember – it’s not just about the most expensive skin cream or the latest laser technology. Beautiful skin has to start from within.