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Can I Prevent Premature Skin Aging?

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Smoking accelerates wrinkles and can make you look old beyond your years.

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By NEIL ALAN FENSKE, M.D. Tribune correspondent

The Tampa Tribune

Published: February 4, 2009

Many people are now well-versed in the signs of chronic sun damage and its link to skin cancer. You may have changed your behavior years ago, or perhaps never subjected your skin to excessive sun exposure.

So maybe you're wondering why your skin continues to change and look older, even though you use sunscreen, eat right and avoid other environmental assaults, such as smoking, that contribute to facial wrinkles.

How quickly your skin ages, independent of lifestyle changes, depends to a large extent on heredity. Some people at 65 have skin that looks 50, and, unfortunately, others have the reverse.

What are some normal changes in the skin's appearance as we age? Most notable is the loss of protective fatty tissue on the face, hands and feet. The plump smooth skin of youth becomes loose with exaggerated expression lines (sunken appearance) as the fat disappears. The dermis thins and weakens from loss of the gel-like matrix (hyaluronic acid), collagen and elastic fibers within that give our skin its strength and resilience. Collectively, these changes are most evident on the back of the hands, where the underlying tendons and blood vessels become more visible.

Years of gravity tug on weakened skin and cause it to sag, resulting in jowls or jiggling fat under the arms. The skin becomes more fragile and prone to bruising, tears and blisters. Skin texture is characterized by subtle wrinkles, or "crinkles," that resemble cigarette paper, especially notable on the inner arms and eyelids.

After age 30, our pigment-producing cells (melanocytes) die at a rate of 10 percent to 20 percent a decade, resulting in less ability to tan and protect our skin from cancer-causing ultraviolet light. In addition, some of the cells that help us fight skin infection and skin cancer are gradually lost with age. Tiny blood vessels near the skin's surface that dilate to dissipate heat also disappear, compromising the capacity to cool down when overheated and making you more susceptible to heatstroke.

Older people experience more damage from the same amount of sun exposure than when they were younger, even if it's less visible. This is due in part to the loss of the superficial surface blood vessels - which provide a "red" warning sign of too much sun when dilated - coupled with the reduction in tanning cells. Some elderly patients tell me they can "take the sun better now that they are older." My response is that they have a false sense of security simply because they can't see the well-known warning sign of too much sun - sunburn!

Although you can't change how quickly you intrinsically age, you can protect your skin from excessive sun and avoid certain behaviors that increase the risk of premature skin aging.

Make sunscreen application part of your daily routine, remembering your hands and other parts of body as well as your face.

Avoid repetitive squinting (wear sunglasses) and overzealous expressions that can contribute to facial wrinkles.

Stop smoking! Smoking accelerates wrinkles and can make you look old beyond your years.

Try sleeping on your back and use slippery silk pillowcases to avoid developing vertical sleep lines on the forehead and facial asymmetry.

Eat foods rich in antioxidants.

Drink plenty of water and avoid excessive alcohol.

Dr. Fenske is professor and chair of the Department of Dermatology and Cutaneous Surgery at USF Health.

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