Derms fight signs of aging

February 21, 2005

Speaking yesterday, dermatologist Melvin Elson, M.D., of Nashville, Tenn., discussed five types of aging that occur on the face and how dermatologic treatments can improve the skin's texture and return its youthful glow.

"Dermatologists evaluate a patient with aging facial skin for many different factors, including how well the face is aging overall. Is there obvious damage to the skin's surface? What does this damage look like? And how deep does it go?" Dr. Elson said.

He said once dermatologists have evaluated the effects of aging, they can take steps to reverse the damage - whether through a single treatment or a combination of treatments.

He also identified five factors that act together to affect facial appearance:

  • Intrinsic aging


Intrinsic aging is the natural process of aging, characterized by a loss of substance to the skin and the underlying fat resulting in a gaunt, thin look with hollowed cheeks and eye sockets. Treatment options designed to replace lost tissue include solid implants surgically placed under the skin or fat transfer - involving the use of fat and tissue from other parts of the patients' body to fill in deeper wrinkles and body contours.

  • Sleep lines


Much as a napkin gets a crease when it is folded in a drawer too long, sleep lines etch the surface of the skin and occur from putting the face into the same position on the pillow every night.

Due to different sleep patterns, women tend to see these lines on their chin and cheeks, while men notice them on their foreheads.

Since changing sleep positions is challenging for some patients, dermatologists recommend the use of botulinum rejuvenation to hold the skin taut.

  • Expression lines


Every smile, frown and laugh affects the face, especially the collagen fibers beneath it. Expression lines are most noticeable around the large muscles of the eyes and the mouth.

Botulinum rejuvenation and various dermal fillers produce immediate, yet temporary, results to improve the appearance of lines.

  • Gravity

As soon as we stand, everything moves downwards - the eyelids fall, the jowls form, the nose tip points downward, the upper lip disappears while the lower lip pouts and even the ears get longer. These facial changes related to gravity become more pronounced as we age.

"No amount of facial exercises or 'good genes' can offset the pull of gravity," Dr. Elson says. "Dermatologic treatments for the everyday effects of gravity remain surgical, such as a blepharoplasty."

  • Photodamage


More than 80 percent of the damage on an aging face is from photodamage, occurring from overexposure to the elements, including the sun and the wind. Individuals with fair skin, light eyes and a history of long-term sun exposure are more susceptible to photodamage, which is represented by blotchy pigmentation, wrinkling and scaling. Dermatologists can improve the appearance of photodamaged skin with laser resurfacing, in which heat or light pulses from a laser are used to rejuvenate the skin's tone and texture and minimize fine lines. Depending on the type of laser used, moderate to advanced fine lines and deeper wrinkles can be treated with very little downtime.

Chemical peels also remove levels of the skin to stimulate rapid rejuvenation. The strength of chemical peels can vary from very superficial to deep, and this strength determines the benefit to the skin and the downtime following this procedure.

"Aging skin is a fact of life, but patients today need to know that dermatologists can offer them more options than ever before," Dr. Elson said.