Deep Dive: Understanding Skin Aging
How to slow the clock on your skin with science-backed strategies
I recently sat down with Harvard Health to discuss skin aging and strategies to minimize age spots, wrinkles, and undereye bags. In the article, I shared insights on how to care for aging skin, as well as treatment recommendations. Here, I’ll take a deeper dive into the mechanisms of skin aging and the most effective interventions to keep your skin healthy and youthful.
The Science Behind Skin Aging
Skin aging occurs due to two primary processes: intrinsic and extrinsic aging.
Intrinsic aging, or chronological aging, is a natural process shaped by genetics and the gradual decline of cell function. It results from programmed cellular aging, oxidative stress, and accumulated cell damage. This results in thinner, drier, and paler skin, along with fine wrinkles and reduced elasticity, causing sagging over time.
Extrinsic aging occurs due to external influences such as UV exposure, pollution, smoking, and diet. These factors generate reactive oxygen species, which can damage DNA and disrupt normal cell function. This type of aging contributes to deeper wrinkles, uneven pigmentation, and loss of skin elasticity.
Key Mechanisms of Skin Aging
Several biological processes drive skin aging at the cellular and molecular levels:
Breakdown of Collagen and Elastin Fibers: Aging skin produces less collagen and breaks it down faster due to enzymes called MMPs (matrix metalloproteinases). This weakens the skin’s structure, leading to wrinkles and sagging.
Oxidative Stress and DNA Damage – Harmful molecules called reactive oxygen species (ROS), or free radicals, build up in skin cells, damaging proteins, fats, and DNA. The body’s natural defense system weakens with age, making it harder to repair this damage, leading to faster skin aging.
Cellular Senescence: Over time, skin cells stop dividing and enter a senescent state, where they release inflammatory substances that cause further damage. This process plays a big role in both intrinsic and extrinsic aging.
Weakened Skin Barrier and Inflammation – The dermal-epidermal junction (the layer between the outer and inner skin) flattens with age, leading to fragile skin and a weakened barrier. Growing research suggests that as the skin barrier weakens with age, it can trigger chronic low-grade inflammation, potentially playing a key role in “inflamm-aging”.
Glycation – High sugar consumption leads to glycation, where sugar molecules bind to collagen and elastin, making them stiff and prone to damage. Glycation contributes to skin aging by forming advanced glycation end products (AGEs). AGEs are toxic to human cells and can cause inflammation, wrinkles, and skin laxity.
Hormonal Changes – After menopause, lower estrogen levels speed up skin aging, making it thinner, drier, and less elastic. Estrogen helps keep skin healthy by supporting collagen, wound healing, and immune defense. Without it, skin becomes more fragile, wrinkles deepen, and the risk of hair loss, pigmentation changes, and skin cancer increases.
Targeted Interventions for Skin Longevity
Skin aging is a complex process, but with the right knowledge and interventions, you can slow down its effects. A combination of sun protection, science-backed skincare, and lifestyle adjustments can help you maintain youthful, resilient skin for years to come.
1. Sun Protection: The #1 Anti-Aging Strategy
UV exposure is the leading cause of premature aging. Daily sunscreen use (SPF 30 or higher) prevents collagen breakdown, hyperpigmentation, and skin cancer.
My recommendation: EltaMD UV Skin Recovery Broad Spectrum SPF 50 Face Sunscreen
2. Antioxidants: Neutralizing Free Radicals
Topical antioxidants like vitamin C, vitamin E, vitamin A (more on this below), and niacinamide help combat oxidative stress and reduce inflammation. They help to brighten the complexion, even out skin tone, and minimize dark spots by reducing excess pigment production.
My recommendation: SkinCeuticals C E Ferulic® Serum or Dr Dennis Gross Vitamin C Lactic 15% Firm & Brighten Serum
3. Retinoids: The Gold Standard in Anti-Aging
“Retinoids” are a group of skincare products derived from vitamin A that help increase collagen, thicken the skin, and refine its texture. Prescription options include tretinoin (Retin-A) and tazarotene (Tazorac, Avage), while over-the-counter products often contain retinol or retinal, which are milder forms of retinoids.
My recommendation: Neutrogena Rapid Wrinkle Repair® Regenerating Anti-Wrinkle Retinol Cream + Hyaluronic Acid OR see your dermatologist for prescription-strength tretinoin and only use as prescribed. Over-use of retinoids can lead to skin irritation.
4. Hydration and Barrier Support
Ingredients like hyaluronic acid, ceramides, beta glucan, and glycerin help maintain skin hydration and strengthen the skin barrier.
My recommendation: La Roche Posay Toleriane Double Repair Face Moisturizer
5. Lifestyle Habits That Protect Your Skin
Prioritize nutrition: A diet rich in omega-3 fatty acids, lean proteins, and antioxidants supports skin health. Limiting sugar intake reduces glycation and collagen damage.
Get adequate sleep: Quality sleep (7-9 hours for most adults) helps the skin repair and regenerate by boosting collagen production and reducing inflammation, which can slow down signs of aging like wrinkles and dullness. Poor sleep, on the other hand, increases stress hormones and weakens the skin barrier, leading to faster aging and a tired appearance.
Avoid smoking: Smoking accelerates skin aging by reducing blood flow, depleting collagen, and increasing oxidative stress. It also damages the skin’s ability to repair itself, making smokers appear older than non-smokers.
Limit alcohol consumption: Excessive alcohol consumption dehydrates the skin, reduces collagen production, and increases inflammation. It can also cause facial redness and puffiness due to its impact on blood vessels.
Note: Excessive alcohol consumption generally refers to drinking beyond moderate levels, which the CDC defines as more than one drink per day for women and two drinks per day for men on average.
References
Shin SH, Lee YH, Rho NK, Park KY. Skin aging from mechanisms to interventions: focusing on dermal aging. Front Physiol. 2023;14:1195272. Published 2023 May 10. doi:10.3389/fphys.2023.1195272
Agrawal R, Hu A, Bollag WB. The Skin and Inflamm-Aging. Biology (Basel). 2023;12(11):1396. Published 2023 Nov 2. doi:10.3390/biology12111396
Zheng W, Li H, Go Y, Chan XHF, Huang Q, Wu J. Research Advances on the Damage Mechanism of Skin Glycation and Related Inhibitors. Nutrients. 2022;14(21):4588. Published 2022 Nov 1. doi:10.3390/nu14214588
Lephart ED, Naftolin F. Factors Influencing Skin Aging and the Important Role of Estrogens and Selective Estrogen Receptor Modulators (SERMs). Clin Cosmet Investig Dermatol. 2022;15:1695-1709. Published 2022 Aug 19. doi:10.2147/CCID.S333663
Cao C, Xiao Z, Wu Y, Ge C. Diet and Skin Aging-From the Perspective of Food Nutrition. Nutrients. 2020;12(3):870. Published 2020 Mar 24. doi:10.3390/nu12030870
Xerfan EMS, Andersen ML, Facina AS, Tufik S, Tomimori J. Sleep loss and the skin: Possible effects of this stressful state on cutaneous regeneration during nocturnal dermatological treatment and related pathways. Dermatol Ther. 2022;35(2):e15226. doi:10.1111/dth.15226
Yazdanparast T, Hassanzadeh H, Nasrollahi SA, et al. Cigarettes Smoking and Skin: A Comparison Study of the Biophysical Properties of Skin in Smokers and Non-Smokers. Tanaffos. 2019;18(2):163-168.
Goodman GD, Kaufman J, Day D, et al. Impact of Smoking and Alcohol Use on Facial Aging in Women: Results of a Large Multinational, Multiracial, Cross-sectional Survey. J Clin Aesthet Dermatol. 2019;12(8):28-39.
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