02.Types of aging and treatments
Generally speaking, there are three forms of skin aging which each need to be treated differently:
- First there’s gravity, which results in drooping and folds around the eyes, jaw and neck. It’s associated with the loss of skin elasticity and depleted subcutaneous fat. Surgical facelifts and fillers such as collagen or hyaluronic acid (brand names RESTYLANE and JUVEDERM) are used to reverse the effects.
- Expression lines from smiling, squinting and frowning permanently etch themselves into your face over time. Botox injections can help prevent them by reducing your ability to make facial expressions, while collagen is used fill in some of the cracks.
- Finally, there’s photoaging, caused by UV damage, which affects the texture of the skin over time, making it rougher and causing fine lines, as well as pigmentation changes such as age spots and freckles. Prescription-only treatments include tretinoin (RETIN-A or RETRIEVE), with resurfacing by acid or laser available at the doctor’s surgery.
Over-the-counter products with ingredients such as alpha hydroxy acids (AHAs), antioxidants (including vitamins A, B3, B5, C and E, green tea, soy isoflavones, grapeseed extract, Coenzyme Q10 and idebenone) and peptides may be of some help for photoaging, though it depends on their concentration, the preparation and your expectations. For example, vitamin C cream works well in concentrations of 10% or more, but it’s difficult to stabilise it in creams and it can lose its effectiveness. For a closer look at the more recent products, see New products.
Claims getting bolder
In the recent past, most anti-aging creams claimed to treat only photoaging: to reduce the appearance of fine lines and wrinkles, to give skin a smoother appearance and reduce the appearance of freckles and blemishes. And to a greater or lesser extent, they did that. But claims for some creams, in particular the cosmeceuticals, are venturing further into the facial cracks and crevices, claiming to act upon expression lines, and even gravity lines like jowls.
- Dermatologists have expressed scepticism about whether they can work, pointing out that many of the claimed benefits are based on research on other parts of the body (such as the benefits of an antioxidant-rich diet on the cardiovascular system), and that cosmeceutical products are often tested only on cell cultures in test tubes.
- Common faults in clinical trials — that is, tests on real people — can include using small numbers, not trying to conceal the product name, not using reliable techniques for measuring effects and/or being funded by the cosmetics companies themselves.