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Dr. Perricone Discusses

Your Most Common Questions About Aging Skin


High temperatures and increased outdoor activity can make summer one of the roughest seasons on skin. Hyperpigmentation, dehydration and other signs of sun damage can become more noticeable. I'm often asked these seasonal skincare questions:

What causes age spots?

Women often develop these brownish spots or patches, especially on the face, and much less frequently on other parts of the body. This type of hyper-pigmentation of certain areas of the skin is known in dermatology as chloasma, or melasma.

This phenomenon often affects young mothers or women taking contraceptive hormones. It has been noted that oxidative stress is involved in the over-production of skin pigments. Exposure to sunlight greatly contributes to further oxidative stress. In attempts to remove these over-pigmented areas, aggressive chemical peeling agents are applied to the skin, even though some are known to cause irreversible skin damage.

I wear a daily SPF and haven't tanned since my twenties. Why are my age spots becoming more noticeable?

The aging process results in the increased activity of pigment cells known as melanocytes, as well as a thickening of the superficial layer of the skin (the stratum corneum) which is made up of dead skin cells. Melanocytes begin to burn out when you reach your late 30s and 40s, making it more difficult for your skin to fight sun damage, which can result in uneven pigmentation.

The combination of a thickened and rough stratum corneum, in conjunction with the increased population of melanocyte pigment cells results in dull skin with more obvious discoloration.

This is exactly the opposite of the radiant skin seen on the youthful face. Chronic sub-clinical inflammation is a major contributing factor, which is why I strongly recommend taking antioxidant supplements, following the anti-inflammatory diet and applying topicals with anti-inflammatory properties. All of which will work synergistically to restore a more youthful brightness and radiance to the skin.

My skin seems thin and papery. What's going on and how can I stop it?

There are numerous causes of thin, fragile skin and one of the biggest culprits is sun damage. The dermis is the thick layer of skin or connective tissue beneath the epidermis that contains blood, lymph vessels, sweat glands, and nerve endings.

The dermis is susceptible to UV damage, which will damage both collagen and elastin fibers. This results in the skin losing its elasticity and makes the skin more delicate.

High levels of the stress hormone cortisol will also cause thinning skin, as do some pharmaceutical drugs, and decreases in hormone levels including testosterone. One of the negative effects of menopause is the loss of the "youth" hormones such as estrogen and testosterone. Although testosterone is traditionally associated with males, women also have small amounts of this important hormone, which also declines with menopause. The loss of these hormones results in physical changes to the body, such as the loss of muscle mass, a thickening in the waist area and thinning of skin.

To help combat the appearance of crêpey skin, follow these tips:

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