General principles of correcting age-related skin changes

Correction of age-related skin changes should be comprehensive and depends on the dominant type of aging, type and severity of aging, skin type (normal, dry, oily, combination), skin sensitivity, as well as concomitant diseases, age and motivation of patients. Timely prescription and correct combination of various methods are extremely important. Comprehensive impact may include home and salon care, massage, peeling, injection, hardware methods, as well as means for systemic impact. Specialists also recommend healthy lifestyle measures (quitting smoking, adequate sleep duration, measured physical activity, balanced diet).

Skin care

Includes gentle cleansing and adequate moisturizing. For daily cleansing, the most acceptable are various synthetic detergents with a pH corresponding to the normal acidity of the skin, soaps containing a large amount of fats, as well as emulsions and tonics specially designed for this. When caring for the skin, it is recommended to use modern emulsion moisturizing creams.

Various agents that act on certain age-related changes can be added to basic care products. Thus, for expression wrinkles, daily skin care creams with a "botox" effect are widely used (Myokin gamma, Vichy Laboratories; Exclusive gamma, Lierac, etc.). Their action is mainly aimed at stopping the release of calcium in the endoplasmic reticulum of the fibroblast (for this purpose, as a rule, Ca antagonists - Mg ions are used) or at slowing down the release of energy necessary for the formation of the actin-myosin complex (for example, adenosine).

In cases of severe dehydration and delipidization of the skin, extremely gentle care is recommended that does not cause the destruction of highly specialized lipids and replenishes the barrier properties of the skin. Of particular importance is the inclusion of ceramides, their precursors (sphingoid bases), and unsaturated fatty acids that participate in the synthesis of ceramides in daily moisturizing products.

In menopausal aging, in addition to adequate hydration and restoration of the skin's barrier properties, it is necessary to use products that stimulate the proliferative activity of basal keratinocytes and fibroblasts. For this purpose, they include phytoestrogens and other agents that can be recognized by key cells of the epidermis and dermis as their own growth factors (Novadiol gamma, Neovadiol cream, Vichy Laboratories; Arkeskin, Lierac; Izoval, Uriage; Argon gamma, Galenic, etc.). In case of skin pastosity characteristic of lymphostasis and venous outflow disorders, care products include substances with drainage properties: caffeine derivatives (for example, Novadit Night cream, Neovadiol Night, Vichy Laboratories), horse chestnut, etc.

In order to restore normal skin texture in fine-wrinkle skin and photoaging, substances with an exfoliating effect are used, usually various acids. Home peels are popular, including enzyme preparations and acids in low concentrations.

In modern cosmetology, products stimulating the functional activity of fibroblasts and possessing pronounced moisturizing properties (phytoestrogens, hyaluronic acid, polysaccharides, glycosaminoglycans, etc.) are already quite traditional. One of the modern trends is the inclusion of a complex of active components in the composition of external products - anti-elastase and anti-metalloproteinases, capable of preventing the destruction of dermal fibers under the action of elastase and matrix metalloproteinases (Liftaktiv Pro, Vichy Laboratories; Izolift, Uriage, etc.). It was also revealed that vitamin A and its derivatives are capable of inhibiting the activity of collagenases, therefore products containing these ingredients also have this point of application (for example, the Retinox Correction gamma, RoC).

For preventive purposes, photoprotective and protective components are added to basic care products, such as protection against free radicals. At home and in beauty salons, various masks (moisturizing, anti-couperose, etc.) are widely used. Manual massage, peeling, injection techniques, and hardware cosmetology methods are widely used to correct signs of age-related skin changes.

It should be emphasized that the choice of one or another method depends on the skin type, the severity of its sensitivity and dehydration, the patient's motivation, and the type of aging. For example, in the case of the deforming type, characterized mainly by changes in the tone of the facial muscles, gravitational displacement of subcutaneous fat and lymphostasis, the main procedures may be those aimed first at active drainage (cosmechanics, microcurrent lymphatic drainage, vacuum lymphatic drainage, ultrasound lymphatic drainage, etc.), and then at restoring the original state of the tone of the facial muscles (microcurrent therapy, myostimulation, biostimulation, myolifting, etc.). In the case of the fine-wrinkle type of aging, characterized by changes mainly at the level of the epidermis and dermis, at the initial stage of management, all methods that allow for rapid moisturizing of both the superficial and deep layers of the skin, as well as restoration of its barrier properties (superficial peeling, oxygen therapy, microcurrent electrophoresis, phonophoresis, etc.) are relevant. In order to activate the synthetic activity of dermal fibroblasts, cosmechanics procedures, ultrasound therapy, light-heat therapy, microdermabrasion, laser rejuvenation, etc. are recommended. To reduce the diameter of the mouths of the sebaceous-hair apparatus (pores) and to smooth out the microrelief in the future, you should choose a peeling of medium depth, as well as microdermabrasion, light-heat rejuvenation or cosmechanics technologies.

For oral administration, vitamins, microelements, products containing unsaturated fatty acids, combination products, and some immunomodulators (thymus peptide products) are recommended. In the case of menopausal aging, the issue of hormone replacement therapy (HRT) is decided. The choice of HRT products is made by a gynecologist after a detailed examination. In recent years, special attention has been paid to "anti-age" diets.

Plastic surgery occupies a special place in the correction of age-related skin changes.

Features of photoaging correction

Adequate correction of photoaging is constantly in the center of attention of specialists due to the high frequency of this phenomenon. This is due to the increased popularity of recreation in regions with active insolation and active use of solariums. The tactics of managing patients with signs of photoaging include mandatory photoprotection and a number of therapeutic measures, the choice of which depends on the nature of skin changes.

As for protection from ultraviolet radiation, patients are advised to refrain from sun exposure, wear closed clothing and hats, and not visit solariums. The use of photoprotective agents on sunny days, which provide highly effective protection from UVA and UVB rays, is recommended.

Daily basic skin care products for photoaging usually include not only moisturizing ingredients, but also derivatives of vitamins A, C, and various acids (Reti-C gamma, Vichy Laboratories; Night Peel, Day Peel, Lierac; Active-C gamma, La Roche-Posay; Retinox-Correction gamma, RoC, etc.). External agents such as retinoids (tretinoin, adapalene) and azelaic acid are used to correct photoaging. With prolonged use (at least 6 months) of these drugs, an improvement in skin texture, a decrease in the number of wrinkles and lentigines, and a paler color of ephelides are noted.

Of the cosmetic procedures, the most commonly used are medium-depth or deep chemical peeling (with fruit or trichloroacetic acids, retinol, phenol, etc.). The complex effect of peeling in photoaging includes an exfoliating effect, whitening, and moisturizing action.

Various physical methods of influence aimed at smoothing the skin surface are also widely used. Such methods include microdermabrasion, laser "polishing" of the skin, dermabrasion. In recent years, photorejuvenation procedures (LHE-merapies) have become very popular. Their essence lies in the complex effect of a system of pulsating light and thermal energy on the skin. A significant advantage of photorejuvenation procedures is their good tolerability, minimal side effects and positive dynamics of the dermatological status. In particular, a significant improvement in skin turgor and elasticity, the appearance of uniformity of skin texture, pallor and reduction in the number of lentigines, fragmentation and reduction in the number of telangiectasias have been registered.

An important factor in the prevention of photoaging is active explanatory work among the population, as well as the promotion of photoprotection in the broad sense of this concept. At the same time, modern aesthetic standards give rise to the popularity among various segments of the population of skin pigmentation obtained after exposure to the sun or in a solarium.

It should be emphasized that photoaging is a phenomenon that is partially corrected. At the same time, a comprehensive approach to the patient and active prevention of further photo damage are necessary.

Dietetics in anti-age therapy

One of the most pressing tasks of modern cosmetology is the fight against premature aging. Currently, many anti-age therapy methods have been created. When conducting them, one must not forget that food is the most important, lifelong regulatory factor that affects all metabolic processes in the body. Nutrition plays a huge role in detoxification processes, in the fight against oxidative stress.

When compiling an anti-age diet, first of all, it is necessary to follow the principles of rational nutrition. Adequate body weight for gender, height, age and body type, the proper ratio of fat and muscle mass in the composite composition of the body are in themselves important factors for the normal functioning of the body. In this section, it is necessary to highlight some aspects of diet therapy that are specific in terms of anti-age nutrition.

Combating oxidative stress

It is oxidative stress that leads to the formation of metabolites of female sex hormones that cause irreversible damage to mitochondrial DNA and disrupt the normal functioning of these structures. The greatest danger in this regard is lipid peroxidation, the products of which are aggressive damaging factors, and therefore the cause and indicator of aging. To combat oxidative stress, antioxidants should be used - substances that can inhibit free radical oxidation processes, as well as provide the body's own antioxidant system with the necessary nutrients. Among the necessary nutrients, iron, copper, manganese, glutathione, selenium, and acetylcysteine should be noted. They participate in the work of antioxidant enzymes as cofactors. For example, copper and zinc are necessary for superoxide dismutase, iron - for catalase. Antioxidant therapy can be carried out in combination - both externally (in the form of cosmetic products) and orally. Among the most important antioxidants, the leaders are fat-soluble (alpha-tocopherol and carotenoids). Their function is to protect the main structural components of biological membranes. There are also water-soluble antioxidants that perform their role in the cell cytoplasm or blood plasma, i.e., inactivating free radicals in an aqueous environment.

Alpha-tocopherol - (vitamin E) - fat-soluble antioxidant. Inhibits peroxidation of unsaturated fatty acids that are part of cell membranes. Restores vitamin A and ubiquinone (coenzyme Q). Has an antiatherogenic effect. It exists as a pharmacological drug, is present in many cosmeceuticals. Daily requirement - 15 mg. Many food products contain it in significant quantities. Therefore, the diet should include: vegetable oil, cereals, soy, legumes, seafood.

Ascorbic acid (vitamin C) reduces the rate of oxidation of very low density lipoproteins, promotes the transport of vitamins A and E, inhibits atherogenesis, participates in the synthesis of corticosteroids and serotonin, promotes the synthesis of collagen from procollagen, the synthesis of thyroid hormones, and the absorption of iron and calcium from the intestine. Daily requirement is 70-100 mg. The main food sources of the vitamin are rose hips, sweet peppers, berries, fruits, greens, and cabbage.

Bioflavonoids and polyphenols (vitamin P), which exist in water- and fat-soluble forms, potentiate the antioxidant effect of ascorbic acid. These substances have a capillary-strengthening effect, neutralize carcinogenic substances, and have a calming effect. The daily requirement is 25 mg. To enrich yourself with bioflavonoids, you need to eat chokeberry, citrus fruits, rhubarb, rose hips, green tea, red wine (its vitamin P content is 10 times higher than in green tea), beets, apples, buckwheat, rice, turmeric, chocolate, and olives.

Ubiquinone (coenzyme Q) is a powerful antioxidant. Its chemical structure is similar to tocopherol. It protects DNA molecules and cell membranes from free radicals. It is often found in cosmeceuticals and its use is certainly justified.

It should be remembered that the most pronounced effect of vitamins, micro- and macroelements is provided either in the form of natural compounds or in chelated forms of pharmacological preparations. When enriching the diet with pharmacological agents, it is advisable to refuse to use vitamin-mineral complexes with a long shelf life (over 2 years), since they contain a significant amount of stabilizers. Preference should also not be given to preparations containing too many vitamins and minerals, due to possible antagonism between the components of the preparation.

All the above aspects of anti-age effects are certainly important. However, one should not forget about hormone replacement therapy of patients during menopausal disorders. It has been proven that the use of HRT for 3 months leads to thickening of the germinative layer of the epidermis, longer use - to an increase in collagen mass. It is important to prescribe HRT no later than 2 years after menopause. Phytoestrogens can also be used, but their effect is ambiguous. Everything depends on the concentration of endogenous hormones in the blood. Phytoanalogues are certainly weaker than endogenous hormones, but their connection with receptors is stronger. From this it follows that phytoestrogens have a paradoxical, antiestrogenic effect in hyperestrogenemia. This is another highly sought-after area of their application. Phytoestrogens are used to prevent and treat premenstrual syndrome, mastopathy, breast tumors. In conditions of hypoestrogenism, phytoestrogens have an estrogen-positive effect. This is the "two-faced" effect of this group of substances. Phytoestrogens also have an antioxidant effect, protecting against LDL oxidation. Phytoestrogens are divided into two large groups - isoflavones and lignans. Isoflavones prevail in soy, legumes, lentils, pomegranates, red clover, dates, cabbage. Lignan precursors are contained in the outer layer of nut grains. Under the influence of intestinal microflora, they are converted into active forms. Lignans and isoflavones have an antiandrogenic effect, therefore they are used in the treatment of oily skin, acne, and androgenic alopecia. To solve the problems of involutional skin changes, the first-choice drugs are cosmeceuticals containing phytoestrogens. Unfortunately, the use of soy and other endogenous plants in human nutrition is not enough to ensure their endogenous action. Too much isoflavones are lost during industrial processing. Therefore, oral preparations containing these substances have now been developed. The therapeutic dose of soy isoflavones is 90-180 mg per day, the maintenance dose is 45-90 mg.

Another important stage of the anti-aging diet is nutrition that neutralizes the adverse effects of external factors. For example, the fight against the intake of radionuclides into the body. These substances are contained in phosphorus fertilizers, fall to the surface of the soil with precipitation. They migrate along the soil-plant chain. Radionuclides accumulate especially easily in soils poor in minerals K, Ca, Na, P. Artesian and many other ground waters isolated from the surface of the earth are free from contamination with radionuclides. Cereals, milk, vegetables, fruits can contain many radionuclides. It is easy to eliminate such contamination. Raw foods should be thoroughly washed (preferably in water with an alkalizing component) and peeled. The top of the root crops should be cut off by 1.5 cm, the peel should be removed from fruits, the upper leaves should be removed from cabbage and the stalk should be removed. Boiling allows you to remove up to 50% of radionuclides. When cooking meat, drain the first broth, mushrooms - soak and boil. Flavonoids, gallates, pectin substances bind and remove radionuclides from the body. The most accessible of them are pectins. Daily dose - 8-15 g. Used during meals and at night. It is advisable to enrich the diet with fluorine, selenium, calcium, iodine - this will increase the overall resistance of the body.

Nutrition when exposed to chemical toxins

Residents of megacities constantly receive increased doses of chemicals from polluted water, soil, and air. Nutrition has a significant impact on the breakdown of toxic substances and their removal from the body. What can be advised to a resident of a large city? Drinking water should be purified using boom filters. It is also important to remember that protein deficiency in food reduces the detoxification function of the liver. Protein should contain amino acids such as methionine and cysteine. Vegetable oils containing polyunsaturated fatty acids are also necessary. Glucuronic acid is formed from carbohydrates, which enters into a conjugation reaction with toxins and their decay products. In general, the diet should be protein-carbohydrate oriented. Do not forget about the toxin-binding role of dietary fiber. It is necessary to enrich with vitamins A, E, C, niacin, vitamins B1, B2, B6.

In the whirlwind of time and life events, a person often does not have time to look more closely at the chemical composition of the food products that he buys. Therefore, the diet often contains an abundance of preservatives, stabilizers, and colorants that make the product aromatic and visually attractive. Often, looking closely at the label, we see many "E" symbols with various numbers. You need to be able to understand this. Food additives of natural origin include: E 330 - citric acid, E 300 - vitamin C, E 375 - niacin, E 363 - succinic acid, E 334 - tartaric acid, E 260 - acetic acid. In moderate doses, they are absolutely safe. You should be careful with E 621 - sodium glutamate. This substance is a flavor enhancer and is used very often. Despite the fact that it is a salt of glutamic acid, its excess leads to "Chinese restaurant syndrome" - weakness, headache, nausea, tachycardia, chest pain, drowsiness, facial erythema. The following are prohibited for use in Ukraine and Russia: E 908, E 957, E 622, E 520, E 505, E 475, E 408, E 375, E 344, E 308, E 303, E 252, E 240, E 213, E 260, E 140, E 123. It becomes obvious that it is definitely necessary to read the labels of modern food products.

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