The appearance of your skin is a product of genetic heritage and environmental upbringing. Skin, be it Caucasian, African-American or Asian has a similar structure consisting of three main layers. First and foremost there is the epidermis, the outermost layer; the dermis, the middle or structural layer; and the innermost subcuticular or fatty layer. These layers interact to produce what is seen as lines and wrinkles, pigmentary changes, and the overall texture and complexion of the skin.
The epidermis is made up of live and dead cells called keratinocytes. These cells have protective qualities that are very instrumental in retaining moisture and providing a barrier function to the skin. The outermost layer, the stratum corneum, consists of dead cells that are continually sloughed off, aiding in the process of cellular regeneration. The cells in the epidermis have a lipid or fatty component. This lipid quality has been identified by researchers as an important aspect of skin hydration and moisture retention.
At the base of the epidermis there are pigmented cells called melanocytes. Melanocytes produce skin pigmentation. Dark skinned individuals have more melanocytes with increased pigment production. This pigmentation provides natural protection from sun damage.
A sun tan, however, is sun damage and does not provide the same sun protection that is naturally present in dark skinned individuals. Freckles and age spots are also the result of ultraviolet stimulation of melanocytes.
An emerging concept with sun damage or photoaging is the free radical concept. Essentially, ultraviolet radiation or energy interacts with the cells of the skin causing a chain reaction of solar damage. This is called free radical damage. The cumulative result is sun damage, wrinkles, dilated pores, irregular pigmentation and textural changes in the skin.
Recommendations for Healthy, Youthful Skin
Sun avoidance, protection and sunscreen are the pillars of good skin care. The strongest sun exposure is from 10 a.m. to 3 p.m. When outdoors, even for brief exposures, sun-protective clothing and sunscreens should be worn to guard against further sun damage. There are a variety of sun-blocking agents and sunscreens that are very effective for sun protection.
The three most widely used treatments for healthy, youthful skin involve antioxidants, Vitamin A preparations, and exfoliating agents.
Antioxidants: Antioxidants are an emerging concept in skin health and maintenance. The sun's ultraviolet radiation produces free radicals that are absorbed by antioxidants. The most common antioxidants are Vitamins A, C and E, along with beta-carotene. These antioxidants are most effective when applied topically. Topical Vitamin C is the most widely used. In addition to its antioxidant activity, topical Vitamin C stimulates cell replication and collagen production. The overall effect is thickening of the skin with reduction in the appearance of fine lines and wrinkles.
Vitamin A: Vitamin A is available in common forms such as Retin-A® (tretinoin) or retinol. Retin-A® is prescription strength and is stronger than over-the-counter Vitamin A derivatives. Over-the-counter retinol, however, is very effective for sun damage. Over-the-counter preparations avoid many of the side effects of redness, irritation, and peeling associated with the prescription products. (See retinol)
Topical Vitamin A is also essential for skin health and maintenance. The skin has receptors that specifically absorb Vitamin A, aiding in cellular growth and differentiation. The results are impressive with a reduction of fine lines and wrinkles and a complexion that is smooth, supple and evenly pigmented.
Exfoliation: Skin exfoliation is achieved by mild acid application to the skin. The acids currently in use are alpha and beta hydroxy acids. (See hydroxy acids.) Hydroxy acids are readily absorbed into the deeper layers of the epidermis. Effects include superficial exfoliation and subsequent stimulation of both the epidermis and dermis. The result is skin thickening with more uniform pigmentation and a reduction in the appearance of fine lines and wrinkles.
What treatment regimen is right for you?
Dermatologists uniformly agree that skin health and maintenance should be addressed twice daily. An excellent, yet simple, treatment regimen should be one product in the morning and another in the evening. Products can be combined, however, this may increase adverse effects such as redness, irritation and peeling. If a simplified regimen is tolerated, products can always be added based on individual goals and preferences.