At 20, your face might look – and feel – dewy-fresh and petal-smooth. But, quite unknown to you, the ravages have already begun. It’s too early for Time to wreak its havoc, but your skin has other enemies.

There are two ways in which your skin ages: Natural, or intrinsic, aging actually doesn’t shown up on your face until age sixty or later. The fine lines and rough spots that appear as early as your twenties (and worsen with each passing decade) are caused by extrinsic aging – due mainly to sun exposure, facial expressions, even sleep positions.

With the diagnostic techniques a dermatologist can identify the source of each line or skin flaw, and can tailor treatments individually. The Causes, effects and treatments of skin damage now can be identified as follows:


Photo-aging, caused sun damage creates deep creases, uneven texture, dryness, brown patches and a yellowish cast. Leading dermatologists today attribute a full 90 per cent of extrinsic aging to photo-aging. While avoiding the sun can prevent it altogether, ongoing research indicates that topical Retin-A can help repair sun damage.
Sleep lines are easy to identify. “They cut across ordinary wrinkles in a pattern that doesn’t make sense,” says Melvin Elson, M.D., medical director of The Dermatology Center in Nashville, U.S. Caused by years of sleeping face to pillow, horizontal sleep lines tend to appear along the side of the chin in women, on the forehead in men. While sleeping on your back is the best prevention, to soften existing lines dermatologists use to injectable filling material such as collagen (a natural protein derived from animal tissue).
Sagging around the eyes and at the tip of the nose, a downward turn at the corners of the mouth (which begins to be visible as early as the twenties or thirties) and an elongation of the earlobes are the result of gravity. Injections of collagen can lift the corners of the mouth, while liposuction (a surgical procedure) can remove fat that collects in sagging jowls. But when the eyelids, nose and earlobes droop, plastic surgery is the most effective treatment.
Expression lines develop from years of repeated facial expressions. Laugh lines may add character, but if deep vertical lines between the eyebrows or furrows along the forehead create an angry or tired appearance, they can be softened with collagen injections.
Intrinsic aging becomes apparent with fine wrinkling, thinning skin and a loss of fatty tissue – all subtler signs than the deep creasing we usually associate with aging. Injections of the patient’s own body fat (usually taken from the outer thigh) can plump sagging skin. Silicone implants, built from a mold made specifically for the defect, can correct “caved in” areas. And new studies show that Retin-A also can diminish the fine lines attributed to intrinsic aging.
Skin-care research has identified a number of promising anti-aging ingredients. As science progresses, watch for news, more therapeutic uses – with claims to match – for these key, skin-saving ingredients:

Alpha-hydroxy acids: chemical compounds contained in apple juice and sour milk (among other things) that reduce fine lines and age-spots.
Lipids: natural chemicals that help to maintain the outer layer of the skin by “gluing” cells together and holding on to moisture. Cosmetics companies extract lipids for use in moisturizers from sources such as neural and embryonic tissues of animals.
Liposomes: tiny delivery systems, made of anything from cell membranes to lipids, used to package moisturizing ingredients. If small enough, liposomes can penetrate skin.
Hyaluronic acid: a chemical ingredient – it’s the body’s natural lubricant – that helps skin hold on to moisture. Found in a number of moisturizers.
Retinoids: a series of vitamin A-derived compounds that occur naturally in skin and aid in its normal functioning (but don’t reduce wrinkles the way Retin-A does).
Nayad: an ingredient derived from the cell walls of certain types of yeasts, believed to stimulate skin cells and restore weakened collagen and elastin.
Antioxidants: substances such as vitamin E and C that are thought to counteract the damaging/drying effects of free radicals.
As treatments for aging skin become more refined, dermatologists are turning increasingly to non-surgical procedures that can be done in a doctor’s office. Two such super-modern options:

Injectable filling materials, used to replenish the skin’s own support network are available in more “weights” – chosen to suit the size of a line, from a small wrinkle to a deep crease – than ever before. Like all injectable fillers, these new materials are absorbed eventually by the body, so injections need to be repeated every three to six months to maintain benefits.

Chemical peels are being done today with lighter solutions that may not require an anesthetic and that reduce the risk of scarring. In most cases, peels are replacing dermabrasion as the preferred treatment for aging skin.