the ageing skin – ::a broad view::

THE AGEING SKIN –::A BROAD VIEW::

BY: MALVI PATELUNDER THE GUIDANCE OF: DR. ABHA DOSHI

For more presentations and information visit http://www.pharmaxchange.info

http://www.pharmaxchange.info/

WHAT IS AGEING?

Ageing is the process of growing old.



THE ANATOMY OF SKINFor more presentations and information visit http://www.pharmaxchange.info


Cells of Epidermis

Keratinocytes• They produce keratin in the skin

Melanocytes• Produce melanin pigment in the skin

Langerhans cells• Participate in immune response

Merkel cells• Touch sensation



Cells of Dermis

Fibroblasts• Provides structural framework• Synthesizes extracellular dermal

constituents

Macrophages• Phagocytosis of cellular debris and

pathogens

Adipocytes• Fat storage cells



THE CHEMICAL CONSTITUENTS OF DERMIS

COLLAGEN• most abundant• Provides strength and support

ELASTIN• Imparts elasticity to the skin

GLCOSAMINOGLYCANS• High water retaining capacity• Most important of them is HYALURONIC

ACID



AGEING SKIN

INRINSIC AGEING

• Telomere Shortening

• Mitochondrial Damage

• Endocrine Dysfunction

EXTRINSIC AGEING

• Photo-ageing

• Smoking• Lifestyle



Telomere Theory of Ageing

What are telomeres?

Its relation to ageing?• Telomere shortening = ageing

Telomerase – the savior• Helps stabilize and replenish the

telomere length



Mitochondrial Damage

The bad effects of these Reactive Oxygen Species?

Lipid Peroxidation

Alteration of gene

expression pathways causing:

Degradation of collagen

Accumulation of elastin

The mitochondria generates reactive oxygen species during

ETC.

What are Reactive Oxygen Species?



Endocrine Dysfunction

•Ageing causes reduced hormone production.

•Estrogen reduces with age.

•Lower Estrogen level is associated with skin ageing and telomere shortening.

Reduced Estrogen causes

Loss of Elasticity

Reduced Water

holding capacity

Increased Pigmentation

Decreased vascularity



Photo-ageing

Ultraviolet (UV) rays from the sun cause skin damage and accelerate ageing of the skin.

Two mechanisms by which UV rays act are: Mechanism 1 (Induction of Matrix

Metalloproteinases) Mechanism II (Mitochondrial Damage)▪ DNA damage▪ Production of ROS



Smoking

Smokers look older than non-smokers of the same age.

Tobacco smoke induces Matrix metalloproteinases.



Lifestyle

Lifestyle of a person can also contribute to ageing.

Factors such as: Lack of sleep Intake of alcohol Improper diet Stress Can have ill effects on the skin and

accelerate ageing.



CHANGES THAT OCCUR IN AGED SKIN

YOUNGER SKIN OLDER SKIN



PHARMACEUTICAL PRODUCTS AND PROCEDURES FOR THE ELDERLY

SUNSCREENS MOISTURIZERS ANTIOXIDANTS FILLERS CHEMICAL PEELS BOTULINUM TOXIN (BOTOX) ESTROGENS PLASTIC SURGERY MAKE-UP



SUNSCREENS

Most of the damage during ageing is due to the harmful UV radiations blocking these rays are the primary step to prevent skin ageing.

We will take a closer look at HOW SUNSCREENS ACT? TYPES OF SUNSCREENS

Approx Rs 100 to 150 For more presentations and information visit http://www.pharmaxchange.info


How Sunscreens Act?

PHYSICAL SUNSCREENS CHEMICAL SUNSCREENS

ACT BY REFLECTING THE LIGHT ACTS BY ABSORBING THE LIGHT

= SUNSCREEN SUBSTANCE



Common Examples of Sunscreen agents

NOTE – It has even been observed that use of sunscreens helps in reversing the effects of ageing. Hence incorporation of sunscreens into your daily skin care regimen is of primary importance.

PHYSICAL SUNSCREENS CHEMICAL SUNSCREENS

• Zinc Oxide• Titanium Dioxide

• Salicylates • Cinnamates• Anthranalites



An example of a sunscreen formulation

Ingredient Quantity Role

Stearic acid 18% Forms primary emulsion with NaOH and also forms an occlusive film

Sodium hydroxide 0.5% Reacts with a portion of the stearic acid insitu to form the emulsifying agent sodium stearate

Cetyl aclcohol 0.5% Emollient , occlusive

Menthyl anthranilate 5% Chemical sunscreen agent

Glycerin 10% Humectant

Water To make 100% Aqueous phase of the cream

Perfume q.s. Gives pleasant odour

A sunscreen formulation in a vanishing cream base



MOISTURIZERS

In old age, it is observed that there is a dryness and dehydration of skin.

Moisturizers help the skin

retain the moisture and this helps to

make the skin soft and supple.

Approx: Rs 100 + For more presentations and information visit http://www.pharmaxchange.info


An example of a skin moisturizer

Ingredient Quantity Role

Stearic acid 4.0% Reacts with triethanolamine to form primary emulsion.

Triethanolamine 0.2%

Mineral oil 8.0%Emolient and occlusive

Lanolin 1.0%

Isopropyl Myristate 2.0%

Glyceryl monostearate

3.0% Helps form secondary emulsion

Glycerin 4.0% Humectant

Propylene Glycol 4.0%

Water 100.0 Vehicle

Perfume q.s. Gives a pleasant odour



ANTIOXIDANTS

Free radicals or reactive oxygen species are the major cause of ageing and damage in cells over time.

Antioxidants act by neutralizing the free radicals and thus prevent them from causing damage to the cells.

Most commonly used are• Vitamin A• Vitamin C• Vitamin E

X



FILLERS

Substitutes for lost dermal components.

•Over age, the dermis loses many components which are responsible for elasticity such as collagen.

•This loss of elastic constituent of the skin leads to wrinkles and furrows in the skin.

•Replenishing the dermal constituents by artificially injecting it helps the skin to reduce the visible ageing.

Approx Rs 1700 to 2000/ creaseFor more presentations and information visit http://www.pharmaxchange.info


List of dermal fillers

Dermal filler type Product

Collagen-Bovine collagen- human collagen

Zyderm, and ZyplastCosmoderm, Cosmoplast

Hyaluronic acid Restylane, Hyalaform, Captique and Juvederm

Biologic combination fillers Alloderm

Autogenous fat

Poly-L-Lactic Acid Sculptra

Radiesse

Polymethylmethacrylate microspheres

Artefill

Injectable liquid silicone



Injection site of dermal fillers

Zyderm IZyderm II (mid dermis)

Zyplast (deep dermis)



CHEMICAL PEELS

Treatment to improve skin condition using a chemical solution which would cause the old skin to blister and eventually peel off exposing new smoother skin.

Around 400 to 1000+ depending on depthFor more presentations and information visit http://www.pharmaxchange.info


Types of chemical solutions

Alphahydroxy acids (AHAs) – eg. Glycolic acid and lactic acid.

Betahydroxy acids (BHAs) – eg. Salicylic acid

Jessner’s Peel – combo of resorcinol, salicylic acid and

lactic acid. Trichloroacetic acid (TCA) Phenol peels



Chemical Peels

Superficial

Very Lighteg. Glycolic acid

10 to 50%

Lighteg. Glycolic acid

50 to 70%

Medium depth eg. Combo of TCA 35% and 70% Glycolic

acid

Deep eg. Baker-Gordon Formula

Classification of chemical peels



Procedure to apply chemical peels

Choosing a chemical peel

Patient counselling and consent

Washing and defatting of

skin

Protection of delicate areas

Premedication given

Peeling agent is applied using a

gauze/cotton swabs

Application of peel is done

from forehead to chin

Allow the peel to stay on till

frost formation

Stop the peeling

process using neutralization

when necessary



BOTULINUM TOXIN (BOTOX)

Botulinum toxin type A is a toxin obtained by the process of fermentation using Clostridium botulinum species of bacteria.

Botulinum toxin is a highly toxic substance which when used in lower concentrations can be beneficial to reduce wrinkles by causing flaccid paralysis.

The toxin is injected in quantity of 5-10 units intramuscularly.

Approx Rs 1700 – 2000/ creaseFor more presentations and information visit http://www.pharmaxchange.info


ESTROGENS

Estrogen and its derivatives can be given Orally

Topically

Newer Selective Estrogen Receptor Modulators (SERMs) can also be used for its specific action on skin.



PLASTIC SURGERY

The word ‘plastikos’ means to mold or to shape.

Many surgical techniques to enhance skin appearance exist.

Of which the most common used are:

Blepharoplasty

Rhitidectomy (face lift)

Dermabrasion

Laser resurfacing

Rs 20,000 +For more presentations and information visit http://www.pharmaxchange.info


MAKE-UP

Commonly used make-

up

Lip-liner

Lip balms

Eye liners and

mascaras– Face powders

Foundation make up

Price VariesFor more presentations and information visit http://www.pharmaxchange.info


CONCLUSION

“Youth has no age”Pablo Picasso



REFERENCES

Journal Articles Skin ageing and its treatment, L Baumann* Journal of Pathology J Pathol 2007; 211: 241–

251 Elderly skin and its rejuvenation: products and procedures for the aging skin, Marcia

Ramos-e-Silva et. al., Journal of Cosmetic Dermatology, 6, 40–50 Dermal filler agents: a practical review, Sukhjit S. Johl and Richard A. Burgett, Current

Opinion in Ophthalmology 2006, 17:471–479 Effect of estrogens on skin aging and the potential role of selective estrogen receptor

modulators. S Verdier-Sévrain Climacteric; Aug 2007; 10, 4; Health Module pg. 289 Facial skin rejuvenation, David E. E. Holck and John D. Ng, Current Opinion in

Ophthalmology 2003, 14:246–252 Nutritional and Botanical Approaches to Antiaging, Chris D. Meletis, N.D., with Nieske

Zabriskie, N.D. ALTERNATIVE & COMPLEMENTARY THERAPIES—DECEMBER 2006, 268-274.

Textbooks : Principles of Anatomy and Physiology, Gerard J Tortora, Chapter 5– The Integumentary

System (pg 139 – 145) Harrys cosmeticology, J. D. Wilkinson and R. J. Moore, Longman Singapore publishers te

ltd. Pg 222 - 258(sunscreens and suntan oils) Cosmetics Formulation Manufacturing and Quality Control, P P Sharma, Vandana

Publications pvt. Ltd. Pg 195 – 198, 183 – 185.

Web References: Wikipedia: (http://en.wikipedia.org/wiki/Telomere, http://en.wikipedia.org/wiki/Skin, http://

en.wikipedia.org/wiki/Botulinum_toxin) E- Medicine ( Chemical Peels by Raymond T Kuwahara - http://en.wikipedia.org/wiki/Botulinum_toxin )


http://en.wikipedia.org/wiki/Botulinum_toxin






THANK YOUFor more presentations and information visit http://www.pharmaxchange.info


the ageing skin – ::a broad view::

Documents

information visit http

ageing skin

skin ageing

effects of ageing

theory of ageing

anatomy of skin

aged skin

cause skin damage