The ageing skin
21 important questions on The ageing skin
What are the parts of the skin (morphology)
- Stratum corneum
- Epidermis
- Dermis
- Fat
- Muscle
- corneocytes
- keratinocytes
- fibroblasts
- hair & sebaceous gland
- Capillary network
- Sweat gland
What are the parts of the skin (morphology)
- Stratum corneum
- Epidermis
- Dermis
- Fat
- Muscle
- corneocytes
- keratinocytes
- fibroblasts
- hair & sebaceous gland
- Capillary network
- Sweat gland
The structure of human skin
- Reticular layer
- papillary layer
- basal layer
- spinous layer
- epidermis
- granular cell layer
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What are the most important common appearance effects of skin ageing?
- Dry skin
- Wrinkling
- Sagging (less flexibility)
- Uneven skin hue
- age spots
- Skin atrophy
- Hair loss
- Hair greying
Underlying structural changes
- Weaker skin fibrous structures (collagen, elastin, integrins)
- Cel morphology changes
What are the most important common appearance effects of skin ageing?
- Dry skin
- Wrinkling
- Sagging (less flexibility)
- Uneven skin hue
- age spots
- Skin atrophy
- Hair loss
- Hair greying
Underlying structural changes
- Weaker skin fibrous structures (collagen, elastin, integrins)
- Cel morphology changes
Our skin is home to millions of bacteria, fungi and viruses: the skin microbiome. What is know about it
- Skin acts as a physical barrier to prevent the invasion of foreign pathogens while providing a home to the commensal microbiota
- Skin sites can be categorized by micro-environment: dry, moist, oily
- 16S RNA fingerprinting is used to get unbiased proportion levels
- Predominant organisms:
- Oily sites: proprionibacterium sp.
- Humid sites: Staphylococcus & Corynebacterium sp.
- Fungal colonization less specific across the body
- Virus colonization is individual dependent
- individuals' microbial communities are relatively stable over time
- diversity of skin microbiomes is less than in gut due to poorer nutrient availability
- overall, the skin harbours a heterogeneous community of microorganism with distinct adaptations to survive on skin
- obsessing over cleanliness of skin is not a good idea
What is the function of Sebum and Sweat and what does it consists of?
- function: avoiding moisture loss, improvement of barrier
- triglycerides (41%)
- wax esters (26%)
- squalene (12%)
Sweat
- function: thermoregulation
- water (99%)
- lactate, sodium, urea, minerals
Excretions of sebaceous and sweat glands influence the skin microbiome
What is the function of Sebum and Sweat and what does it consists of?
- function: avoiding moisture loss, improvement of barrier
- triglycerides (41%)
- wax esters (26%)
- squalene (12%)
Sweat
- function: thermoregulation
- water (99%)
- lactate, sodium, urea, minerals
Excretions of sebaceous and sweat glands influence the skin microbiome
What is the comparison between skin and gut axis
- Both organs have large surface areas exposed to the external milieu
- both organs posses epithelia with high turn over and highly active immune system involvements
- microbial dysbiosis creates impaired epithelial barrier function and can result in IBD in gut and psoriasis in skin
- Gluten sensitivity may influence both gut (IB) and skin (dermatitis)
- Food allergies have a strong relationship with atopic dermatitis
- Skin-gut relationship is mediated by the host immune system
- gut health is essential for skin health
There is a risk of skin conditions due to pathogenicity of some skin organisms, which ones
- S. Aureus colonizes 1/3 of skin sites
- its presence is a signifiant risk factor for subsequent infection
- in clinical infections, 80% of S. Aureus blood stream isolates match those identified in the skin sited of the individual
- Some S.epidermidis ssp inhibits S. Aureus
- Dysbiosis of the microbiota can lead to acne (P acnes), eczema and chronic wounds
- Eczema (atopic dermatitis) is mainly caused by S. Aureus due to impairment of skin barrier and immune function
Research
Hypothesis: skin ageing results from a combination of genetic, lifestyle and environmental factors.
- digital photography
- Nurses functioned as assessors for 'perceived age'
In the twin sample and the total sample higher perceived age is correlated with:
- lower grip strength
- poorer cognitive scores (MMSE)
- shorter telomere length
- (scores were corrected for age and sex)
- Looking old for your age is an indicator for poor health
- Perceived age is robust biomarker of ageing
- Perceived age was highly and significantly correlated to mortality and significantly correlated even after adjustment for chronological age
What is the 'take home' message of the Danish Twin Study?
In over 70's
- an extra chronological year older results in a 11% mortality risk
- looking older an extra year relates to 15% mortality risk
- 'perceived age' is a validated, independent marker of chronological age
- 'perceived age' is correlated with other ageing biomarkers such as cognition; telomere length and grip strength independent of sex and age
'Perceived age' method
unilever studies: quantification of lifestyle&environment
- standardized digital photography
- only the face is recorded
- use of 50 naive 'assessors' results in high reproducibility
- perceived age reproducible: +/- 1 year
- correlation better than 0.96
- using male and female assessors
- using assessors in different countries
Which things in your lifestyle have an effect on the ageing skin?
- UV exposure: photo ageing
- Smoking
- Stress
- Metabolism & diet
What is the influence of UVA and UVB radiation
- DNA damage
- ROS
What is the effect of (exam) stress on your hair?
- Significant changes in TH1/TH2 cytokine balance
- Subtle, reversible changes in hair growth due changes in observed immune response
- Hair tip pigmentation first detectable marker of stress response
- With longer stress events this may result in premature greying
What can you do about skin ageing [prevention of cure?]
- prevention of photo damage
- UVA&B filters
- general skin appearance
- cremes/conditioners
- reduce wrinkle formation
- alpha-hydrocc acids
- retinoid acid derivatives
- HRT
- and recently .. Probiotics
Other more 'drastic' routes
- Cosmetic surgery
- fillers (collagen, fat)
- Botox
- Chemical Peels
- Led devices
- Ablative and non ablative laser photo regeneration
By what is the hair growth stimulated?
- instrumental method results
- increased terminal and villus hair count
- less hair shedding
- self perception results
- improved hair growth
- more hair thickness and volume
- improved skin health
- results correlated with improvement in quality of life
- supplement contained shark cartilage and omega-3 FA's
What are the diet derived micro-nutrients that are beneficial for the skin? And what are there functions
- Vitamin A
- Vitamin E
- Antioxidant vitamins
- Vitamin D
- Polyphenols
- Structural components
- n-3 PUFA's
- Probiotics & dairy
functions
- direct absorption of Uv A/B
- photoprotection
- reduction of photoaging
- capture of oxygen radicals
- anti-inflammatory activity
- reduced erythema
- improvement of barrier function
- reduced matrix degradation
- regulating skin thickness
- regulating cell proliferation
What about delivery of dietary components?
- Dietary omega-3 PUFAs, DHA, EPA&GLA are associated with healthy skin and ameliorating skin disease such as acne, dermatitis and psoriasis
- tocopherols appear in skin and sebum
- Beta-carotene and lycopene also are present in skin after supplementation
- vitamin C is present 30mg/kg skin
- gaps in the understanding of the bioavailability and disposition remain
What is a skin friendly diet?
- Skin health diet components
- fruit&veg
- fermented dairy
- oily fish/omega3-FA's
- extra virgin olive oil
- nuts& seeds
- some herbs
- pre-and probiotics
- protein: collagen peptides
- avoid development of AGE's
- avoid high G.i. Substances
- high glucose and fructose foods
- avoid 'fast food'
- oral supplements
- probiotics
- heliocare
- vitamins (D,E,C)
- minderals (Ca, Zn, copper, chelated selenium)
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