Ageing Process

AGEING PROCESS

Etiology

Problem: aging, [photoaging, acne, enlarged pores, scarring)

Intrinsic aging: irreversible progressive loss of homeostatic capacity – genetically programmed phenomenon

Photoaging results in changes in gene expression – results from exposure to UV radiation

UV radiations: UVA, UVB

Light contacts w skin – scattered, reflected in the stratum corneum, absorbed in the epidermis or is transmitted.

UVB: shorter wavelength – more powerful- absorbed by epidermis – 10% penetrating to deeper layers

UVA: longer wavelength – less powerful – 50% penetrating to epidermis – reach papilla dermis

Therefore, immediate & long-term changes ofphotodamages occur in epidermis and upper dermis

Pathophsiology

Intrinsic process of chronologic aging results from

thinning of epidermis + dermis

loss of elasticity

affects all layers of face

results – bony resorpton, atrophy of subcutan fat, attenuation of the musc.scel system, alter skin surface

dermal-epidermal junction flattens – loss of rete ridges – thinner app to epidermis

dermis – thin, decrease of elastic ffibers, coll prod, vascularity, ground substance, all in collagen + elastin – lax – resilient

collectively – fine wrinkling & sagging

Extrinsic photoaging

degeneratif changes that are superimposed on normal chronologic aging process

clinically – coarse & dry skin, deep wrinkles, sallowness, dyschromis

hist: epidermal hyperplasia + displasia, thickened dermis w solar elastosis, actinic vasculopathy, decreased coll fibers, increased ground substance

Heliodermatitis – chronic inflamm changes & degeneration of elastin and collagen in photodamaged skin

Photoaging – damage DNA – risk os SCC & BCC

The Glogau classification of phptoaging groups:

· Mild (28-35 y)

o Little wrinkle or scarring

o No keratosis

o Require little or no make-up

· Moderate (35-50 y)

o Early wrinkling, mild scarring

o Sallow color w early actinic keratosis

o Requiring little make-up

· Advanced (50-65 y)

o Persistent wrinkling

o Discoloration w telengiactasias and actinic keratosis

o Wear mae-up always

· Severe (60-75 y)

§ Wrinkling- photoaging, gravitational,dynamic

§ Actinic keratosis w/wo skin cancer

§ Wear make-up w poor coverage

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