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Keep Ageing at Bay

Sunscreen, collagen fillers, and other minimally invasive procedures to prevent skin ageing

10973118_xxlSkin ageing becomes more noticeable when women reach their mid-40s. Facial ageing processes are complex and happen in a three-dimensional way, involving different layers of skin, ligaments, fat pads, and bony structures.

Reduction in the facial volume of the fat compartments lead to a sagging face. The tear grooves and nasolabial lines become more pronounced. Eye bags also tend to become more obvious. The skin starts to show signs of ageing with increase telangiectasia, keratosis, wrinkles, pores, and skin elasticity. Pigmentation becomes obvious, such as freckles, lentigines, patchy hyper pigmentation, and depigmented lesions, e.g.  guttate hypomelanosis.

Causes of Skin Ageing

There are two main processes of skin ageing – intrinsic and extrinsic. Intrinsic ageing is inevitable and related to genetics and race. This causes structural and functional changes to all skin layers. There is a progressive decrease in the renewal rate of epidermis cells, from 28 days in young skin to 40-60 days in the elderly. Slow turnover causes thinning of the skin and gives the aged skin a translucent appearance. This affects the skin barrier function, repair, and cell turnover, causing a rough, scaly appearance and texture.

Extrinsic ageing is caused by environmental factors such as cigarette smoking, sun exposure, pollution, harsh weather, alcohol use, and poor nutrition, of which sun exposure accounts for 80% of facial ageing. This process is preventable. This leads to fine wrinkles, roughness, mottled hyperpigmentation, loss of skin tone, and dilated blood vessels.

Woman with her face divided to show agingPrevention of Skin Ageing


Approximately 80% of skin sun damage is thought to occur by age 18. Thus, preventive methods should start in early childhood. Regular use of sunscreen can prevent the effects of skin ageing, such as pigmentation and wrinkles. Sunscreen can also reduce the incidence of age-related skin conditions such as actinic keratosis, solar elastosis, and squamous cell carcinoma.

There are two types of sunscreens – physical sunscreen and chemical sunscreen. Physical sunscreen contains titanium dioxide or zinc oxide, which provides broad spectrum coverage, blocking the UVA and UVB radiation. Chemical sunscreens contain para-aminobenzoic acid (PABA) to protect from UVB. Some may contain oxybenzone offering, protecting the skin against UVA wavelength.

The sun protection factor (SPF) is the international standard rating effectiveness of sunscreens. Unfortunately, it is based solely on the use against UVB radiation. Thus, the inadequacy of rating UVA protection has raised a concern that high SPF product may give a false sense of protection against sunburn.


Free radicals such as reactive oxygen species play a vital role in the process that leads to the clinical manifestation of skin ageing. The skin has an intrinsic antioxidant defence mechanism that scavenges free radicals and protects skin against skin damage.

Oral supplementation of antioxidants has not been successful to reduce skin oxidative stress due to physiological process, including absorption, transport, and metabolism. However, some studies show that percutaneous delivery of antioxidants to the skin may help, e.g. topical vitamin C can effectively penetrate the skin and enhance the skin’s vitamin C level.

There are many different commercially available anti-ageing products that contain antioxidants. But, unfortunately, only a few studies have been done to prove the efficacy of topical antioxidants on human skin.

Minimally Invasive Procedurestable 1

  1. Optimal Pulse Technology

Intense pulsed light (IPL) has been the gold standard for photo rejuvenation and pigmented lesions. However, traditional IPL sources have some shortcomings: the energy peak of ‘V-shaped’ pulses could possibly cause overload burning and post-inflammatory hyperpigmentation (PIH), and the energy slope below the therapeutic threshold is not sufficient to produce photothermolysis on the targeted chromophores. Some traditional IPL system does not incorporate the cooling device, which increases the risk of complications and need to purchase various hand pieces for different wavelengths meant for various treatments.

Thus, a novel IPL source incorporates a genuine breakthrough in the form of optimal pulse technology (OPT). The essence of OPT is the system’s ability to control the pulse shape and to deliver homogenous ‘squared-off’ pulses, resulting in more even distribution of the energy within each individual pulse and between sub-pulses. This novel pulse shape control mechanism enables use of lower fluency levels and can result in safer, more effective, and more reproducible treatments. The hand piece incorporates cooling device, maximising patient comfort.

  1. Dermal Fillers

According to the American Society of Plastic Surgeon, in 2012, two million Americans received hyaluronic acid (HA) injections. HA is the second most popular procedure performed in America after Botox. The goal of dermal fillers is to smooth out wrinkles and folds; even out scars; volumise furrows, uneven contour, and laxity; and sculpt skin into a fully rejuvenated look. Collagen fillers were the first to be used. Subsequently, these have been replaced by HA fillers.

HA fillers are now the gold standard for soft tissue augmentation. HA or hyaluronan is a non-sulphated glycosaminoglycan that occurs naturally in the skin as part of the extracellular matrix. HA is ubiquitous across species, and thus non immunogenic. As ageing decreases the concentration of HA in the skin, replacing it with HA injections will serve to plump up the skin, giving a more youthful appearance.

There are two main categories of HA fillers – animal-derived and bacterial-derived. Side effects of HA fillers are mild and rare. These include bruising, temporary swelling, acne, and, rarely, acute hypersensitivity. Arterial occlusion, thought to be due to the swelling of the HA implant, causing vascular compromise, can rarely occur.

Considerations in choosing a HA fillers include ‘G’ prime which measures the stiffness or gel hardness,  cohesivity or spreading tendency , degree of cross linkage,  concentration of HA, hydration level of product, and presence of lidocaine for anaesthesia.

A combination of OPT and HA fillers is safe and effective for giving an overall rejuvenated look. OPT can target skin lesions such as dyschromia, pigmentation, pores and skin dullness, whereas HA fillers can volumise and plump up the skin, reducing signs of ageing.

Dr Erwin Kay from Healthwerkz Medical Centre.
Posted by ezyhealth on May 12 2014. Filed under Aesthetics. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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