Research shows that there are, in fact, two distinct types of aging. Aging caused by the genes we inherit is called intrinsic (internal) aging. The other type of aging is known as extrinsic (external) aging and is caused by environmental factors, such as exposure to the sun’s rays.

Intrinsic Aging
Intrinsic aging, also known as the natural aging process, is a continuous process that normally begins in our mid-20s. Within the skin, collagen production slows, and elastin, the substance that enables skin to snap back into place, has a bit less spring. Dead skin cells do not shed as quickly and turnover of new skin cells may decrease slightly. While these changes usually begin in our 20s, the signs of intrinsic aging are typically not visible for decades. The signs of intrinsic aging are:

• Fine wrinkles

• Thin and transparent skin

• Loss of underlying fat, leading to hollowed cheeks and eye sockets as well as noticeable loss of firmness on the hands and neck

• Bones shrink away from the skin due to bone loss, which causes sagging skin

• Dry skin that may itch

• Inability to sweat sufficiently to cool the skin

• Graying hair that eventually turns white

• Hair loss

• Unwanted hair

• Nail plate thins, the half moons disappear, and ridges develops

Genes control how quickly the normal aging process unfolds. Some notice those first gray hairs in their 20s; others do not see graying until their 40s. People with Werner’s syndrome, a rare inherited condition that rapidly accelerates the normal aging process, usually appear elderly in their 30s. Their hair can gray and thin considerably in their teens. Cataracts may appear in their 20s. The average life expectancy for people with Werner’s syndrome is 46 years of age.

Extrinsic Aging
A number of extrinsic, or external, factors often act together with the normal aging process to prematurely age our skin. Most premature aging is caused by sun exposure. Other external factors that prematurely age our skin are repetitive facial expressions, gravity, sleeping positions, and smoking.

The Sun. Without protection from the sun’s rays, just a few minutes of exposure each day over the years can cause noticeable changes to the skin. Freckles, age spots, spider veins on the face, rough and leathery skin, fine wrinkles that disappear when stretched, loose skin, a blotchy complexion, actinic keratoses (thick wart-like, rough, reddish patches of skin), and skin cancer can all be traced to sun exposure.

“Photoaging” is the term dermatologists use to describe this type of aging caused by exposure to the sun’s rays. The amount of photoaging that develops depends on: 1) a person’s skin color and 2) their history of long-term or intense sun exposure. People with fair skin who have a history of sun exposure develop more signs of photoaging than those with dark skin. In the darkest skin, the signs of photoaging are usually limited to fine wrinkles and a mottled complexion.

Photoaging occurs over a period of years. With repeated exposure to the sun, the skin loses the ability to repair itself, and the damage accumulates. Scientific studies have shown that repeated ultraviolet (UV) exposure breaks down collagen and impairs the synthesis of new collagen. The sun also attacks our elastin. Sun-weakened skin ceases to spring back much earlier than skin protected from UV rays. Skin also becomes loose, wrinkled, and leathery much earlier with unprotected exposure to sunlight.

• Avoiding deliberate tanning, including use of indoor tanning devices.

• Staying out of the sun between 10:00 a.m. and 4:00 p.m., when the sun’s rays are the strongest.

• Wearing protective clothing, such as a wide-brimmed hat and long sleeves, when outdoors during the day.

• Applying sunscreen year round. Sunscreen should be broad spectrum (offers UVA and UVB protection) and have a Sun Protection Factor (SPF) of 15 or higher. Sunscreen should be applied 20 minutes before going outdoors to all skin that will be exposed. It should be reapplied after sweating or being in water.

Treatment. If you are bothered by visible signs of aging, a number of treatments are available. Injectable fillers and botulinum toxin are suitable for people with busy lifestyles who do not want the inconvenience of a long recovery. Radiofrequency is a procedure that offers an alternative to the traditional facelift. Dermabrasion, laser resurfacing, chemical peeling, microdermabrasion, and some topical treatments can restore skin, giving it a smoother and refreshed appearance.

Scientific research in the field of anti-aging continues to give rise to new and promising treatment options. A dermatologist can help you sort through the numerous options, including the myriad of over-the-counter products. During a consultation, the dermatologist will examine your skin, discuss your expectations, and recommend suitable treatment options.