Albuquerque, NM -- Aging is a natural process. Know how to delay your aging skin through various therapies. Microneedling and HRT are some procedures for you.
The quest for eternal youth, especially in visibly soft, clear, vibrant skin, continues from generation to generation.
Everyone wants to look beautiful and young for the rest of their life. And everyone knows that is not simply possible!
However, with all the advances in technology and research, the industry has simply found ways to “buy more time” in delaying the aging process.
Aging is inevitable, but it’s delayable.
The Infusion and Injection Clinic of ABQ is one of those clinics which employed technology and research to offer guaranteed, safe, and long-lasting solutions for aging. If you are interested to know more about our programs and products, you can set an appointment with our clinicians at this number:
But before you pick up the phone to schedule your first appointment, let us first learn a few facts about aging to help us understand what we are doing.
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What is aging?
Aging is a series of biological and physiological changes that come along with increasing age. It is a complex, gradual process dependent on intrinsic (genetic) and extrinsic (environmental) factors.
Environmental factors tend to amplify the effects of aging. Examples of this are habits and lifestyle: the tendency to smoke, drink alcoholic beverages, involvement in stressful professions, and so on.
Aging is a phenomenon that is multifaceted and was once barely understood. Thanks to technology, a better understanding of the aging process enables us to know how to reverse it.
What is skin aging?
The aging of all body organs starts from birth. However, being the most voluminous organ, the skin is the first to demonstrate the effects of genetic and environmental factors causing aging.
Characterized by features such as wrinkling, loss of elasticity, laxity, and rough-textured appearance, skin aging is undeniable (Zhang and Duan, 2018).
As people age, their worries about appearance focus more on the face (Honigman and Castle, 2006).
Aging is the effect of time on the human body. There are multiple levels of aging, which include:
Our cells continuously divide and repair themselves as we age. However, as time passes, genetic material may no longer be copied accurately. Furthermore, environmental factors and even free radicals cause damage to cells hence the need for cells to replicate more.
Hormones highly influence the aging process. It causes the transition from childhood to puberty and subsequently causes menopause. Hormone levels fluctuate throughout life.
Metabolism creates energy readily used by the body as it proceeds with its daily activities. Byproducts of all these metabolic activities can be harmful and cause damage to the body over time.
What does aging skin look like?
As the skin ages, it thins out, becomes less elastic, more fragile, and the fatty tissue just below the skin remarkably decreases. (Mayo Clinic, 2020).
There may be easy bruising and drier skin due to less production of natural oils. According to Mayo Clinic (2020), changes, such as the following, are observable:
- Skin becomes rougher.
- Skin develops lesions such as benign tumors.
- Skin becomes loose due to the loss of elastin.
- Skin becomes more transparent because of the thinning of the epidermis.
- Skin becomes more fragile due to flattening of the area where the epidermis and dermis (layer of skin under the epidermis) fuse.
- Skin becomes more easily bruised because of thinner blood vessel walls.
- Loss of fat under the skin, especially in the cheeks, temples, chin, nose, and eye area (hence the appearance of loose skin and sunken eyeballs
- Bone loss, commonly observed around the mouth and chin, may become evident after age 60
- Cartilage loss in the nose results in drooping of the nasal tip, further resulting in an emphasis on the nose’s bony structures.
What are the causes of skin aging?
There are two leading causes of skin aging: (1) intrinsic factors and (2) extrinsic factors.
Intrinsic aging is an inevitable physiological process. It results in thin, dry skin, fine wrinkles, and a gradual decrease in the size of dermal tissues (Zhang and Duan, 2018).
Research has noted that as a person ages, the production of cells in the basal layer also decreases (Zhang and Duan, 2018). As a result, the skin thins out, and the cells undergo a process called senescence.
Aside from cellular senescence and decreased proliferative capacity, other intrinsic factors include a decreased cellular DNA repair capacity, DNA mutations, chromosomal abnormalities, and loss of telomeres in cells (Makrantonaki and Zouboulis, 2007).
Telomeres are little protective caps at the ends of the DNA molecules that make up the human chromosome (Australian Academy of Science, 2020). These are responsible for ensuring that in cell division, the reproduced cells have correctly copied DNA.
In fact, l research consistently links telomere to aging. This aging is because telomeres adjust the cell response to stress and growth stimulation based on previous cell divisions and DNA damage (Aubert and Lansdorp, 2008).
External environmental factors highly influence extrinsic aging. External environmental factors include air pollution, smoking, poor nutrition, and sun exposure (Zhang and Duan, 2018). These factors directly cause the formation of coarse wrinkles, loss of elasticity, laxity, and the notable rough-textured appearance of the skin.
Photoaging is also a primary factor of extrinsic skin aging (Zhang and Duan, 2018). Long-term exposure to solar ultraviolet radiation characterizes photoaging.
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What happens during the skin aging process?
There are different mechanisms used to explain the skin’s aging process. Understanding these mechanisms led to the discovery of multiple aging-reversal techniques that we see today.
Scientists proposed that only 3% of these aging processes are intrinsic, while extrinsic factors contribute to the rest (Zhang and Duan, 2018).
Here are some important models and advances in molecular mechanism research on skin aging:
Among all the theories explaining aging, it is the free radical theory that is already long proven and established (Harman, 2003). To put it simply, oxidative stress is an imbalance between the pro and antioxidant molecules (Zhang and Duan, 2018).
In metabolism, the body normally generates reactive-oxygen species (ROS). Oxidative stress happens when an imbalance occurs due to excess ROS or oxidants over the cell’s capability to mount an effective antioxidant response (Ray et al., 2012).
Under normal conditions, antioxidants neutralize ROS and prevent its effective binding to other molecules. However, under UV radiation, cellular chromophores absorb the energy and get excited, thereby producing more ROS oxidation products.
ROS oxidation shows prolonged exposure to extrinsic factors, such as photoaging, promotes the overproduction of ROS. ROS overproduction leads to an imbalance in the body’s pro and antioxidants, resulting in oxidative stress.
It is because of this long-standing theory that researchers highly recommend the use of antioxidants in delaying aging. Emerging research evidence has suggested that natural compounds found in the body (e.g., glutathione) can reduce oxidative stress and improve immune function (Zhang and Duan, 2018).
The constant and prolonged exposure of skin to UV radiation increases DNA damage and mutations. Mutations and DNA damage lead to structural rearrangement of nucleotides, further leading to premature aging and even carcinogenesis (Zhang and Duan, 2018).
These findings led to the use of sunscreen, which has been found effective against UV-B, therefore protecting the skin against squamous cell carcinoma and melanoma (Zhang and Duan, 2018).
Telomeres are little protective caps located at the end of DNA molecules, designed to keep the DNA strands from getting shorter with each cell division. An enzyme called telomerase keeps adding more of the repeating sequence onto the end of DNA strands, so the telomeres in these cells do not shorten (Australian Academy of Science, 2020).
In most cells, telomerase is less active, leading eventually to gradual shortening of telomeres as time passes (Australian Academy of Science, 2020).
Researchers believe this “shortening to be causative of cell aging. If telomeres are too short, cells eventually become inactive or “senescent” and can no longer divide (Australian Academy of Science, 2020). UV radiation causes the overproduction of ROS, which can further result in telomere shortening (Zhang and Duan, 2018).
Advanced Glycation End Product Accumulation
Glycation, initially described in diabetes, is when proteins, lipids, or nucleic acids are bound by sugar molecules.
Glycationresults in the inhibition of target molecules’ normal function (Zhang and Duan, 2018).
In the process, advanced glycation end (AGE) products form. The excess glucose in skin fibers triggers an internal reaction and changes the molecular arrangements in collagen fibrils (Bansode et al., 2020).
Collagen and elastin usually help keep skin firm and supple. The binding of advanced glycation end products to collagen results in tissue stiffening and reduced elasticity (Zhang and Duan, 2018).
Inflammation or “Inflammaging”
Inflammaging refers to the chronic low-grade inflammation that progresses along with advanced age. It also contributes to the initiation and progression of age-related diseases (Franceschi et al., 2018).
Scientists proposed, through a model, that UV radiation induces oxidative stress in epidermal cells, resulting in damaged cells with oxidized lipids (Zhang and Duan, 2018).
These damaged cells and oxidized lipids are recognized by the complement system and cause inflammation. Macrophages are then activated to remove the damaged cells and oxidized lipids (Zhang and Duan, 2018).
These activated macrophages trigger the production matrix metalloproteinases, which degrade collagen (Zhang and Duan, 2018).
Repeated UV exposure triggers another series of events again, resulting in overburdened macrophages and the production of more matrix metalloproteinases and ROS. It results in a deadly cycle repeating itself over time (Zhang and Duan, 2018).
What are some of the current methods to delay or reverse the effects of aging on the skin?
You can quickly notice many antioxidants are being marketed nowadays as a quick and easy measure against aging. In various forms and preparations, antioxidants reduce agents that relieve skin aging by neutralizing ROS already formed in the body (Zhang and Duan, 2018).
Common antioxidants, such as Vitamin C and Vitamin E, stop the degradation of collagen. Antioxidative enzymes, including superoxide dismutase, catalase, glutathione peroxidase, and coenzyme Q10, are also effective in controlling the production of matrix metalloproteinases (Zhang and Duan, 2018).
Some plants can even be natural sources of antioxidants. These natural resources include the popular aloe vera and green tea.
Catechin, found in green tea, prevents skin aging via the epidermal growth factor receptor (EGFR) pathway in a mouse model, resulting in better skin structure.
Glutathione oral supplementations and infusions are among the most popular ways to “detoxify” and regain one’s youthful glow. It is a low molecular weight thiol-tripeptide that protects intracellular redox balance (Sonthalia et al., 2016). In the process of aging, the body’s natural supply of glutathione actively decreases.
Since aging makes glutathione levels appear to decline in several tissues, cells are at an increased risk of yielding stress (Maher, 2005). The effectiveness of glutathione as an antioxidant is due to its ability to delay cell death or apoptosis (Sastre et al., 1996).
Healthcare professionals primarily administer through the following routes (Sonthalia et al., 2016):
- oral (pills, solutions, sublingual tablets, syrups, and sprays),
- parenteral (intravenous and intramuscular),
- intranasal, and
Oral glutathione is the most popular form and is marketed as a dietary supplement, either alone or in combination with vitamin C, alpha-lipoic acid, and other antioxidants (Sonthalia et al., 2016). However, data on the bioavailability of oral glutathione remains controversial.
On the other hand, intravenous infusions of glutathione are also becoming more popular due to the expectation of 100% bioavailability like other intravenous infusions (Sonthalia et al., 2016). Researchers expect the oral route to have lower bioavailability levels than the intravenous route due to the first-pass metabolism. However, there is still no sufficient data to support the hypothesis of a 100% bioavailability of intravenous glutathione in humans.
Some researchers suggest that antioxidant supplements do not have preventive effects on chronic diseases. Excessive supplementation of β-carotene and vitamins A and E may be harmful (Zhang and Duan, 2018). Therefore, it is imperative to be evaluated by a healthcare provider before using antioxidants. The goal of antioxidants is not to eliminate ROS but to restore intracellular balance.
Stem Cell Therapy
Stem cells are unique cells that can develop into different cells, given the right environmental conditions. These are otherwise known as the body’s raw materials, from which all other specialized cells are generated (Mayo Clinic, 2020).
Scientists attribute The development and maturation of individual tissues and organs to the proliferation of differentiation of stem cells - a process starting right after birth. (Yu, 2018).
As an individual matures, these stem cells within the individual's tissues ensure the metabolism of different cells and tissues. An example is that of the hematopoietic stem cells in the bone marrow (Yu, 2018).
The aging of stem cells in human tissues is a major cause of the decline in tissue regeneration capacity (Yu, 2018).
The good news is, the application of advanced stem cell technology improves the ability to regenerate and repair cells. This technology provides a solution and delays aging. It also reverses the effects of aging and aging-related illnesses (Yu, 2018).
Stem cells do not only proliferate and differentiate, but they also have a secretion function. These cells secrete various growth factors and cytokines to regulate the tissue microenvironment (Yu 2018). Because of this added knowledge, the use of stem cells has become very promising in the reversal of aging.
Despite being an otherwise invasive method, stem cell transplantation is a novel and promising therapy for skin aging therapy. Specifically, adipose tissue transplantation could improve skin quality at the recipient site in addition to increasing skin volume (Zhang and Duan, 2018).
The secret lies within these adipose tissues: adipose-derived stem cells generate a series of growth factors. These cells postulate to influence cutaneous cells through these growth factors, resulting in rejuvenating underlying skin (Zhang and Duan, 2018).
Retinoids are not new in the treatment for aging. It most often comes in the form of topical applications for daily use. It is a popular choice among dermatologists as part of the skincare regimens offered to patients.
Retinoids are chemically similar to Vitamin A and are otherwise known as Vitamin A derivatives. The first retinoid approved for clinical use is tretinoin (Zhang and Duan, 2018). Researchers documented in various studies the use of retinoids reverses aging with clinical and histological evidence indicating its effect against photoaging (Katsambas and Katoulis, 1999).
Retinoids are lipophilic molecules that can penetrate the epidermis easily. Its mechanism of action is through modulating gene expression - binding to nuclear receptors and then to specific DNA sequences (Sorg et al., 2005). It specifically inhibits the transcription factor activator protein-1, suppressing the expression of matrix metalloproteinases and preventing the degradation of collagen (Zhang and Duan, 2018).
Scientists document that various retinoids increase the synthesis and concentration of both hyaluronate and collagen in the skin by reducing their rate of degradation (Sorg et al., 2005). Also observed is an increase in epidermal thickness and anchoring fibrils upon histologic examination (Zhang and Duan, 2018).
The biological, chemical and physical properties of retinoids may help treat skin aging and photoaging. This treatment, attributed to a typical chemical structure shared by retinoids, contains several conjugated double bonds that trap free radicals and absorb UV radiations from the sun (Sorg et al., 2005).
In effect, retinoids protect cellular targets such as DNA, lipid membranes, or proteins by preventing direct photochemical damage or UV‐induced oxidative stress (Sorg et al., 2005). Retinoids are usually part of the topical therapy combinations offered to patients, often used in conjunction with alpha-hydroxy acids (AHAs) (Kockaert and Neumann, 2003).
Part of a systemic therapeutic regimen against aging skin, used in conjunction with Vitamin C, uses oral retinoids(Kockaert and Neumann, 2003).
Hormone Replacement Therapy
Menopause is an estrogen-deficient state which has a significant impact on the skin. The decreased estrogen levels in the body result in a hormonal imbalance, which further results in the mechanisms responsible for the signs of aging: rapid collagen breakdown, decreased elastin, dehydration, and impaired wound healing (Borda et al., 2019).
d Used in reversing the effects of menopause, hormone replacement therapy (HRT) is also helpful in slowing down the skin’s aging process.
It has been Researchers documented that HRT improves skin thickness, collagen content, and elasticity. However, studies suggest HRT increases the risk of developing breast cancer and thromboembolism, resulting in doubts regarding its use (Borda et al., 2019).
The visible signs of aging, primarily attributed to hormonal imbalance, correct the result to more youthful, vibrant-looking skin. Despite some trials’ adverse effects, hormone replacement therapy remains a promising avenue in reversing aging (Rinaldi, 2004).
In fact, it is not just appealing to women but also men, particularly in the middle-aged and older age group in the US. (Rinaldi, 2004).
A study in 2004 noted that after menopause, decreased estrogen levels resulted in a decline in skin elasticity by 0.55% / year. A 12-month regimen of hormone replacement therapy increased elasticity by 5.2% in the respondents (Sumino et al., 2004).
There are two types of hormone replacement therapy: conventional hormone replacement therapy and bioidentical hormone replacement therapy.
In conventional HRT, drugs come in standard doses, which are then prepacked and dispensed by pharmacies. On the other hand, the advent of Bioidentical Hormone Replacement Therapy uses precise duplicates of human hormones, synthesized through extracting a compound called diosgenin from plants (Crofford, 2019). This extraction diminishes apprehension related to cancer because of its dose-specific preparations.
Bioidentical hormone replacement therapy decreases the likelihood of coronary heart disease and breast cancer in post-menopausal women (Col et al., 1997). This decrease is one of the huge advantages of customized hormone therapy.
Hence, compounding in bioidentical hormone replacement therapy decreases the overall risk involved in hormone replacement therapy. Compounding can allow lower concentrations of hormones than commercially available products (Borda et al., 2019).
Some clinics instruct their patients to undergo assessment first so that the patient's symptoms cater to bioidentical hormone replacement therapy can be catered according to the patient’s symptoms. Some others measure hormones in the saliva or serum to identify the correct therapeutic combination (Borda et al., 2019).
In effect, because of the ability to specifically cater to patient needs, it appears that bioidentical hormone replacement therapy is safer than conventional hormone replacement therapy in preventing aging. A literature review supports this theory, highlighting the superiority of bioidentical hormone replacement therapy (Rosenthal et al., 2019).
Scientists have found a way to lengthen telomeres using modified messenger RNA (Conger, 2015). RNA transmits the instructions from DNA towards the protein-making machinery of the human cell.
Lengthening telomeres is an ideal approach in reversing skin aging; however, there is a standing risk for epidermal carcinogenesis in the procedure (Zhang and Duan, 2018). Hence, further investigation and studies are needed to evaluate the safety of the enhanced proliferation done by the artificially lengthened telomere.
Diet can cause skin aging or can either improve skin aging.
One of the simplest but overlooked ways of combating aging is through diet modification. Through the daily diet, one gets a daily dose of antioxidants, vitamins, and other essential nutrients necessary for health maintenance.
However, foodborne antioxidants have certain limitations. These limitations include unstable storage, low skin bioavailability, and poor solubility. Recent methods, however, improved the delivery of these antioxidants through chemical modification, collagen drug delivery, plus a combination of supplements (Cao et al., 2020).
Glycation is still one of the most widely studied processes regarding aging and aging-related diseases (Nguyen and Katta, 2015).
Once glycation occurs, it is already impossible to revert glycated proteins to their original state. Hence, Scientists still direct the primary strategy towards preventing these proteins from undergoing glycation (Zhang and Duan, 2018).
The problem is, our usual diet provides not only sugars like glucose and fructose, but it also has preformed advanced glycation end (AGE) products. Recent studies have disclosed specific methods of food preparation (i.e., grilling, frying, and roasting) generate much greater levels of AGE compared to water-based cooking methods such as boiling and steaming (Nguyen and Katta, 2015).
Therefore, foods with lower sugar content that undergo cooking with water (e.g., boiling or steaming) would also decrease the intake of preformed AGEs. It also stops the production of physiologically glycated proteins (Zhang and Duan, 2018). Hopefully, researchers discover medicines with the deglycation capability, and such would be a significant breakthrough discovery against aging and aging-related diseases.
Furthermore, several studies promote calorie restriction to delay and prevent aging. It appears that on the cellular and molecular level, a high-fat diet causes rapid cellular aging in fibroblasts, while caloric restriction prevents it (Millar, 2018).
Scientists also believe that culinary herbs and spices such as cinnamon, cloves, oregano, and allspice, may have a role in inhibiting fructose-induced glycation (Zhang and Duan, 2018).
Furthermore, the following compounds have a role in inhibiting AGE formation (Zhang and Duan, 2018), with mechanisms still under investigation:
- α-lipoic acid,
- flavonoids (e.g., green tea catechins),
- sodium selenite,
- selenium yeast,
Microneedling is not a new practice for skin improvement. It is considered one of the minimally invasive procedures used for anti-aging.
In fact, it dates back to 1905, when a German dermatologist initiated the use of a device with rotating wheels and rasps in the treatment of acne scars, keratoses, and hyperpigmentation. By 1995, two doctors, David Oreintreich and Norman Oreintreich, introduced a process, called “subcision” involving hypodermic needles in the induction of wound healing (Iriarte et al., 2017).
Microneedling involves the use of a roller product to make fine, uniform pinprick wounds on the epidermis. Microneedling stimulates the production of growth factors, as well as collagen and elastin.
The mechanism behind microneedling involves tapping on the body’s natural healing mechanisms to improve one’s skin. It relies on the premise that the body responds in the same way towards minute wounds versus more significant wounds.
Microneedling is also known as percutaneous collagen induction. Its edge over other cosmetic techniques is that it preserves the epidermis while it stimulates collagen deposition. This preservation reduces the risk of post-treatment complications and patient downtime (Ablon, 2018).
Microneedling works by stimulating intradermal collagen production and is also used in achieving trans-epidermal drug delivery (Casabona and Marchese, 2017). Today, most clinics recommend microneedling combined with the use of serums on the skin’s epidermis, simultaneously using the same procedure.
These results are even better once microneedling, coupled with serums such as topical anti-aging vitamin C serum and tretinoin application, for combination therapy for the delay and reversal of aging.
In terms of frequency, research illustrated four microneedling treatments of facial skin, spaced four weeks apart, significantly improved lines, wrinkles, skin laxity, and skin texture, 90 and 150 days after the first treatment (Ablon, 2018).
In general, microneedling was well-tolerated. There was only minimal pain, discomfort, and little to no downtime. Side effects were minor and easily managed compared to other invasive technologies, such as laser ablation and radiofrequency (Ablon, 2018).
MicroNeedling is a very safe, minimally invasive procedure of which the benefits vastly outweigh the risks.
The use of lasers in treating aging skin is not new. Now and then, there are new variants of laser treatments.
There are two types of laser treatments: the ablative laser and the nonablative laser.
The ablative laser works by removing the thin outer layer of skin (epidermis) and heating the underlying skin (dermis). This procedure stimulates the growth of new collagen fibers (Mayo Clinic, 2020).
In the process of healing and regrowing, the area treated will visibly appear smoother and tighter. Types of ablative treatments are the carbon dioxide (CO2) laser, the erbium laser, and combination systems (Mayo Clinic, 2020).
On the other hand, the nonablative laser is a non-wounding laser; hence it is noninvasive. The process still stimulates collagen growth, which over time helps improve skin tone and texture.
However, it is less effective compared to ablative lasers. An example of nonablative lasers is intense pulsed light (IPL) devices (Mayo Clinic, 2020).
Laser resurfacing may not be easily recommended to everyone (Mayo Clinic, 2020), especially if:
- You have taken a specific isotretinoin during the previous year.
- You have an autoimmune disease.
- You are immunocompromised
- You are scar-forming
- You have undergone radiation therapy to the face.
- You have had the herpes virus before
- You have a darker skin tone.
- You are pregnant or breastfeeding.
It is best to seek consultation before booking an appointment involving laser treatments.
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Radiofrequency therapy, or RF therapy, uses energy waves to induce heat at the dermis, subsequently stimulating collagen and elastin production. It is non-surgical and noninvasive. It encourages cell turnover, hence making skin look and feel firmer, thicker, and younger-looking (American Board of Cosmetic Surgery, 2020).
Radiofrequency is a form of energy measured in wavelengths per second. This energy form is about 100 million times slower than visible light and over 1 billion times slower than an x-ray (American Board of Cosmetic Surgery, 2020).
Equipment used for radiofrequency is highly controlled. The ideal equipment based on FDA standards allows the practitioner to monitor and control the device during treatment. This monitoring and controlling ensure that targeted tissues reach the optimal temperature to induce new collagen production and cell regeneration without overheating (American Board of Cosmetic Surgery, 2020).
Hence, it is essential to choose a qualified provider for radiofrequency treatments to obtain excellent results.
As a non-invasive way to prevent and delay skin aging, radiofrequency is highly effective.
Studies reported that type I and III collagen increased significantly in the dermis after monopolar radiofrequency treatment (Yokoyama et al., 2014). A statistically significant increase in the mean of collagen types I and III and newly synthesized collagen was noted even after as early as three months post-treatment (El-Domyati et al., 2011).
Radiofrequency also showed equal efficacy towards chemical peels in treating facial rejuvenation of patients with photoaging (Wakade et al., 2016).
- Aging is a process that begins after birth and culminates after death. The skin, being the most voluminous organ, is the first to show signs of aging.
- Scientists attributed skin aging to intrinsic and extrinsic causes. Various mechanisms are responsible for skin aging.
- Antioxidants are one of the most marketed supplements nowadays. Glutathione, an antioxidant that comes in various forms (i.e., as an oral supplement, sublingual spray, topical cream and ointment, or parenteral infusion), has gained a lot of popularity due to its anti-aging effect.
- Hormone replacement therapy anchors on the fact that hormonal imbalance trigger menopause, which is then responsible for the clinical manifestations of aging. Bioidentical hormone replacement therapy eliminates the concerns brought about with conventional hormone replacement therapy through customizing management based on specific patient needs.
- Microneedling is a minimally invasive procedure that is guaranteed to have a noticeable effect against skin aging with little to no downtime.