Whatever your reasoning, staying young and healthy is important. But how can you do it? With such a wealth of information available at the tips of our fingers through the internet, it can be difficult or even impossible for everyday individuals to determine what really works from what doesn't. That is exactly why this book was written.
In Look Young, Feel Young, and Stay Young, experienced anti-aging guru Dr. David Ling Sieng Ngan and renown alternative health and wellness specialist Dr. Grace Low Yock Ngan come together to share cutting-edge beauty secrets to keep you looking younger longer. Whether you're looking for natural ways to maintain your youth or looking to immediately change your appearance through surgery or high-tech equipment, the answers and information you need to make the most informed decision for your health and appearance can be found within.
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Look Young, Feel Young, and Stay Young
By David Ling, Grace Low
PartridgeSGCopyright © 2014 Dr David Ling & Dr Grace Low
All rights reserved.
How the Skin Look Like to Me
In order to understand aging and the formation of wrinkles, it is crucial to understand each anatomy of the skin and their functions. Each and every one of these structures, play a big part in maintaining the appearance of the skin and the regulation of some of the most important processes of our bodies. This chapter explains which layer of the skin structure affects the aging process and the changes it goes through.
The function of the skin allows man to adapt to a wide variety of environment. The tough fibrous collagen of the lower layer, the dermis is designed to withstand mechanical trauma. The outer most layer of epidermis is called stratum corneum and is made up of many layers of horny plates which are relatively but not absolutely impermeable to fluids from within and prevent evaporation of tissue fluids. However, small transepidermal wastage is inevitable.
Skin is one of the biggest organ in our body, principally involved in regulating the body temperature. Exposure to cold causes a reduction of skin blood flow which insulates and maintains body temperature. Increased blood flow in the superficial blood vessels and evaporation of sweat from sweat glands increases heat loss and enables man to remain cool in hot weather. The presence of pigment in all layers of epidermis filters out most of the harmful ultra-violet radiation, UV A and UVB ray. Finally, the sensory nerves can only receive impulses through normally functioning skin.
There is a wide regional variation in the structure of the skin of the same person. For example: the thick horny epidermis in the palms and soles can be contrasted with the delicate thin epidermis of the eyelids, and the density of hair follicles varies from the profuse growth on the scalp to complete absent on palm and soles.
Three Skin Layers
The skin is made up of 3 layers—the epidermis, dermis, and subcutaneous tissue.
The epidermis is the surface or outer most layers of the skin covering and functions as a barrier to protect from the external environment. The epidermis further contains 5 distinct layers of cells. The cells of the epidermis, keratinocytes, move from the bottom layer of the epidermis to the top layer as it multiplies and grows, building up a large amount of keratin and developing a tough outer shell that is able to resist hash external elements. When these cells reach the top, they flake off eventually. If this process becomes abnormal the skin can look scaly, as seen in various diseased conditions.
Dermis, the true skin
The second layer of skin, which is just beneath the epidermis is called the dermis (the true skin) which contains the structural elements of the skin which is the connective tissue. There are various types of connective tissue with different functions. Why we call them as connective tissue is because it connects and binds together all the other components that form the skin, to give the skin the whole volume in 3 dimensional arrangements.
Fibrous protein collagen for instance, gives the skin its strength, much like the function of steel bar inside the reinforced concrete. Collagen fibre is embedded in ground substance containing a high proportion of muco-polysaccharide (analogy to the cement inside the concrete). The dermis has a great capacity of retaining water and is an important reservoir of body fluid. Collagen is formed by fibroblasts, which are present in large number in the dermis. Other types of cells, such as the mast cells have the power of releasing histamine when damaged; and the histiocytes is derived from reticuloendothelial system. The reticulum and elastin fibres weave a supporting web around the collagen bundles. This combination of all 3, collagen, reticulum and elastin fibres give the dermis its physical properties. They form a framework through which run the hair follicles, sweat ducts, blood vessels, lymphatics, and cutaneous nerves which terminate either in specialised endings beneath the epidermis or at the epidermal appendages.
The keratin of the epidermis is maintained supple by the secretion of the sweat and sebaceous glands, and oil produced by the epidermal cells themselves. The sweat glands, which are situated deep in the dermis are formed as a coiled tube of cubical epithelium which leads via the sweat duct and a spiral cleft between the epidermal cells to the skin surface. The sweat gland is under the control of central nervous system and can be stimulated to secrete by the needs for the body to lose heat, or by fear. They are innervated by the autonomic nervous system.
Sebum production is dependent on the size and mitotic activity of the sebaceous cells. The glands are present in high density and large in size, on the face and over the midline of the back. However it is absent on the palm and the sole. A few sebaceous glands that do not open into hair follicles are present in the male and female genitals, and on the red margin of the lips and the buccal mucosa. Sebum production is increased by the androgen derived from the testosterone in the adrenal glands, and also directly or indirectly by the other pituitary hormones including the growth hormone. This explains why teenager has more active pimple eruption due to higher level of androgen.
The imaginary space that lies between the dermis and the epidermis is an important structure. It is important in terms of structural integrity it gives to the skin, and the special function it deliver.
The basement membrane, which itself is multi-layered, gives structural support and serves as a lay of "gum" that glue the epidermis and dermis together.
The dermal-epidermal junction interlocks, forming finger like projections called rete ridges (imagine that bottom surface of epidermis, and the upper surface of the dermis, both of which have lot of fingerlike projection, when the 2 layers comes together, it basically lock into place and stick together as one, preventing any possibility of sliding movement along each other). In this way, the cells of the epidermis receive their nutrients from the blood vessels in the dermis. The rete ridges increase the surface area of the epidermis and dermis, which is exposed to blood vessels, and lymphatic. The needed nutrient it requires is diffused to the epidermis and the waste is diffused back to the lymphatic.
The bottom inner layer of skin is called subcutaneous tissue containing fat cells and other connective tissues. These fat cells give the skin volume and provide insulation to the body and make the skin look plump or full. They also contain all the arteries, veins, lymphatic and nerves.
Chronological Aging and Wrinkles
The above diagram shows that as a person ages the epidermal cells become thinner and less sticky. When this happens, the skin will look, and becomes noticeably thinner. It is important to take note that, decreased stickiness of the cells means decreased effectiveness of the barrier function, thus allowing more moisture to be released and lost instead of being kept within the skin. When this happens, the skin tends to become easily dehydrated, thin, and thus wrinkles easily. Such dehydration brings about irritation of the skin causing dryness and itchiness from the hostile environment.
The aging process that bring about dermal layer changes is of profound effect and significant. The dermal layer becomes thinner and thinner; lesser amount of collagen fibres are produced; elastin fibres that give the skin elasticity is also decreasing and wearing out. Such changes in the scaffolding of the skin eventually cause the skin to collapse due to the void of structure, thus producing wrinkles and eventually cause the sagging of the face. The sebaceous glands get bigger but produce significantly less sebum, and the number of sweat glands decreases too. Both of these changes lead to skin dryness.
The analogy of rete-ridges of the dermal-epidermal junction is like the interlocking fingers of two hands locked together. With the aging process these finger-like structure get shortened, and eventually smoothed and flattened out. When this happen, the upper and lower layers of the skin which is like glue that stick them together becomes weak, fragile and making it easier for the two layers to slide, like to shear injury, resulting with bruises easily, as seen in all elderly skin. The bruises are caused by the broken vessels that traverse the two layers. The shearing injury decreases the amount of nutrients supply to the epidermis by decreasing the surface area in contact with the dermis, also interfering with the skin's normal repair process. All combined; that is broken vessels, decreased nutrient supply, compromised repair process, finally cause epidermis to age. The vicious circles worsen and speed up the aging of the skin, thereby causing pigmentation, wrinkles, thinning of skin, lose of elasticity.
In the subcutaneous layer, the fat cells get smaller with age. Decreased food intake, and energy reserve, the fat cell (Called adipose cell), start to shrink. This eventually cause more and more noticeable wrinkles, and finally sagging occurs, as the fat cells can no longer "fill in" to replace the void left behind from shrinking fat cell, as well as from the damage from the other layers as mentioned above.
Your commitment early in life to Look Young, Feel Young, and Stay Young will help a long way.CHAPTER 2
How the Inside of the Wrinkles Look Like
Understanding the types of wrinkles and how they develop could come a long way in helping patients in taking the necessary preventive measure. Similarly, knowing the factors that cause premature aging and the daily expression that potentially etch the permanent lines on our faces also helps in preserving the youthfulness of the skin prior to turning towards cosmetic measure. But first, let's take a look at what is defined as a wrinkle.
What exactly are wrinkles?
1. It is a small furrow, ridge, or crease present on a normally smooth skin surface, caused by crumpling, folding, or shrinking of the skin structure.
2. A line or crease in the skin, formed from aging.
Collagen fibres are tough filament structures that support and give skin its 3 dimensional shape. Elastin fibres are tiny long filament structures that support skin, keep it elastic, moist and hydrated.
How the insides of Wrinkles look like?
These deep furrows can show permanently or come about when facial muscles contract. The former is called static wrinkle, and as the name suggests, even at rest when the muscle is not contracting the wrinkle still persists. This is found in older subject where the skin has lost substantial amount of supporting structures, such as collagen, and elastin fibres.
In the later case, where the wrinkle is only formed during muscular contraction and disappears completely once the muscle relaxes, is called dynamic wrinkle. As compared to static wrinkle, dynamic wrinkle is less bothersome.
The Midface Facial muscle Anatomy: The muscles of the mid and lower face
By understanding the anatomy of a wrinkle, you will be better able to treat it.
Understanding of the Facial Muscle Anatomy
Face muscles are complex and a thorough understanding of contracting and relaxing muscles that cause wrinkles is essential for treatment.
Wrinkles are often referred to as signs of vast wisdom and life experience, which may sound highly respectable. However, most people would rather do without it. In time, the skin all over the body ages but is it most prominent in sun exposed areas like the face, neck, forearms, and back of the hands. Sun damage or photoaging causes skin dryness, roughness, sagginess, wrinkles, and skin growths commonly known as liver spots. Other factors that promote wrinkling include smoking, heredity, low oestrogen hormone levels in a post menopausal lady, and skin type. Ultraviolet (UV) rays from the sun injure the epidermis and dermis, weakening their supporting structures-the epidermis, dermis, and subcutaneous tissue, which subsequently weaken the connective tissue.
Two types of wrinkles based on depth.
1. Fine lines.
They differ in structure and origin, and respond to different types of therapy. Fine lines or wrinkles come about because of the breakdown of specifically 2 types of fibres of collagen and elastin in the dermis layer, which is due to aging as well as the sun damage.
Such fine lines response to hydrating local cream application, and also Botox.
2. Deep furrows.
These are caused by extreme lost of cutaneous as well as sub-cutaneous tissues volume, for example such as supporting fat over a period of time, as a result of repeated facial expressions.
The analogy is like the same way when you flex you forearm that causes the sleeve to wrinkling. In such an event, the overlying dermis comes to direct contact with the underlying muscles. When the muscles start to contract, it pulls and moves the overlying skin thus folding it, causing deep furrow.
These deep furrows can show permanently or only form when facial expressions are made such as the appearance of "crow's feet" when a person smiles and squints the eyes. Initially there are dynamic lines which are present only during muscle contraction. Over prolonged period of aging, they eventually become fixed static line, which by now becomes more difficult to treat.
These categories of wrinkles respond to different types of therapies. The dynamic line wrinkles response the best to Botox treatment, whereas the Static lines response the best to filler agent treatment.
Preventative and restorative measures should be taken early in life to prevent wrinkles. The earlier you start the easier to treat. Among the preventative measures are avoiding excessive sun exposure and smoking as these situations create a lot of highly reactive molecules called free radicals that wonder around in the cells causing damage to skin cells nucleus. Sun protection is a must in every skin care regimen, especially use the sunscreen with a minimum sun protection factor (SPF) of 30.
The use of collagen boosting products and supplements are both restorative and preventative.
Smokers usually develop lines around their lips caused by repeated puckering while inhaling during smoking. Like sun exposure, smoking breaks down collagen and elastin, accelerating the rate at which, the skin sags and wrinkles.
With the aging process, the epidermis thickens due to clumping of external layers of dead cells and becomes drier, leading to the effect of rough, dull, and lifeless appearance. The breakdown of collagen and elastin fibres in the dermis causes the skin to wrinkle and eventually sag. This also leads to an increase in its fragility.
In addition, the collagen producing fibroblasts are less active by now. The sun damage may stimulate an increased production of capillaries, which show up as spider veins or spider naevi.
Your commitment early in life to Look Young, Feel Young, and Stay Young will help a long way. You spend less if implementing maintenance early in life, like the way you look after your car engine by regularly changing the engine oil every 5000 kilometres.CHAPTER 3
Different Types of Wrinkles
There are several types of wrinkles that occur on our skin. This chapter will explain on each type of wrinkle, areas of occurrence, what can be done to prevent its appearance and the cosmetic procedure commonly done to eliminate them.
Various types of Wrinkles
Although aging is inevitable, you can actually take measures to help slow down the speed of aging, and possibly turn back the clock. The effect of these treatments is visually visible on the surface of the skin with the improvement of wrinkles. Listed below are various types of wrinkles and how we may be able to greatly put a brake on the aging seen externally.
The University Hospital of Liege researcher has come up with the classification which was published in the Journal of Cosmetic Science, an international edition, during 2006. It has divided them into 4 different types:
1. Atrophic Crinkling Rhytids – this is the very initial first type of wrinkle that develop, we simply called them Fine Line. Translated literally, it means regressing skin quality due to photo aging fine line. They appear only on exposed body parts to the damaging ultraviolet ray. It appears from around age 30, much earlier if you are serious sunbather. These lines are always arranged parallel and very close to each other.
Where they occur: They normally show up on the face, various parts of the face as it is the most exposed body part. For the sunbather, it also appear on the entire body. Such line will normally disappear the moment the skin is stretched, and it tends to move around due to the movement of the body, and changing posture.
The cause of this category of wrinkle is due to lost skin elasticity. Elastin and collagen fibres that give it the elasticity is decreasing in number and volume.
Excerpted from Look Young, Feel Young, and Stay Young by David Ling, Grace Low. Copyright © 2014 Dr David Ling & Dr Grace Low. Excerpted by permission of PartridgeSG.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
About the Author, xi,
Chapter 1: How the Skin Look Like to Me, 1,
Chapter 2: How the Inside of the Wrinkles Look Like, 8,
Chapter 3: Different Types of Wrinkles, 15,
Chapter 4: Causes of Wrinkles, 18,
Chapter 5: Different Ways I can Reduce My Wrinkles, 26,
Chapter 6: Anti Aging Cream to My Rescue, 38,
Chapter 7: Exercise to Reduce Wrinkles, 41,
Chapter 8: Diet and Wrinkles, 44,
Chapter 9: Fruit Acid Peeling to My Brand New Skin, 49,
Chapter 10: Tender Polishing for Snow White Skin, 57,
Chapter 11: The Design of An Aesthetic Clinic, 61,