Ageing skin describes the changes in the appearance and characteristics of the skin that occur as people get older. Ageing changes are particularly pronounced on the face and hands.

Chrono-Aging:

Skin alterations accumulate over the course of a lifetime. Numerous phases of life leave their mark.

• Healed inflammation and scarring from adolescent acne
• Inflammatory processes that make the skin thin and delicate
• Severe sunburn or chronic sun damage
• Pigmentation caused by pregnancies
• Enlarged pores
• Slow-down of metabolism
• Stress robs the skin of energy
• Even laughter, stern glances and other facial mimic deeply affect the skin

All of these aspects leaves traces and changes the elasticity of the skin because scar tissue and healed wounds are not flexible..

Photo-aging and UV radiation:

Photoageing is due to damage caused by solar radiation. Cell damage occurs because of the formation of reactive oxygen species.

• High energy, short wavelength UVB damages DNA and other components of the epidermis.
• Longer-wavelength UVA is 100 times more prevalent than UVB at the earth's surface, but is of lower energy, so is less damaging to DNA. UVA penetrates more deeply into the dermis, damaging elastic tissue, collagen, blood vessels and immune cells.
• Infrared radiation penetrates to the deeper dermis and subcutaneous tissue, where it may also contribute to sun damage.

Common, visible signs of photoaging include dark spots, wrinkles, droopy skin, a yellowish tint, broken blood vessels and leathery skin.

Glogau classified the degree of sun damage by its clinical signs.

• Mild (age 28-35 years): few wrinkles, no keratoses
• Moderate (age 35-50 years): early wrinkling, sallow complexion with early actinic keratoses
• Advanced (age 50-60 years): persistent wrinkling, discolouration of the skin with telangiectases and actinic keratoses
• Severe (age 65-70 years): severe wrinkling, photoageing, gravitational and dynamic forces affecting skin, actinic keratosis, skin cancers

Pre-malignant Lesions & Malignancy:

The most common "precancerous" skin lesion is an "actinic keratosis", which is a sun-damaged area of skin that usually appears as a red and scaly patch of skin. Because it is caused by sunlight, the most common location for actinic keratoses is the face, ears, scalp, arms, upper back, and upper chest. These lesions are labeled as being "precancerous" because without treatment, a small percentage of these lesions develop into squamous cell carcinoma.

The other commonly treated precancerous lesion is the "dysplastic nevus", also known as an atypical mole. These lesions are usually brown or black moles which are biopsied due to having suspicious features of melanoma, such as irregular borders or asymmetry or having multiple colors.

Hyper Pigmentation & Skin Discoloration - How it happened?

Hyper-pigmentation or skin discoloration, is the result of a black-brown pigment (called melanin) in the cells in the upper-most layer of the skin. Melanin is produced by melanocytes, which are specialized cells within the epidermis (top layer of skin).

The creation of melanin (and skin discoloration) is the result of a three-phase process:

- Activation of the Melanocytes



- Synthesis of melanin within the melanocyte



- Expression of melanin on the surface of the skin

Other Factors:

The following conditions promotes extra melanin production can result in skin discolorations.

• UV Light
  
• Pregnancy
  
• Stress
  
• Pollution
  

Skin discolorations cause a loss of skin brilliance and luminosity. Skin appears uneven and dull.