Research shows that there are 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, which is also known as the natural aging process, is a continuous process that normally begins in our 20s. Inside of the skin, collagen production slows and elastin, the substance that enables skin to snap back into place, has a bit less elasticity. Dead skin cells do not shed as quickly as they once did and regrowth of new skin cells start to decrease slightly. While these changes usually begin in our 20s, the signs of intrinsic aging are typically not visible for quite some time. The typical signs of intrinsic aging are the following:

• Thin/transparent skin
• Fine wrinkles
• Loss of underlying fat leading to hollow cheeks and eye sockets as well as sagging of the neck
• Bones shrink away from the skin due to bone loss, which causes sagging skin
• Dry skin that may itch
• Graying hair that eventually turns white
• Hair Loss

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

Just a few unprotected minutes of sun 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, 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. 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. Photoaging occurs over years. With repeated exposure to the sun the skin loses its 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 repeated unprotected exposure to the sun. Deep wrinkles, age spots, and leathery skin also indicate premature aging caused by years of unprotected exposure to the sun. People who live in sun-intense areas such as California, Florida or Arizona can show signs of photoaging as early as their 20s. In fact, some people who live in sun-intense areas develop actinic keratoses (AKs) and skin cancer in their 20s. While it may seem that the signs of photoaging appear overnight, they actually lie invisible beneath the surface of the skin for years. UV photography enables us to see the damage accumulating beneath the surface of the skin years before the signs of photoaging appear.

Gravity constantly pulls on our bodies. Changes related to gravity become more pronounced as we age. In our 50s, when the skin’s elasticity declines dramatically, the effects of gravity become evident. Gravity causes the tip of the nose to droop, the ears to elongate, the eyelids to fall, jowls to form, and the upper lip to disappear while the lower lip becomes more pronounced.

Sleeping Positions. Resting your face on the pillow in the same way every night for years can also leads to wrinkles. Called sleep lines, these wrinkles eventually become etched on the surface of the skin and no longer disappear when the head is not resting on the pillow. Women, who tend to sleep on their sides, are most likely to see these lines appear on their chin and cheeks. Men tend to notice these lines on the forehead since they usually sleep with the face pressed face down on the pillow.

Smoking. Cigarette smoking causes biochemical changes in our bodies that accelerate aging. Research shows that a person who smokes 10 or more cigarettes a day for a minimum of 10 years is statistically more likely to develop deeply wrinkled, leathery skin than a non-smoker. These signs can be greatly diminished, and in some cases avoided, by stopping smoking. Even people who have smoked for many years, or smoked heavily at a younger age, show less facial wrinkling and improved skin tone when they quit smoking.