Holistic approach can address signs of aging face

Istanbul - A multitude of topical and oral therapies can be skillfully used to help patients achieve their anti-aging goals, according to a clinician who spoke at the European Academy of Dermatology and Venereology Annual Congress.

“We often will combine systemic and topical treatments in our cosmetic patients in order to achieve not just a youthful looking face, but a healthy-looking one as well,” says Demetrios Ioannides, M.D., Ph.D., professor of dermatology, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece. “However, as all patients differ in their needs in this regard. The appropriate treatment regimen for each patient can differ, and the therapeutic approach chosen depends on varying factors including the age of the patient, skin type, general health status, previous cosmetic procedures performed, as well as the individual patient’s goals and expectations.”

Dermatologists will often take a holistic approach when addressing skin rejuvenation in their patients, Dr. Ioannides says. A holistic approach aims to reduce, postpone and even repair the effects of endogenous as well as exogenous aging.

Variety of strategies

According to Dr. Ioannides, a complete anti-aging treatment can consist of many strategies or combinations of them, such as avoiding exogenous factors of aging, changing one’s lifestyle and habits (i.e. smoking, UV radiation, nutrition, physical activity, stress), and using topical cosmeceutical agents and/or oral nutraceuticals. There is also an array of cosmetic procedures such as chemical peels, injectable skin biostimulation and rejuvenation techniques, and a multitude of evolving laser and light therapies, to name a few.

Systemic anti-aging agents such as the nutraceuticals are formulated from a multitude of different ingredients, Dr. Ioannides says, which target all levels of intrinsic and extrinsic aging processes and enhance the beauty and health of the skin. Melatonin is one popular oral nutraceutical that is commonly used. Although it has been shown to have a favorable influence on the aging process, Dr. Ioannides says definitive data is still lacking and there is no substantial evidence in the literature to support the anti-aging action of the supplement.

Among the ingredients used in nutraceuticals, Dr. Ioannides says the antioxidants represent the most crucial of them all, and include vitamins C, E, A, D and E, carotenoids, copper and selenium, as well as flavonoids and polyphenols.

“Systemic antioxidants not only have anti-aging properties but also a probable role in the prevention of various diseases associated with oxidative stress such as cancer, cardiovascular and neurodegenerative diseases,” he says.

In his middle-aged cosmetic patients, Dr. Ioannides says he will often recommend resveratrol - a natural antioxidant found in the skin of grapes and other fruits - as well as sylimarin, as these systemic antioxidants have a significant anti-aging action and antioxidant effect on the liver and other organs. To this, he may suggest a daily regimen of vitamins E and C, which both can be taken from a daily healthy diet with fruits and vegetables.

Care with cosmeceuticals

The topical creams and lotions known as cosmeceuticals contain biologically active ingredients that can improve the appearance of the skin, Dr. Ioannides says, without altering its structure and function.

“These topical agents hold a significant and distinct role in the anti-aging skincare regimen, as they not only support and maintain the outcomes of cosmetic surgery and other more invasive cosmetic procedures, but also improve skin texture and dyspigmentations that often can not be ideally addressed with other treatment modalities,” he says. “Moreover, topical approaches are ideal for those patients who do not want or are contraindicated for more invasive skin rejuvenation approaches.”

Although many topical cosmeceuticals are readily used - including broad-spectrum sunscreens, various moisturizers, exfoliating agents (i.e. salicylic acid, alpha-hydroxy acids) and depigmenting agents (i.e. hydroquinone, retinol, ascorbic acid, kozic acid, lactic acid, and azelaic acid) - Dr. Ioannides says the antioxidants remain as some of the most important of these agents in skin rejuvenation treatments.

“Topical antioxidants not only reduce the free radical damage that is implicated on both the intrinsic and extrinsic aging processes, but also inhibit inflammation which leads to collagen depletion, as well as provide protection against photo-aging and skin cancer,” he says.

Additional topical options

In his patients, Dr. Ioannides will often recommend various topical products containing different antioxidants such as vitamins C, E and B3, the polyphenols and flavonoids (i.e. green tea extract, lycopene, ferulic acid, resveratrol, sylimarin, glutathione and caffeine), as well as co-enzyme Q10 and alpha-lipoic acid.

“Aside from recommending topical products containing resveratrol and sylimarin, I frequently will also recommend those with co-enzyme Q10 and alpha-lipoic acid,” he says. “There are excellent products on the market with these two antioxidants, which are very cosmetically acceptable, and there is also evidence in the literature that supports their ability to protect the skin from oxidative stress. Science-based data is very important and I believe that our decisions on therapy should be supported by such evidence.”

For ideal skin rejuvenation outcomes in the long term, Dr. Ioannides says cosmetic patients should take daily anti-aging regimens for months or years - if not indefinitely - as the aging process is ongoing. Sun protection and appropriate lifestyle and habits are conducive to keeping the skin looking young, he says, and should be practiced accordingly from an early age.

“Prophylaxis is absolutely key in helping us look and feel younger and healthy. Many of these topical and oral anti-aging products work very well and we should trust them because they can produce a visible effect when used regularly,” he says. “In addition, however, it is also very useful to combine these with a healthy diet consisting of abundant fruits and vegetables, an invaluable source for numerous anti-aging agents.”

Disclosures: Dr. Ioannides reports no relevant financial interests.