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Skin aging is becoming a serious issue in this current society of strict beauty standards . It is stated that by 2010, the anti aging market was expected to account for $16.5 billion in sales(Choi and Berson, 2006). Sun-exposed areas of the skin, such as the face, neck, chest and hands are the places most prone to skin aging. The clinical signs of photoaging include dryness, irregular pigmentation, sallowness ,deep furrows or severe premalignant lesions and a leathery appearance (Yaar, Eller, & Gilchrest, 2002) while on the other hand chronological skin aging is distinguished by laxity, fine wrinkling and the development of benign growths (Yaar et al.2002). The process of skin aging occurs when UV irradiation leads to generation of ROS which causes increased MMP production responsible for breaking down collagen. Each UV insult induces a wound response with subsequent imperfect repair, leaving an invisible “solar scar.” Repetitive visible “solar scar,” will the form visible wrinkles (Kang, Fisher, & Voorhees, 2001)
This journal is targeted towards nurses and healthcare professionals who wish to educate patients about dermatological aging and photoaging. This journal stresses on the clinical signs of chronological skin aging and photoaging, the fundamental mechanisms of this process and the multiple treatment options available. The majority of this article highlighted the treatment methods for aging skin and divided them into two groups; preventive measures and medications to undo the damage. The treatment options for aging skin addressed were photoprotection, topical retinoids , cosmeceuticals, botulinum toxin and laser procedure.
(Helfrich, Sachs & Voorhess,2008) mentioned that topical retinoids showed anti-aging properties. They stated that topical retinoids are derived from vitamin A which includes retinoin,adapalene,tazarotene and retinol. This statement is justifiable and found to be valid. In line with what research (LENGHTEN)has shown that topical retinoids shows remarkable anti-aging effects through three major types of skin cells: epidermal keratinocytes, dermal endothelial cells and fibroblasts, (Quan T, 2013). Furthermore. Topical retinoids significantly increased epidermal thickness by stimulating keratinocytes proliferation and upregulation of c-Jun transcription factor. In addition to epidermal changes, topical retinoids significantly improved dermal extracellular matrix (ECM) microenvironment; increasing dermal vascularity by stimulating endothelial cells proliferation (Quan T, 2013). Tretinoin was the first retinoid which has been used in the treatment for aged-skin,(Sorg, Kuenzli, Kaya & Saurat,2005). By using tretinoin to treat aged-skin,there were some improvements on surface roughness, fine wrinkles and dyspigmentation,(Weiss et al., 1988, as cited in Helfrich et al.,2008). However, retinoid dermatitis could be developed in the first month of tretinoin therapy (Sorg et al., 2005). Sorg et al.,( 2005) states that retinoid dermatitis can result in erythema, scaling, pruritus, burning, stinging, and dryness.Thus, different concentration of topical tretinoin (0.1%,0.05%,0.02,0.025%) are being used as some of the patients are sensitive to the effect of tretinoin, lower strength of tretinoin is more recommended to them, (helfrich et al.,2008). Hubbard et al.,2014 mentioned that continuous use of tretinoin is needed to prolong and keep up the result and benefits of it.
According to ( Gilchrest,1996 as cited in Helfrich, Sachs & Voorhess,2008), photoprotection is an umbrella term used to categorise protective measures from UV including sunscreen, sun protective clothing and sun avoidance.(ADD YOUR OWN OPINION,STAND OR OPPOSE)Jallad KN ( 2017 ) mentioned that sunscreen against the skin by minimizing the damaging effects of harmful UV radiation from the sun. He stated that sunscreen ingredients are broadly classified into two types, which are chemical and inorganic substances. However, there are certain ingredients in the sunscreen that cause hormonal changes in the body. According to Heurung AR, Raju SI, Warshaw EM (2014), sunscreen contains an organic filter called the oxybenzone, it is one such ingredient which affects the estrogenic levels in the body, and it has the highest rate of photoallergic among other UV filters. Continuous use of the sunscreen will prevent the exposure of the skin to UVB radiations thus there would be insufficient vitamin D synthesis in our body. To increase the patient compliance, sunscreens have preservatives, fragrances which might induce allergic reactions in sensitive individuals
In conclusion, the journal was overall well stated as it emphasizes on the core treatment of aging skin by providing valid information but it lacks concrete supporting data to backup its facts. The journal can be further improved by providing more statistical data and supporting details. The author was also particularly biased as he was only stating the positive effects of each treatment without its drawbacks.
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