What is skin aging?

Skin aging is a natural biological process that occurs in many people. For some, aging of the skin becomes an issue, as it might affect their overall well-being and perception of their health. Our skin begins to age as we get older, and it may occur due to several different factors, such as medical conditions, stress, environmental conditions, etc.

There are 2 types of aging, intrinsic and extrinsic.

  1. Intrinsic aging: this type of aging occurs over years, and is not affected by external factors. This is considered as the natural aging process and involves fibers such as collagen and elastin. As we age, our skin loses about 1% of collagen fibers each year. Collagen and elastin become thicker and looser, which results in the skin becoming brittle and losing its elasticity. By around the age of 40, collagen is no longer produced, which further increases the brittleness of the skin, resulting in wrinkles and aging lines.
  2. Extrinsic aging: this type of aging occurs due to environmental or external factors. Due to these factors, the skin can become thicker, develop freckles and sunspots, and overall lose collagen and elastin at faster rates. These factors induce free radicals, which are molecules that have damaging effects to the skin.

Common signs of skin aging:

Typical signs of aging include:

  1. Wrinkles
  2. Fine aging lines
  3. Sagging of the skin
  4. Skin color changes
  5. Freckles

Anti-aging treatments:

Besides keeping the skin hydrated, there are several medications that can provide anti-aging effects.

  1. Retinoids: Retinoids are vitamin A derivatives. These medications have antioxidant effects, and can induce the creation of collagen. Retinoids also decrease the breakdown of collagen. The most commonly used retinoid is Tretinoin, which has been shown to reduce early skin aging due to UV exposure.
    1. Common concentrations: Tretinoin 0.05%
    2. Side effects: stinging, irritation
  2. Vitamin C: Vitamin C, or L-ascorbic acid, is a potent antioxidant, which means that it provides protection against damaging free radicals. It has been shown to have anti-aging effects as it increases the production of collagen and inhibits its breakdown as well.
    1. Common concentrations: 5% to 15%
    2. Side effects: irritation
  3. Hydroxy acids: Alpha hydroxy acids, such as glycolic, citric, and lactic acid, are important acids for the skin. They are used as exfoliators, as they work to remove dead skin cells from the top layer of the skin. By doing so, the skin looks younger and smoother.
    1. Side effects: irritation, skin peeling
  4. Hyaluronic acid: Hyaluronic acid is commonly found in the skin and plays a role in tissue repair. For anti-aging, this acid provides hydration to the skin and also helps increase cell growth.
    1. Side effects: irritation
  5. Niacinamide: Niacinamide is a derivative of vitamin B3, and is a potent antioxidant. It helps reduce the effects of free radicals and water loss from the skin. By doing so, elasticity of the skin may also improve. Niacinamide is also found to regulate cell regrowth, which allows for newer skin to form.
    1. Common formulations: 5%
    2. Side effects: irritation, redness
  6. Vitamin E: Vitamin E is a potent antioxidant and anti-inflammatory agent. It works by smoothing the skin and maintaining the moisture in the skin. Vitamin E also provides sun protection for the skin. Effects are increased in combination with Vitamin C.
    1. Common formulations: 2% to 20%
    2. Side effects: irritation, redness

Lifestyle changes:

Lifestyle changes play an important role in maintaining the skin. Such changes include:

  1. Protect the skin from the sun: It is important to always protect the skin with sun protective clothing and broad spectrum SPF 30 sunscreen.
  2. Stop smoking: Smoking can cause drastic changes to the skin, such as wrinkles and a dull complexion.
  3. Eat a healthy, well balanced diet: The diet should include fresh fruit and vegetables, which are high in antioxidants and vitamins. A high carbohydrate diet can quicken aging.
  4. Drink less alcohol: Alcohol can dehydrate the skin, which can further damage the skin.
  5. Apply a facial moisturizer on a daily basis: Moisturizers provide hydration to the skin, which gives a more younger appearance.


  1. Ganceviciene R, Liakou AI, Theodoridis A, et al. Skin anti-aging strategies. Dermatoendocrinol. 2012; 4(3): 308-319. doi: 10.4161/derm.22804
  2. Wrinkle creams: your guide to younger looking skin. Updated November 20, 2019. Accessed March 29, 2021.
  3. 11 ways to reduce premature skin aging. Updated February 24, 2021. Accessed March 29, 2021.