How to manage aging skin
Dr Gurinderjit Singh

Before treatment After treatment

The desire to look young and in turn vital has been a lure to man since ancient times, though aging as a rule remains a fact of life. Aging is of two types, intrinsic and extrinsic. Intrinsic aging is the slow irreversible degeneration of the tissue that affects all body organs and is inevitable. Skin that ages intrinsically is smooth and unblemished, but is characterised by the loss of the underlying fat leading to hollowed cheeks and eye sockets, with the noticeable loss of firmness on the hands and the neck.

Extrinsic aging to varying degrees is controllable and is determined by exposure to sunlight, pollution or nicotine, repetitive muscle movement like squinting or frowning, and miscellaneous life-style components such as diet, the sleeping position and overall health.

Prevention of aging

Photoprotection: It refers to measures that can be taken to protect the skin from ultraviolet (UV) damage and is achieved by sunscreens, sun-protective clothing and sun avoidance. Patients should be educated to avoid midday sun exposure when UV radiation is most intense, to participate in outdoor activities early or late in the day, to avoid sunbathing (even with sunscreens) and to seek shady, covered areas rather than direct sunlight.

Caloric restriction

Caloric restriction — under-nutrition without malnutrition — is known to extend one’s lifespan and slow aging.

Anti-aging supplements

Vitamin A, C, beta-carotene, selenium, estrogen, testosterone, silymarin, pyenogenol and procyanidins are the major players in anti-aging therapies. Antioxidants, all of which display various distinguishing characteristics and activities, are believed to be an important focus in the prevention of aging, as these free radical scavengers protect the skin via several mechanisms.

Treatment of aging

In today’s society the desire to maintain a youthful appearance has driven the development of minimally invasive dermatological procedures that are designed to rejuvenate the aging face. Traditionally, facial rejuvenation incorporates both medical and surgical approaches. The medical approach includes the combined use of topical and systemic pharmaceuticals and cosmeceuticals, whereas surgical methods include non-ablative rejuvenating devices, chemical peels, dermal fillers and injectable collagen stimulation as well as botulinum toxin, which work by altering the three-dimensional framework of the aging face to create a youthful appearance.

Botulinum toxin

The cosmetic application of botulinum toxin (BTX) has revolutionised the medical aesthetic arena, bringing the minimally invasive procedures to the fore. Initially used to relax dynamic lines and wrinkles, subsequent facial contouring techniques continue to develop demonstrating BTX’s versatility in cosmetic application: these include enhancement of the feminine eyebrow arch, lifting of the down-turned corners of the mouth or drooping nasal tip, smoothening of a puckered, “pebbly” chin and reduction in gingival exposure in those with a “gummy smile”.

Intra-dermal fillers

Although BTX is very effective in addressing dynamic lines and undesirable effects of hyperkinetic muscle contraction, it cannot restore the fullness, particularly of the lower face, that is lost with age. Filler substances can restore facial fullness and smoothness and can be used in combination with BTX to provide longer lasting results. Fillers also have a role in the treatment of acne scarring and facial lipoatrophy. Treatment with hyluronic acid (HA) fillers was the second most popular cosmetic procedure performed in the US last year next only to BTX.

Chemical peels

They are used to rejuvenate photoaged skin. The depth of the peel required depends upon the location of the disease process: superficial peels can improve the appearance of the skin, medium-depth peels can treat superficial wrinkles and pigmentary changes, while deep peels can treat deep wrinkles but take a long time to heal. Other options such as topical tretinoin non-ablative and ablative laser techniques and microdermabrasion can also be considered as adjunctive or alternative methods to do photo-rejuvenation. Prevention of further damage using broad-spectrum photoprotection and sun-smart behaviour must be emphasised.

The field of cosmetic dermatology continues to expand worldwide. Good understanding of the complexities of facial aging is the key to balanced rejuvenation and a natural appearance. However, realistic patient expectations are of paramount importance.

The writer is Chief Dermatologist, Mohan Dai Oswal Cancer Treatment & Research Foundation, Ludhiana. Email: gursheen@satyam.net.in

Ayurveda & You
Healthy gut can help lead disease-free life
Dr R. Vatsyayan

The scientific term for the entire “tube” running from mouth to the anus is the alimentary canal. Gut is a conversational term used for the stomach, intestines and the related structures. It is generally seen that a healthy gut works silently whereas one of the first signs of ill health is a gut that makes its presence felt. In other words, gut feelings are a reliable indicator of many diseases.

Every morsel of food we ingest makes a journey passing through esophagus, stomach, duodenum and small and large intestines. According to ayurvedic beliefs, mouth and stomach are dominated by “kapha” whereas the duodenum and the intestines till the rectum are respectively controlled by “pitta” and “vata”. The food in its passage from mouth through the gut is mechanically crushed, chemically simplified (digested) and then transferred across the intestinal wall into the blood (absorbed).

This whole process may look simple but, to the contrary, it is one of the most complex operations of the human body. Digestion requires various enzymes and secretions emanating from the stomach, liver and pancreas and its main process along with absorption is completed in the small intestine. Undigested and undigestible food is delivered to the large intestine where bacterial metabolism, gases and water in the residue matter play an important role. The digestion and absorption are highly coordinated activities, which are additionally controlled by the nervous and endocrine systems.

If we eat the right amount and right type of food and that too at right time and in a right way, the gut works properly. The efficient functioning of the gut nourishes the body. That is why the health of the gut is indicative of the general health of an individual. Centuries ago Acharya Charak gave us the dictum that in the pathogenesis of any disease a bad gut must have played its role. Just as the gut reflects the health of the whole body, the well-being of our digestive system depends on our lifestyle as a whole.

Realising the true purpose of food, we should select what is good for the body and eat just the right amount - neither too much nor too little. The largest meal, though not exceeding the required quantity, should be lunch. Breakfast and dinner can be light, and eating between the meals should be limited to some fruit and light snacks or a healthy drink. Intake of too much tea and coffee disturbs the gut and is a major reason for acidity, gas formation and dyspepsia.

Like the good assimilation of food, proper evacuation is also equally important to our general health. Apart from a diet that is balanced in nature and mostly fibrous, the clearance of bowels further depends on other lifestyle factors such as regular physical activity, adequate sleep and mental peace. Frequent use of laxatives spoils the condition of the gut.

Ayurveda says that good health depends on a good functioning gut.

The writer is a senior ayurvedic physician based in Ludhiana. Email:yourhealth@rediffmail.com

Health Notes
Abdominal CT scans may help reveal heart disease risk

Washington: A new study claims that the presence of plaque on an abdominal CT scan is a strong predictor of coronary artery disease and mortality.

Researchers at Henry Ford Hospital observed 367 patients who underwent an abdominal CT and cardiac catheterisation between January 2004 and May 2009.

They found that patients had a 58 per cent risk of having coronary artery disease with an AAC (abdominal aortic calcium, commonly known as plaque) score over 1,000 compared to patients who had an 11 per cent risk with an AAC score of zero. — ANI

CT scan overuse linked to cancer

Sydney: Health experts have warned that unjustified use of CT scans is increasingly becoming a reason behind cancers. Medical research has claimed that more than 400 new cases of cancer a year in Australia occur due to diagnostic radiology.

However, it has not reduced the number of computerised tomography scans growing about 12 per cent a year. Now, Director of the Professional Services Review, Tony Webber, has published a recommendation for doctors to stop using CTs as a first-choice diagnostic tool for problems such as lower-back pain. — ANI

Potential therapeutic target for breast cancer identified

London: Scientists have identified a potential target for the treatment of breast cancer. They have discovered a protein which could stop cancer tumours from growing and spreading.

Professor Reuven Agami of the Netherlands Cancer Institute in Amsterdam found that the protein, known as BRD7, activates an anti-cancer gene, P53, which is already known to combat breast and other tumours. — ANI