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aging well is an inside-out job

making these four things a priority gives your skin its best chance at looking great as it ages.

by frances krawiec

may 2 2022

6 minute read

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inside out: is this the secret to aging well?

a healthy body is the first step to maintaining or regaining skin health. getty

‘inside out’ is a catchy phrase suggesting that what can be seen on the outside is a reflection on the health of the body inside. this is true for the most part. the skin is the largest organ of the human body and provides a protective barrier from harmful substances. but, like other organs, skin is equally impacted by extrinsic factors (uv radiation, smoking, pollution, diet, other lifestyle factors) and intrinsic factors (genetics, skin function, chronic conditions).

in fact, with the exception of the effects of solar damage, the skin cells can be used as a biological marker of age. repeated exposure to such triggers stimulate chronic inflammation, oxidative stress, immune dysregulation, and instability of cells which alter their ability to repair and replace — referred to as “skin inflammaging.” these time-dependent changes contribute to the deteriorating structure of the face such as skin fat loss, collagen fragmentation, alterations of texture of skin, and soft tissue repositioning which, in turn, lead to lines, changes in contour and “heaviness” of the lower face. skin inflammaging also predisposes us to skin diseases such as rosacea, melasma, and different types of skin cancers.

the health of a person is not always reflected in the skin. but the opposite can be true as well. the health and vitality of an individual is sometimes unfairly not reflected in the skin and in one’s appearance. lean body mass, exposure to sun with healthy outdoor activities coupled with aging over decades can leave the face looking gaunt and aged. of course, this does not undermine the value of exercise and maintaining appropriate weight, but people intuitively recognize that skin aging signs are negatively perceived by others. in fact, “the desire to look as good as one feels,” is one the most expressed statements in cosmetic clinics. and while this is achievable, it’s important to consider the impact that the pillars of health — sleep, exercise, mental health and nutrition — have on skin. a healthy body is the first step to maintaining or regaining skin health.

sleep well, age well

the importance of sleep to aging well is often underrated, but a lack of it is associated with poorer health, poorer quality of life and cognitive decline, greater inflammation, aging decline, and a higher number chronic conditions. with each advancing decade of life, sleep patterns become more disorganized and decline, causing sleep deprivation, particularly in older adults. circadian rhythm (timing of sleep and wakefulness) is important to the wellbeing of our organs, including cell regeneration, function and repair. from a skin perspective, less than five hours of sleep is linked to skin water loss, decreased barrier function, increased inflammation of the skin, less skin turnover, a higher number wrinkles and worse elasticity. seven to eight hours of sleep, as recommended by the sleep foundation, is necessary to support healthy aging and brain function for older adults and only one hour less for ages 26 to 64 yrs of age.

even a little exercise reduces mortality

there is plenty of evidence now for the benefits integrating 150 minutes per week or 30 minutes per day five times per week of exercise into lifestyle. exercise improves blood flow, which is important for carrying nutrients to all organs including the skin. it also improves oxygen capacity, forces muscles and blood vessels to grow and generally makes us functionally stronger. exercise has found to be beneficial for increasing lifespan, as well as reducing hormone levels associated with inflammation and dna damage, while promoting cellular defences and longevity of cells. to put it simply, routine exercise has the capacity to prevent the onset of approximately 40 diseases including the onset of diabetes, coronary artery disease, and even cancer.

it’s important to note that the intensity of exercise plays a role in disease prevention and longevity genes. exercise that significantly raises heart and respiratory rates, like high intensity interval training or endurance training, turns on a number of positive cellular mechanisms that are important to biological youth which is not necessarily achieved to same degree with less intense exercise such as a leisurely walk. but even with walking, approximately 15 minutes or more has been associated with a reduction in mortality by as much as 30 per cent.

more exercise, better mental health

mental health is complex, but it is intertwined with feelings of self, the ability to present oneself, the perception of the ability to control one’s environment, as well as the ability to engage in healthy lifestyle behaviours. there is a large body of evidence that suggests one healthy behaviour promotes the likelihood of engaging in other healthy behaviours, which in turn has a synergistic positive impact on overall health.

as exercise improves physical health, it also plays a role in mental health. for example, science has illustrated the benefit of physical activity to the improvement in cognitive function and long lasting reduction in the incidence of depression. exercise is also associated with improved sleep, better mood, and may increase the chance of forming regular exercise habits. physical activity has also been shown to have a direct impact on mood by increasing endorphin and serotonin activity in the brain. certainly, exercise can be a positive coping strategy for mental health, improving quality of life (qol) and connecting the pillars of health.

what goes in, shows on the skin

there is also plenty of research linking unfavourable foods or food groups to the early onset of diseases, while healthy nutrition delays chronic conditions such as diabetes, cancer, immune conditions, coronary artery disease through healthy nutrition. good nutrition has also been shown to reduce skin aging, and even prevent skin diseases such as acne, dermatitis, rosacea, psoriasis, and eczema. while smoking and uv exposure remain important risk factors to aging of the skin, micronutrients and vitamins is essential for good wound healing, strengthening the structures of the skin, collagen development, hydration and response to oxidative stress causing cellular death.

scientists and nutritionists now also understand that certain foods can be protective to the skin as well, and even improve outcome of cosmetic treatments. generally, these diets are low in simple carbohydrates, sugar and saturated fats and high in fruits and vegetables. fruits and vegetables tend to be full of polyphenols and flavonoids which are protective to organs, providing anti-inflammatory antioxidant benefit to cells that promote regulation and function. diets with high sugar levels, however, promote “glycation” — a major risk factor for skin aging, behind inflammation, dna damage and damage from related hyperglycemia diseases such as obesity and diabetes.

regardless of biological age or skin diseases, the appearance of the facial skin is often linked to perception of health, one’s competence, feelings of depression and happiness, as well as the ability communicate emotion through facial expression. in addition to maintaining the pillars of health — sleep, exercise, mental health and nutrition — cosmetic treatments can help re-establish skin health and achieving harmony between the feeling of vitality — or beauty — and one’s appearance, creating an inside that’s harmonious with the outside. much can be accomplished with medical aesthetic treatments that repair and improve skin quality, texture, hydration and barrier function; botox relaxes muscles which addresses lines; and finally, fillers support the structure and contour of the face while hydrating and repairing texture. it’s also good to know that aesthetics has moved well beyond the face and neck for sometime now to address all body aesthetic issues, including body skin laxity, muscle stimulation and development, and fat contouring.

frances krawiec is a nurse practitioner at preventous cosmetic medicine.

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aging well is an inside-out job

making these four things a priority gives your skin its best chance at looking great as it ages.

we can't prevent aging, but we do have the power to stay healthy for longer

asking for a friend: how toxic are my skin care products?

sleep well, age well

even a little exercise reduces mortality

more exercise, better mental health

what goes in, shows on the skin

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aging well is an inside-out job

making these four things a priority gives your skin its best chance at looking great as it ages.

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