INTRODUCTION
Skin aging is a natural process that occurs due to oxidative stress and cumulative DNA damage in cells that leads to unwanted changes in the skin, such as atrophy, laxity, wrinkling, dryness, abnormal pigmentation, and overall reduced brightness.1 Changes to aging skin occur as a result of a combination of exogenous and endogenous factors. Endogenous factors include genetic background, decreased estrogen, androgen, and growth hormones, decreased collagen production, and breakdown of the elastin network, whereas exogenous factors include sun exposure, smoking, inflammation, psychological stress, diet, medications, air pollutants, and comorbid illness.1
Combatting Skin Aging
Molecular Mechanisms of Skin Aging
While fundamental mechanisms of aging are poorly understood, inflammation and oxidative stress processes are known to play a significant role in the skin aging process. Intrinsic, chronological aging is generally associated with thinning of the epidermis and dermis as well as loss of sensibility due to a reduction in sex hormones and a number of nerve endings. It is caused by the build-up of reactive oxygen species (ROS) that are produced through cellular oxidative metabolism. Solar radiation can accelerate the process by degrading skin matrix material, leading to wrinkles.2 Antioxidants such as ubiquinol, vitamin E, and vitamin C are present in the skin to bind and reduce ROS; however, the skin's natural antioxidant defense system also diminishes with age.3 For these reasons, skin rejuvenation is achieved using treatments that stimulate neocollagenesis, neoelastinogenesis, and replenish antioxidants, to achieve fuller and brighter skin.
Combatting Skin Aging
Cosmetic rejuvenation and enhancement in dermatology has seen a dramatic expansion in use and popularity in recent decades.4 Interestingly, all patient age groups demonstrate equal interest in nonsurgical facial rejuvenation procedures
