What do sunburn, smoking and being overweight have in common? It may surprise you that each of them damages your skin and makes you look older. Researchers at Case Western Reserve University School of Medicine in Cleveland reached this conclusion after studying 65 pairs of identical twins at a twins festival. "The festival offers a rare opportunity to study a large number of twins, to control for genetic susceptibility," the authors wrote.
The twins, aged 18 to 77, answered questions about their weight, skin type, smoking and drinking habits, and any history of skin cancer. Each was given a photodamage score that rated features such as wrinkling and changes in pigmentation. The researchers found that skin damage was similar within each pair of twins, suggesting that "people with the same genetic make-up are more likely to have the same kind of sun damage", said Dr Keyvan Nouri, a dermatologist at the University of Miami Miller School of Medicine. In other words, "if your mother aged early, you will age like her".
Still, 40% of ageing and related skin changes come from non-genetic factors. The researchers noted that age, smoking and skin cancer were all linked with higher levels of photodamage. In fact the rate of skin cancer among the twins was higher than in the general population, which surprised Dr Jeffrey Salomon, a clinical assistant professor of plastic surgery at Yale School of Medicine who wasn't involved in the research. "An 8% rate of skin cancer in the twins seems high, compared with less than 0.5% in the general population," he said. "That alone deserves further study of other possible risk factors, such as X-rays and ultrasound scans before birth and low birth weight."
Smoking has long been known to cause wrinkles. Although smoking-related wrinkles may not show for ten years or more after the first puff, damage to the connective tissue that keeps skin smooth happens with every cigarette. "Cigarette smoke induces matrix metalloproteinases in the skin and blocks the production of procollagen by altering transforming growth factor beta," the researchers explained. Smoking combined with sun exposure is especially toxic.
Being overweight was also linked with photodamage, the researchers say, although a study of Danish twins concluded that a higher body mass index was linked with less facial ageing. Wrinkles from excess weight aren't obvious, even if the extra weight may make skin more sensitive to damage, because it often hides wrinkles in older people: "their skin won't look wrinkled because the fat on the face puffs it out".
Drinking alcohol, on the other hand, was linked with less photodamage. The researchers explained that this may be because some drinks, such as red wine, contain powerful antioxidant polyphenols such as resveratrol, which may help protect the skin.
The most common signs of skin damage are dryness, flaking, yellowish or leathery-looking skin, broken blood vessels, coarse or fine wrinkles and pigment problems. Sun spots, also called liver spots, are brown patches that appear on the body, often on the face, arms and hands. The researchers hope people will use the findings to change their behaviour and prevent extra skin damage from the environmental factors they can control.
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