Tuesday, September 3, 2019

Anatomy of the Skin - The Basis for Understanding Aging Lines andWrinkles

The epidermis is the superficial layer of the skin and provides the first barrier or protection against invasion of foreign substances into the body. The basic cells of the epidermis are called keratinocytes. The epidermis is divided into five layers or strata, stratumivivum (SG), stratum spinosum (SS), stratum granulosum (SGR), stratum lucidum (not seen in this photomicrograph) and stratum corneum (SC) keratinocye gradually migrate to the surface and release in a process called desquamation.
The condition of the epidermis determines how "fresh" your skin looks and also how your skin absorbs and holds moisture. Clots, pores, uniforms, porphyrins, and UV spots are all evident in our epidermis.
Wrinkles, however, are formed by changes in the dermis.
The dermis assumes an important function of thermoregulation and supports the vascular network to supply the avascular epidermis with nutrients. The dermis is usually divided into two zones, the papillary layer and the reticular layer. The dermis contains mostly fibroblasts that are responsible for the healing of collagen, elastin and soil substances that provide support and elasticity of the skin. Also present are immune cells involved in defense against foreign invaders through the epidermis.
Dermis papillaria (PD) is a vascular network that has two important functions. The first is to support the avascular epidermis with essential nutrients and the second to provide a network for thermoregulation. The vasculature is organized so that by increasing or decreasing blood flow, heat can be restored or lost. Vaskulature interdigitates in an area called the dermal papillae (DP). The dermis papillaria also contains free sensory nerve endings and a structure called meissner's corpuscles in highly sensitive areas.
The reticular dermis (RD) layer is composed of dense irregular connective tissue, which is different from the papillary layer, consisting of the loosest connective tissue (note the difference in cell count). The reticular dermis layer is important for giving the skin its overall strength and elasticity, as well as housing other important epithelial structures such as glands and hair follicles. This reticular layer is our target for collagen production.
Collagen
Collagen is a connective tissue: the cartilage, bones, tendons, fascia, ligaments, and blood vessels. The nature of any connective tissue is determined by the function of certain cells that compromise the tissue. The major fatty proteins are collagen and elastin. The major nonfibrous components are complex carbohydrates mainly: hyaluronic acid, proteoglycan, and glycoprotein. Collagens are a class of proteins, members of the same chemical properties and structure, but each are the result of specific genes (hence, specific connective tissue disorders). One characteristic of all collagen molecules is their unique three-strand helix, a specific conformation of the three polypeptide (alpha) chains, each containing approximately 1000 amino acids. Chain validation is determined by the amino acid content, with glycine forming one third of the total and occurring at each of the third positions in the amino acid sequence. There are two main classes of collagen: interstitial and pericellular. Interstitial collagen is the main collagen of skin and bone type (type I); articular cartilage and pulposus nucleus (type II); and collagen found on the skin, blood vessel walls, and parenchymal organ matrix (type III). The parsley collagens are of type IV and V and dominate in the basement membrane.
Biosynthesis
Collagen chain biosynthesis is a multistep process in which the form of a precursor (procollagen) is first synthesized, with peptide connections at both ends. During synthesis, some amino acids are uniquely modified after translation (after insertion into the polypeptide chain). The post-translational modifications include hydroxylation of praline residues (hydroxyproline) and lysine residues (hydroxylysine) and addition of sugar (glucose and galactose) to hydroxylysines, and the formation of hydroxylysing and lysine aldehydes. Specific proteases act to break down the extension of procollagens to produce processed collagen molecules, which can then act as polymers to form fibers and fibers. Our lasers target cell intermediates that stimulate the production of procollagen I & III.
Aging
Skin aging (skin) is a complex biological phenomenon. Older skin disorders are caused by photoaging (UVR) than chronological aging. There is a gradual dermis atrophy and epidermis and an abnormal accumulation of elastic tissue with microfibrils and related proteoglycans. These elements replace the normal collagen-rich dermal base, which leads to a weak, thin layer of donation. UVR consists of UVA (320-400nm) + UVB (280-320nm) and UVC which currently do not penetrate our atmosphere. UVA light is a major agent that offends collagen loss and subsequent wrinkles. The shorter UVB length only affects the epidermis. Because the dermis layer "sags" so it follows the epidermis, and wrinkles appear. This decrease in collagen is due to an increase in degradation (UVA) than a significant decrease in production (age). The term solar elastosis is used to describe oxidized skin.
Skin thickness changes with age: young skin gradually thickens to about 20 years of age, after which the dermis atrophy gradually develops. In the dermis of the papillaria, a rather nonechogenic band emerges and develops with age. The exact reasons for the appearance of these shadows are unknown, but they correspond to the homogenization of dermis papillaria, loss of elastic fibers and local collagen, and their replacement with an indistinguishable matrix of hydrated gycosaminoglycans (elastosis tissue). This level of reflection increases with age and is a reliable indicator of skin aging (loss of collagen density).
These shades are found in two types of aging skin: pictures and chronology. Increased skin thickness from laser therapy was found in the upper dermis and was due to an increase in collagen fibers and no other components in the matrix.
Laser heat causes denaturation of some of the older collagen and accelerates the process of new collagen synthesis by fibroblasts and new glycosomogenic deposition and leads to the reabsorption of elastic materials. The increase in echogenic bands in the upper dermis is easily visualized by ultrasound and is directly associated with increased collagen. Two possible benefits of laser collagen remodeling therapy. Dermal thickness increases and / or collagen density increases.
Anti aging
Anti-aging methods are classified by type:
Type I therapy is directed to the epidermis (microdermabrasion / chemical chemistry / laser)
Type II therapy is directed to the dermis (laser / skin chemistry / ultrasound)
Type III therapy is surgery or injection (face lift, botox, filler).





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