[Aging of skin and hair]

Anti-aging medicine is dedicated to the advancement of technology to detect, prevent, and treat aging related disease and to promote research into methods to retard and optimize the aging process. Dermatology offers good basics for rational preventive and therapeutic anti-aging strategies. The role of the skin in anti-aging medicine is not merely that aging is most obvious on the skin, but that the skin is a highly accessible and unique organ that offers unequaled opportunities to the gerontologist for the study of age-related effects. The study of skin aging focuses on two main streams of interest: On one hand, the esthetic problem and its management; on the other, the biological problem of aging in terms of microscopic, biochemical, and molecular changes. Probably the same molecular mechanisms underlying the aging of skin and its appendages, including the pigmentary system, underlie age-dependent degenerative changes of the inner organs and entire organism. The skin and hair are subject to intrinsic or physiologic aging, and extrinsic or premature aging due to external factors. Intrinsic factors are related to individual genetic and epigenetic mechanisms with interindividual variation. Extrinsic factors include ultraviolet radiation and cigarette smoking. Primary prevention encompasses measures that are taken before the aging process has started, secondary prevention when the first signs of aging have come into sight. Eventually, tertiary measures are aimed at correcting established signs of aging. Prevention starts with photoprotection and avoidance of cigarette smoking. In dermatologic practice sun protecting agents, dermocosmetic substances, hair growth promoting agents, and anti-aging compounds play an ever increasing role. Finally, tertiary anti-aging measures include minimally invasive cosmetic procedures such as chemical peels, microdermabrasion, soft tissue fillers, non-ablative laser rejuvenation, radiofrequency techniques and botulinum toxin, as well as laser skin resurfacing and corrective surgical procedures, including autologous hair transplantation.