How To Avoid Botox - Prevent Wrinkles With A Healthy Lifestyle

Can skincare help you avoid Botox? Not as much as lifestyle choices
I was recently asked to contribute some quotes for a local magazine, and one of the questions the reporter asked was, 'how early in age would women have to begin using anti-aging skin products so they could avoid the need for treatments such as Botox.' I think this question is very interesting, because it shows that many people are unaware of the ongoing effects of environment and lifestyle choices on their skin.

Many people only start worrying about wrinkles in their thirties, when the stresses of hectic, active or unhealthy lifestyles start showing up in the form of dull skin or fine lines on previously pristine complexions. By their forties, the damage would have worsened enough that indeed, Botox, lasers and skin tightening therapies would be a god-send. Applying anti-aging products at that stage may not be enough to reverse or delay the damage that was already done. 

Should women be using anti-aging skincare in their teens and twenties to prevent effects of aging in later years? Anti-aging creams and lotions have certainly improved vastly in previous years, and many have proven skin smoothing and tightening qualities, but most are designed to replenish and boost insufficient collagen production, which is not a concern in such a young age. Others contain retinoids, which work by encouraging the rate of exfoliation and skin renewal, also not a concern when the skin is young and healthy and able to renew itself naturally. These anti-aging skin products are mainly focused at the 30s to 40s age group, when natural skin rejuvenation qualities of the skin have been compromised or decreased as part of the aging process.

Skincare products can be helpful but should not be the key focus when the goal is to prevent signs of premature aging. Aging is a process that begins as early as birth, and some scientists even argue it is a process that commences at the moment of conception. The key building block of healthy skin, collagen, declines at a rate of about 1% per year, so a 30 year old woman will have lost about 30% of her collagen, although these factors, as outlined below, may cause that rate of deterioration to be accelerated. 



UV rays - stay out of the sun to stay young

The skin is especially susceptible to damage from exposure to UV rays, and even though many women use sun protection religiously, by the time they are aware of the need, the damage may already have been done. Most doctors agree that the vast amount of premature skin aging is caused by exposure to damaging ultraviolet rays. Sun worshipers have noticeably dry, lined and crepey skin, and wrinkling and melasma can be seen in as early as the twenties in extreme cases. At the Queensland University of Technology in Australia, researchers found that exposure to UV rays up to the age of 18 contributed significantly to skin cancer and aging in later years. Skin damage done at this age may not be as apparent as the skin is still resilient enough to function effectively, but it will already have begun to deteriorate more rapidly than usual, and be prone to early wrinkling and sagging. 

In one of my earlier posts, I wrote about a trucker who had extensive sun damage on the side of his face that was exposed to many years of sunlight filtering through his driver's side window. The unexposed cheek was noticeably smoother and healthier. I have also observed that many North Asians have skin that women in South-East Asia are deeply envious of. Although many attribute their porcelain, unblemished skin to genetics, I believe the harsh, tropical climate and year-round sun exposure must take the bigger blame. Many a student who has ventured to colder countries for studies have returned with fairer, clearer and smoother complexions, which revert to normal once they return to our humid, sunny conditions. 

It is very hard to avoid the sun completely, but an effective sunscreen regimen (as outlined here) is still your best option. A topical retinoid such as those discussed in this post, can improve your defense against UV damage.


Cigarette smoking may look cool, but it also makes you look old

Photo of identical twins, one smoker
A study done by an American plastic surgeon , Dr. Bahman Guyuron, examined 186 pairs of identical twins and found they often age differently due to a number of factors. 

In this example, one twin was a smoker and the other was not. Notice the deep forehead lines, under-eye bags and lines around the mouth in twin B, the smoker. 

Smoking damages the skin in many ways. The carbon-monoxide in cigarette smoke decreases the availability of oxygen in the body, and blood flow is diverted from the extremities to more important internal organs. Over time, capillaries in the skin start to shrink and collapse, causing the skin to be undernourished and oxygen-deprived. Toxins gradually build up in the skin as the liver struggles to filter out chemicals such as nicotine, cyanide, formaldehyde and tar from the blood. Essential vitamins such as Vitamin C are destroyed by cigarette smoke, and this leads to a decline in collagen production. Vitamin A, which provides protection from skin damage, is also depleted by smoking. Nicotine levels in the blood also encourage the formation of matrix metalloproteinase, an enzyme that speeds up the breakdown of collagen. 

The physical action of smoking also contributes to the decline in facial features, as the act of dragging on a cigarette leads to smoker's lines on the lips, sunken cheeks and crow's feet. The full extent of the damage from smoking may not be apparent for many years. The impact of smoking on skin rejuvenation and wound healing is so well-documented that many doctors may decline to perform procedures on you as the results or risks would be prohibitive. 

The good news is, once you quit smoking, the body is immediately relieved of a great deal of the daily stress it is subjected to. The body's natural rejuvenation process means that within six weeks the skin's condition will be visibly improved. The earlier you quit, the easier it will be for your skin to recover.

Read this Health.com article for more information on how smoking impacts your looks.


You are what you eat - poor diet equals poor skin

Dietary habits can be your biggest downfall or your greatest ally when it comes to maintaining your looks. A diet high in animal fat, red meat and dairy products, for example, exposes the skin to greater amounts of free radicals, which hinders the natural cellular rejuvenation process. Highly processed foods such as deli meats and junk foods have also been shown to cause inflammation which inhibits collagen production, while excessive amounts of caffeine and alcohol dehydrate the skin. 

Having a sweet tooth is a factor in premature aging, as reported in a study published in the British Journal of Dermatology. Every time you consume something that has sugar, it causes a process called glycation, where molecules called advanced glycation end-products (AGEs) are produced. As AGEs accumulate, they damage collagen and elastin fibers in the skin, causing wrinkling and sagging in the long term. As the skin ages, the effects of glycation are especially noticeable due to the decreasing levels of available collagen. 

Diabetics, who may suffer from years of undetected high blood sugar often look older than others of their own age, and may have up to 50 times the normal amount of AGEs in their bloodstream. In fact, some of the top anti-aging specialists believe that any anti-aging skincare regime is incomplete if sugar consumption is not moderated as part of the treatment. High fructose corn syrup in particular, is believed to produce more AGEs than other types of sugar products. For best results, sugar should make up not more than 10 per cent of the total caloric intake. 

A diet rich in antioxidants has been shown to combat the aging process, and examples of antioxidant-rich foods include citrus fruits, tomatoes, broccoli, berries and leafy greens. Green tea is an especially potent antioxidant, as are soy products such as soy milk and edamame (green soy beans) which contain isoflavones to combat oxidative stress. Dark chocolate, eaten in moderation, is also a great source of antioxidants. Orange-colored vegetables such as carrots and pumpkin provide beta-carotene, a natural exfoliant which is converted into Vitamin A in the body.  

The key is to eat a greater variety of fresh fruits and vegetables rich in vitamins such as vitamins C and E and selenium, and reduce the amount of fat and carbohydrate intake as you grow older. Supplementing the diet with vitamin B1 and B6 also helps to inhibit AGE action. Water, is of course, vital in the pursuit of healthy, glowing skin, as it flushes out impurities and keeps skin hydrated and plump.


Other factors that contribute somewhat to the physical age of your skin include poor sleep habits, hormonal changes, and high levels physical and mental stress. Weight fluctuations and weight extremes are also conditions that age your skin prematurely. 


For those who are younger, and want to prevent premature aging it is also important that  proper skin cleansing and moisturizing habits be adopted from an early age. Regular exercise is also greatly beneficial. For older persons, it is not too late to slow down aging with the methods described above, so the need for Botox can be delayed or perhaps, with luck, dispensed with entirely! 

-- Cosmetic Medicine, MD

Dr. Liow Tiong Sin is an aesthetic practitioner who practices in Kuala Lumpur and Melaka, Malaysia. He has more than 12 years of expertise with non-surgical cosmetic treatments, and  conducts training courses for other doctors from all around Asia. To connect with Dr. Liow, Like Cosmedmd's Facebook page. medical centre website or email







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