As with all of our organ systems, our skin quality, function and rate of physiologic aging is determined not only by extrinsic factors such as diet, stress, and exposure to toxic agents, but also, and even more significantly, by intrinsic genetic factors. We know that the genetic backgrounds of certain ethnic populations (Northern European) strongly differentiate themselves from other ethnic populations (African and Asian) by the quality and durability of their skin. We all (in the skin care profession) know intuitively and by experience that fair/red haired- blue eyed individuals will have more “problematic”, damage prone skin compared to darker complected, brown eyed people. We know that these “at risk” populations will show significant evidence of aging in a more rapid, severe, and aggressive manner compared to genetically “favored” populations.

The basic mechanism by which intrinsic aging of skin occurs is complex and not well understood. However, in both types of aging (intrinsic and extrinsic) the rate of aging is said to be a fine balance between deoxyribonucleic acid (DNA) damage and repair. Recent advances in molecular biology have helped us to better understand this process. Currently, several mechanisms have been proposed as contributors to the aging process, such as disruption of genes in cell cycle regulation, alteration of cellular constituents (proteins, lipids, nucleic acids), production of reactive oxygen species (free oxygen radicals), and telomere shortening. In all of the above, the central mechanism involved is the cell’s inability to repair DNA damage that has occurred. Mutations in DNA repair genes have been linked to various diseases such as cancer, accelerated aging, and neurological diseases. It is also well known that inherited defective genes can lead to premature aging syndromes such as progeria. These syndromes are characterized by genetic mutations, and these mutated genes can be identified. Since current scientific evidence indicates that skin quality and premature aging are mainly regulated at a genetic level, specific genetic markers such as these will enable us to identify the gene(s) involved in the skin aging process.

Unfortunately, to date we are unable to tailor our skin care and treatment protocols to the most important determinant of skin quality – the genetic component. Our scientific understanding of skin physiology and function has helped us make great strides in optimizing skin quality, but can carry us only a limited distance when confronting the genetic limitations of an individual’s skin composition. For instance, we are all aware of the need for the stimulative effects of retinoids, and the antiaging and damage preventing effects of antioxidants in improving skin quality. Not to mention now the increasing emphasis on the restorative and anabolic effects of growth factors on the skin. But as effective as these components are, the next level of intervention will logically be when we can not only optimize skin function at whatever baseline one has, but can actually intervene at a genetic level to reconfigure the genetic makeup to enable the body to produce better quality genetically superior protein components for the skin.

With our increasing understanding of the human genome, it is conceivable and even expectable that we will acquire the knowledge necessary to understand the critical sites in our genetic code that affect skin function and physiology, and to manipulate them in specific and tailored fashion to effect improvement in each individual’s skin. This information is not yet available, and to achieve this level of detailed information of our genetic code and its relationship and effect on the skin will require further extensive investigations on large populations. Our research team is currently involved in a project to identify genes that determine skin quality and develop effective methods to counter the adverse effects of aging. We will examine the genetic profile of an ideal population which reflects both subtle and established age-related features. In some individuals these changes begin in the third decade and are gradual, while in others, it becomes pronounced within a short period of time. We believe that by identifying the specific gene(s) we will be able to get an insight into the underlying mechanism of how skin ages, thus paving the way for early diagnosis and development of targeted therapies. Until the scientific breakthroughs become reality we will continue to incrementally improve our understanding and care of the skin with the phenotypically tailored remedies and technologies.

Dr. Banis is a Certified Plastic Surgeon with over 20 years of experience in plastic surgery. He was an early pioneer in the use of microsurgery, routinely addressing the most challenging cases of reconstruction. Over his years of practice he understood the importance of healthy skin. His research has led him to develop vitamin/herbal formulations for skin support and disorders such as acne. Please feel free to contact Dr. Banis or his nurse, Abbey Helton, at 502-589-8000.

Telomere – Protective chromosomal end caps. Degradation of these important structures lead to normal or accelerated aging.