Internal skin ageing is caused by the genes we inherit from our parents. It is influenced by hormonal changes that occur with age, for example, those associated with menopause. External skin ageing is mainly caused by our modern lifestyle, e.g. smoking and in particular, excessive exposure to the sun.^26,50,51

As our skin changes from the fresh, dewy complexion of a newborn to the wrinkled appearance of an elderly person, it undergoes a number of structural changes as shown in Figure 1.

Figure 1. What happens in our skin as we age?^{17,28,51,61,107}

The structural changes that occur with age become apparent with the onset of a number of visible changes that occur in our skin’s appearance, particularly fine lines and wrinkles which are the first signs of ageing.^26,50,54,58

• Dryness
• Dark spots
• Dark under-eye circles
• Sagging jawline                    
• Dullness
• Rough texture
• Visible pores             
• Double-chin               
• Lines and wrinkles
• Crow’s feet
• Sunken appearance 
• Neck lines                             
• Loss of firmness and elasticity
• Frown lines
• Drooping skin in the cheek area
• Increased discolouration

Concerns about facial ageing increase and evolve as we grow older. A survey carried out among women aged 25 - 70, suggested that younger women worry mainly about signs of tiredness and dark circles around the eyes. Dry and dehydrated skin also starts to become a concern for this group. From the age of 35, women complain about fine lines, wrinkles and loss of tonicity, while slackening of the neck becomes a problem from 45 years of age onwards.

Interestingly, for nearly 70% of women, an important measure for ageing well and maintaining attractive skin is to moisturise the skin on the face and body.¹⁰⁸
 

Indeed, keeping the skin moist is key to diminishing the appearance of wrinkles and encouraging a healthy complexion.
Hyaluronic acid that is found in our skin accounts for almost 50% of the total hyaluronic acid in our body: here, it acts like a sponge by holding onto water and keeping it soft, plump and youthful-looking.^12,54