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A tan gives you wrinkles but no one told me it shrinks your skin

A tan gives you wrinkles but no one told me it shrinks your skin

2009, The MailView PDF


Jetting from rain-lashed Britain to top up your tan? Read this cautionary tale from the star of Changing Rooms first...

The 3-D computer image looked like a hideous death mask. My own. My eyes looked sunken, grooves appeared beneath them and lines ran from my nose where my cheeks were starting to droop. I was starting at the harsh results of all my years of sun-worshipping.

I was sitting in the Harley Street office of cosmetic surgeon Angelica Kavouni, looking at the images she had taken to show me the effects of ageing.

She leaned in close and asked how much sunbathing I'd done. I knew that my love of tanning would encourage wrinkling but I was horrified when she told me that it speeds up the destruction of collagen, which gives plumpness to your face.

I'm from the Jane Fonda leg-warmer era when everyone used sunbeds. In fact, in my early 20s when I was working as an aerobics instructor, I had a sunbed at home. I would use it a couple of times a week at least - in those days, the browner you were the better. And in summer, I'd be hanging out of windows to get some rays on my face. Whenever I could, I'd be out sunbathing with my friends using coconut oil to speed up the tanning process.

A friend once used butter on her skin, to try to cook herself. So if I'd lost more collagen in my face than I should have at the age of 45, it would not surprise me.

It could have been fat worse than superficial damage - last week the World Health Organisation's scientist decided that sunbeds are as great a cancer threat as cigarettes, and the ultra-violet radiation from them could trigger the disease.

The irony is that I always swore to myself that I would grow old grace-fully, accept the lines appearing on my face and get on with enjoing life. I'd still never dream of going under the knife or Botox away the lines that reveal my laughter, frustrations and joys. But what if, as Angelica then suggested, an injection could restore some of youth's freshness that years of sunbathing and outdoor living have taken away?

It sounded tempting. There is the age you look and the age you feel. And as you get older, the gap between these two can become uncomfortably and irreversibly larger.

For me, the truth of this "gap" gave me quite a shock one day last summer. I'd driven mu daughters Bibi-Belle, who is seven, and Dixie-Dot, six, to school in my Mini convertible. And I just happened to glance up into the rear view mirror, only to see my face reflected back in the crisp morning light with unnerving honesty.

I was used to seeing it reflected back softly in our worn antique mirrors at home. Suddenly, I was staring at a pair of tired-looking eyes and gaunt cheeks, a face aged by living well and enjoying life (and I don't regret it for a minute).

I feel happier, more alive and fulfilled now that at any point in my life. I bought my zoo in Pembrokeshire last year. Running it with my husband Colin has become my passion. My daughters adore the animals and have their friends round to play in the zoo all the time. They used to stare with wide-eyed fascination at the gibbons and the zebra, but now they don't blink at anything. They especially love the horses that even come trotting into the house from time to time.

Now I would like to become an older Michaela Strachan, presenting TV Wildlife programmes. For that I would like a fresh, natural and healthy-looking face. But what I saw that morning wasn't particularly fresh-faced.

I wondered if there was anything I could do that would give a little rejuvenation in a more natural way. And that is how I came to be sitting in Angelica's office. I had phoned friends for recommendations and she is a cosmetic surgeon with a strong reputation for both surgical and non-surgical cosmetic procedures. Collagen loss, she explained, happens to everyone particularly after the age of 35. Collagen is an elastic tissue that helps build cartilage, ligaments and tendons.

It is also responsible for skin strength and elasticity and is the main component of the lower layer of skin - the dermis.

The production of collagen slows down in your early 30's due to ageing process. This is when the face starts to lose volume and your cheeks can start to look gaunt by your early 40s.

But the loss of collagen is greater when your skin is exposed to sun and ultra-violet (UV) light. The rate at which it diminishes varies from individual to individual, but exposing your face to sunlight continually over decades could speed up the rate of collagen depletion and the corresponding loss in facial volume by ten years or more.

My sun-worshipping youth and my outdoor lifestyle would certainly have triggered this process. Where I live on the Pembrokeshire coast, I get ample amounts of UV light.

The climate is wonderful. In summer, we can have hot weather for weeks. We have palm trees growing in our garden and crickets chirping in the evenings. With the kookaburras howling with laughter in the morning, you'd think you were somewhere in the tropics. I'm outside all day, walking the dogs or caring for the animals. On a typical day I might feed the zebra, check on our baby hairy pigs in their wallow or help build a new island home for our gibbon. Until I spoke to Angelica, I had used a good moisturiser to stop my face drying out. Now I use one with aSPF 50. Thankfully, though, Angelica said it was possible to restore collagen loss safely and in a non-invasive way. She recommended a new cosmetic injection of poly-L-lactic acid, a synthetic substance that triggers cells called fibroblasts in the skin to secrete collagen.

Called Sculptra, it can fill out your face to restore the plumpness of youth an give you a kind of facelift that lasts between 18 months and two years. Although the procedure is new, PLLA has been used in the medical profession for 25 years with no adverse side effects. It is used mainly to plump out facial tissue in AIDS patients who have lost excessive amounts of weight.

Just last week, Sculptra was granted approval by the US Food and Drug Administration for cosmetic use.

In fact however, it has been used for this purpose for ten years. Despite this, when I arrived at Harley Street for my first treatment, my heart was in my mouth - I was worried I'd end up looking overly puffed up like a chipmunk.

Luckily, that hasn't happened. The treatment was fast - it took about 40 minutes - and easy.

Once an anaesthetic cream had numbed my face, I had about ten injections in each cheek to enhance my cheekbones, lift up jowly areas and add volume.

Afterwards I held icepacks over the area. It didn't hurt - it just went a little red.

For a few hours after each treatment you get a brief preview of how the final result will look, because the injections also contain water which plumps up your skin, but then it is rapidly absorbed by the body. What is left is the magic ingredient that, over the coming month, stimulates your natural tissue to regrow.

The true results take far longer. I'll need three treatments in total, at six-weeks intervals. Overall, it will take four-and-a-half months for all the collagen to grow.

That is because it takes more than a month for the collagen cells to appear following each treatment. During this time, you are encouraged to drink plenty of water as this combines with the collagen to create plumpness. Although gradual, the results of Sculptra have been exciting. After six weeks, my skin has definitely looking better. My cheeks were fuller. Filled out by the extra volume, the jowls that were beginning to appear have vanished.

At 12 weeks, and after having had the second treatment, my face is looking generally fuller and more lifted. Friends keep telling me I look "really well".

Another picture was taken after my second treatment - in this my cheeks are noticeably fuller, more like the way that they were ten years ago. You can see from the contours that my face now has a younger shape.

I still have to undergo one more session, but I can see from the results so far that the final look will really rejuvenate my face in a subtle and healthy looking way - I never wanted a dramatic change.

I think I now look 30 to 35, which is much closer to the age I feel.

But the most positive effect of this process has been on my new attitude towards my little girls - especially as they are fair-skinned redheads. I have always been careful about their skin, but now I am super vigilant.

I'd hate their little faces to age unnecessarily. Children's skin is much more fragile than an adult's. It's thinner and more likely to burn.

I'm now careful about covering them in total sunblock and insist that they wear brimmed hats to keep the sun off their faces.

Attitudes towards the sun have changed. I've little doubt that when Bibi-Belle and Dixie-Dot are young women, their approach to the sun will not be the same as mine. And I will certainly encourage them to be careful. I don't want them cooking themselves in the sun as I did.

Injection can turn back time
but not without risk

"Sculptra is the brand name given to an injectable chemical called poly-L-lactic acid (PLLA) which is similar to the lactic acid naturally produced by the muscles." explains consultant cosmetic dermatologist Dr Sam Bunting of the Renew Medical clinic.

"It was developed to treat a medical condition known as lipoatrophy - facial fat loss - usually as a result of anti-HIV medication, and is a very effective way of stimulating new collagen growth. But I don't usually use it for cosmetic purposes as the results can be unpredictable."

Collagen is the protein that forms part of the natural scaffolding of the skin, giving it volume and elasticity.

The other major component of this connective tissue is hyaluronic acid (HA), which lubricates the skin.

"Levels of both chemicals naturally decrease with age, which is why the skin loses volume and elasticity, and becomes drier, as we get older," explains Dr Bunting.

"How much we have in the first place, and at what age it begins to wane, depends largely on genes."

"But environmental factors such as smoking, sun exposure, stress and most significantly, weight loss can cause collagen depletion. The thinner you are, the earlier you will lose facial volume. And once it's gone, it cannot be replaced - unless with medical intervention."

PLLA is injected into the skin in areas where fat has been lost, and where it then stimulates increased production of collagen in response to the presence of a foreign substance.

This improves the appearance if folds and sunken areas, and hides fat loss. The effects of treatment can last up to two years.

However, one per cent of patients report hard lumps forming under the skin. These are permanent, unless surgically removed.

"PLLA is very effective in restoring volume but it is essential that the patient massages their skin daily to stop lumps forming." says Dr. Bunting. There have been cases where patients have forgotten, with disastrous results.

"Today, surgeons inject dilute solutions of PLLA, which seems to be less risky. But I prefer to use HA-based dermal fillers such as Juvederm and restylane as they are less likely to have side effects."

...and three age-busting treatments

Collagen replacement

Collagen supplements may help maintain skin elasticity and plumpness - although this is not proven. Try Holland & Barrett's Hydrolysed Collagen Tablets. Serums rich in Vitamin C are known to boost collagen synthesis. MedIK8's CE-Tetra antioxidant serum has been found to increase collagen production.

Sun damage correction

Fruit acids and concentrated vitamin serums stimulate cellular repair skin cells. Vit-A-Plus illuminating Serum contains Vitamin A to repair skin and glycolic acid to remove age spots.

Eat your way to young-looking skin

One way to reduce collagen breakdown - and therefore help maintain the skin's strength and elasticity - is to increase its supply, by stimulating collagen synthesis. BUt apart from injectables, are there other ways of doing this?

Collagen is made from amino acids that are found in protein-rich food such as eggs, meat, fish, nuts and seeds. Iron and manganese also strengthen collagen.

Vitamin C is also essential for the synthesis of collagen and is a powerful antioxidant that can help reduce skin damage caused by free radicals. Smokers lose Vitamin C, which is one reason their skin may suffer wrinkles prematurely.

The best way to boost your ... of keeping good skin is to eat a diet packed with antioxidants. Beetroot is a great source and purple foods that contain anthocyanins - blueberries, black currants and prunes, for example - support collagen production. Dark green vegetables such as spinach, kale and asparagus also help strengthen the body's ability to manufacture collagen.

And what about protecting your skin against UV rays? Dr. Ronald Watson of the University of Arizona, has discovered that the antioxidants in red, yellow and orange foods such as carrots, sweet potatoes, peppers and tomatoes build up...the skin, creating extra UV protection.

"The effect is so strong that eating six portions a day for two months will build a natural barrier equivalent to a factor four sunscreen," he says.

To try at home

UV protection

Using moisturiser containing sunscreens every day is now standard advice. Moisture Defence Antioxidant Moisturiser SPF 20 is good and lightweight. Use higher SPFs when it is sunny. Try Creme de Soleil and Sunsense Daily Face.

Doctor, doctor

Does topless sunbathing increase my risk of breast cancer?

There is certainly no evidence to suggest it would, but it may increase your risk of skin cancer if you do not use sunscreen.