What is “inflammageing” doing to your skin?

The beauty buzzword “inflammageing” refers to how excess inflammation accelerates the skin’s natural ageing process. Based on the nature of contemporary lifestyles, “inflammageing” is probably happening to you right now. Discovering what chronic low-grade inflammation is doing to your skin and how to combat it is your most valuable ticket to maintaining a healthy, resilient, and youthful complexion.

Are you living a high-stress life? Is your nutrition optimal or a little off? Is a quality night’s sleep hard to come by? Are you exposed to environmental toxins? If you answer yes to any or all of the above, it’s highly likely that you’re experiencing a degree of excess inflammation in your body. The cascade effect of this inflammation has the ability to age you prematurely from the inside out. So, what exactly is “inflammageing” and how does it impact your skin? A dive into examining what’s going on in the body below skin surface level, plus understanding how to protect yourself from the damaging effects of cellular inflammation, is a beauty and wellness secret you’ll want to know about. Here’s the science behind mitigating inflammation in order to slow the clock on ageing.

Ageing vs premature ageing

Physiological ageing is inherent to the natural cycle of being human. Over your lifespan, cellular processes and your body’s ability to repair and regenerate slows down. This results in myriad changes to various systems in your body. When it comes to beauty, the thing most people are invested in preventing is the ageing of the largest organ — the skin. With age, your skin thins and becomes less elastic and more fragile. The fatty tissue that offers youthful “padding” just below the skin also decreases. This results in fine lines, wrinkles, larger pores and slower wound and bruise healing, along with an overall sagging and drooping effect of the tissues.

While this process of ageing is normal and not something that should be feared, premature ageing occurs when these physiological changes are expedited, something that isn’t ideal from either a beauty or a health perspective. It’s commonly recognised that various environmental and lifestyle factors play a role in the ageing process, whether this be living in a city with a lot of air pollution, excess sun exposure or a diet high in processed foods. Yet no matter what contributor you look at, research is finding the common denominator to be an underlying inflammatory process as the root cause.

“Inflammageing” explained

According to Dr Sarah Tranter, a cosmetic doctor and skin expert, the term “inflammageing” encapsulates the process of chronic, low-level and asymptomatic inflammation that is responsible for the premature ageing of our skin. “Inflammageing affects processes such as cellular replication and DNA replication, and also the activity of our immune system, causing it to slow down and dysregulate,” she explains.

Our bodies are smart and actually use inflammation as a way of signalling stress from the inside out. Although inflammation is the body’s natural immune response to external aggressors, if you are consistently dealing with stress and translating that into an inflammatory response, it does bear consequences over time. Given that factors like high stress, excess exposure to aggressors, poor diet and being sedentary saturate the way of living in the contemporary day and age, it comes as no surprise that chronic inflammation typical of “inflammageing” is extremely prevalent.

Too much stress is never good

Stress can affect the skin in two ways: first, in terms of external stressor stimuli, which could mean extreme temperatures (either too hot or too cold), injury or UV sun exposure. “This kind of stress is detected in the skin and relayed to the spinal cord and then triggers the release of stress hormones like glucocorticoids, corticotrophin-releasing hormone and adrenaline, which exert their effect in the skin,” explains Dr Tranter. Second, skin stress can also be influenced by the fight or flight response involving the sympathetic nervous system and the adrenals.

“Essentially emotional stress that we experience can be translated to the skin by the way of our brain–skin nervous system

feedback loops, and the resulting release of hormones directly impacts your skin cells and cellular processes,” Dr Tranter says. Too much of either form of stress, or the all too commonly combined occurrence of both types, results in extended patterns of inflammation.

How does this impact the skin?

Looking at the science of what’s going on during such prolonged periods of low-intensity inflammation illustrates how this plays a key role in cellular ageing. Unfortunately, though, this kind of inflammation can often fly below the radar and be unseen at first, before the true impacts manifest visibly on the skin — all the more reason to be aware of what is actually happening beyond skin-deep.

Once a particular irritant — think anything from a high sugar diet, chemical cosmetic ingredients, psychological stress and trauma to bacteria, smoking and UV exposure — triggers an inflammatory response in the body, free radicals activate the release of inflammatory hormones, white blood cells and enzymes known as MMPs (matrix metalloproteinases). When the skin has an acute trauma, this bodily response is not problematic; however, constant exposure to low-grade inflammation comes with repercussions for the way you age by causing a breakdown of healthy collagen, elastin and connective tissues that are essential for maintaining the elasticity, hydration and integrity of your skin to retain a youthful-looking complexion.

A cellular cascade

Internally, too much inflammation initiates a wave of destructive processes. “At a cellular level, chronic underlying inflammation activates your immune system to release pro-inflammatory cytokines (small proteins that are crucial in controlling the growth and activity of other immune system cells and blood cells) and other immunemediators that contribute to inflammation and disordered cellular processes,” says Dr Tranter, who at her Byron Bay practice sees patients daily who are looking for solutions to their inflammatory-linked skin concerns, whether it be ageing skin (the most common) or other conditions with inflammatory roots, such as acne, eczema, psoriasis and rosacea.

“For example, inflammatory cytokines and reactive-oxygen species directly and indirectly damage DNA,” she explains further, “and this interferes with your cell’s ability to repair itself. They also directly contribute to processes which lead to the breakdown of collagen and elastin by triggering the activity of the MMP enzymes, which shows up in the skin as a loss of firmness, smoothness and vitality.” Inflammageing also trigger dehydration in the skin and a breakdown of hyaluronic acid, which is the main molecule responsible for holding water and hydration in the skin.

How to combat inflammageing

Once you understand the link between inflammation and the processes involved in the premature ageing of your skin, you are empowered to take action to tackle inflammageing. Combating it is all about keeping your inflammatory response ata healthy level, rather than allowing it to tip over into extremes or a chronic state, which is when the ageing process gets accelerated and the condition of your skin really begins to pay the price.

The ideal method of managing and preventing inflammation is through a holistic inside-out approach that includes developing healthy lifestyle practices, such as regular exercise, enjoying anti-inflammatory foods and harnessing the benefits of both topical and ingestible antioxidants to help halt and repair cellular damage.

As Dr Tranter observes, “The more and more we are understanding the role of inflammation as the key mediating factor in cellular ageing and immunosenescence (the changes in the immune system associated with age), which is responsible for the slowing down and dysregulation of body functions that we see with physiological ageing, the clearer it is that the best response includes avoiding triggers (such as smoking, high sugar, alcohol and processed foods) while incorporating beneficial substances. This includes welcoming adaptogens and antioxidants into your diet and skincare routine, moving the body and managing stress as a way to reverse and prevent chronic, background inflammation and the premature ageing this brings with it.”

Dr Sarah Tranter’s anti-inflammageing protocol

Even if your skin has been subject to damage caused by inflammageing, it’s never too late to take steps to reduce inflammation to prevent further premature ageing and begin healing existing damage. To do so, it’s important to focus on removing the bad —avoiding triggers is essential, since if you continue to expose your system to a trigger there will be no chance for repair and healing to take place — and then adding in the good — developing a healthy lifestyle that can help halt and repair damage caused by inflammageing.

Based on her inside-out approach, Dr Tranter believes in following a protocol to influence underlying inflammation and reduce inflammageing by focusing on what you put into your body and how you look after yourself, in conjunction with utilising an effective topical skincare regime.

From the inside

• Look after your gut. The link between the skin and the gut is an important one, and both organs serve a uniquely similar role, as they both form our main interface with the outside environment. More studies are showing the close relationship between the two, known as the gut–skin connection, with the gut microbiome playing a role in regulating the skin both in terms of its immune function and neuroendocrine function (how it responds to insult, inflammation and injury). Make sure you include pre- and probiotics with adequate dietary fibre to support your gut flora and microbiota.

• Eat a balanced, wholefood diet. Healthy dietary choices make a huge difference to preventing and reducing inflammation and supporting your skin’s health. Include quality protein loaded with amino acids essential for building and repairing tissues, healthy fats (essential for a well functioning skin barrier and for fighting inflammation), and enjoy eating a wide variety of fresh fruit and vegetables, particularly those high in antioxidants to mitigate free radical damage — think berries like raspberries, blueberries and strawberries, as well as goji berries, artichokes and pecan nuts.

• Focus on polyphenols. Widely found in plants, fruits, vegetables, nuts and seeds, these micronutrients act like antioxidants to combat oxidative stress, and in particular, can help combat UV-induced photo-damage and the development of skin malignancies. Examples of polyphenols include green tea polyphenols, pomegranate fruit extract, grape seed pro-anthocyanidins, resveratrol, silymarin, genistein and delphinidin. Polyphenols occur naturally in plants. For a concentrated dose, they can be taken orally as supplements or from juicing fruits and vegetables to get the maximum benefit.

• Add in adaptogens. Adaptogenic substances are usually herbs, roots or mushrooms, which offer another way you can help your body deal with stress and inflammation. These plant-based compounds act by increasing the body’s resistance to physical and mental fatigue and stress. Adaptogens that are particularly good for the skin work by reducing inflammation, regulating stress hormones like cortisol and acting to delay damage to the skin. Some top adaptogens to incorporate for your skin’s health include Indian gooseberry, ashwaganda, ginseng, reishi mushroom and goji berry. Choose a high-quality liquid formulation or powder extract and incorporate it into your routine each day — easy ways to harness the benefits include adding them to your smoothies or hot beverages.

From the outside

• Be consistent with a routine. Develop a simple yet effective skincare routine and practise it daily. The goal of this is to cleanse the skin, keep it hydrated, protect it and include skincare ingredients that keep the skin healthy.

• Lock in moisture. Keeping the skin hydrated at the cellular level is key. Ingredients such as hyaluronic acid and the adaptogenic tremella (snow mushroom) can be applied topically to attract and hold water in the skin to keep it plump and moisturised.

• Care for your skin barrier. The outermost layer of your skin, called the stratum corneum, consists of sturdy skin cells that are bound together by lipids and is known as the skin barrier. A well-functioning skin barrier is essential for optimal skin health and for reducing inflammatory conditions. Research shows that certain plant oils, such as avocado or grapeseed oils, may help repair the skin barrier and also prevent your skin barrier from losing moisture. Vitamin E, ceramides and squalene are also beneficial ingredients to look out for.

• Regulate skin cell turnover. Encouraging healthy skin cell turnover is a highly effective anti-ageing skincare method. Opt for products with retinoids or bakuchiol, a natural vitamin A alternative, to support this.

• Feed it antioxidants. Just like their function in the diet, antioxidants are substances that are useful topical ingredients that work to help protect the skin from oxidative damage caused by free radicals and environmental aggressors. Include vitamin C and antioxidant-rich plant extracts like pomegranate and polyphenols such as resveratrol.

• Include SPF protection. UV rays from the sun are known to cause skin stress and damage that leads to premature ageing as well as pigmentation, so always apply quality sunscreen.

Following these suggestions, combined with other cornerstones of a healthy lifestyle such as staying active, quality sleep, human connection, stress relief and time in nature will not only help keep your skin robust, healthy and youthful by preventing the beauty-robbing effects of inflammageing, it will also bolster your total state of wellbeing. “The same mechanisms involved in the concept of inflammageing applied to the skin are also recognised as a pathogenic process for other systemic disease processes such as diabetes, Alzheimer’s disease and atherosclerosis,” Dr Tranter notes.

Ageing is inevitable. However, chronic inflammation and premature ageing are not constituents necessary to the process. Taking active measures to prevent and reduce inflammageing from both inside and out allows you to age more slowly and gracefully, while feeling good as you do it.