An interesting piece which explores the current evidence of the factors that are thought to lead to facial ageing through fine lines. The author outlines a detailed discussion of the many intrinsic factors which can lead to the emergence of fine lines, including the impact of declining oestrogen levels and changes within the extra-cellular matrix (ECM), with descriptions of different types of collagen. The author captures the visual and tactile characteristics of an ageing skin, with an emphasis on the practitioner’s role in promoting good skin health and appropriate anti-ageing skin care regimes, as well as diet in relation to foods high in AGEs. There is some discussion around the role of pigmentation in skin in relation to photoageing. The role of telomeres in ageing is clearly conveyed along with the role of matrix metalloproteinases. The author also acknowledges the literature and anatomical work from Pessa et al. (2014) regarding the location of vessels in determining cutaneous wrinkles, noted through the presence of forehead and glabellar rhytides. This is an excellent, well referenced and detailed account of the many facets involved in skin ageing, with important concepts for aesthetic nurses to understand when assessing and treating skin.

Improving the anatomical understanding of the causation of fine lines.
Newson C.
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Anna Baker

BJN Aesthetic Nurse of the Year 2016.

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