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While aging is inevitable, how it affects the way your face looks and wrinkles is not predetermined or set in stone. You did get the type and quality of skin from your parents, but how you treat it over time will affect how it looks as you get older. A new study of twins confirms that factors such as too much sun exposure, being overweight, and smoking has much to do with the wrinkles, brown spots, and telangectasias that eventually appear in all.

Twin studies are always interesting because their genes are identical and the influence of different environmental factors can be more easily seen. In the December issue of Archives of Dermatology,  a study was published on an analysis of environmental skin-damaging factors in pairs of twins by using a questionnaire.

They examined facial skin of 130 twins, 18 to 77 years old, who lived mostly in the northern Midwest and Eastern regions of the U.S. who were attending the Twins Days Festival in Twinsburg Ohio in 2002. The study group consisted of 52 fraternal and 10 identical twin pairs, plus 3 pairs who were unsure of their twin status. Identical twins share all of their genes and fraternal twins share only about half. The survey collected information about each participant’sFitzpatrick type, history of skin cancer, smoking and drinkinghabits, and weight from a cohort of twins. Clinicians then assigneda clinical photodamage score to the face of each participant.  

From these data, the study noted a strong association between smoking, sun exposure and history of skin cancer, and being overweight with facial skin that had more signs of environmental damage as evidenced by wrinkles, brown spots, and visible blood vessels. Interestingly, by contrast, sunscreen use and alcohol intake provided more of a protective effect with better skin quality scores.

 The study of twins provides a unique opportunityto use genetic similarity in order to isolate how the environment influences facial skin aging. This important study shows that well known risky behaviors do make a difference in how the face looks. While one can debate about how significant those differences are, the cumulative effects of smoking, sun exposure, and weight lead to more cases of skin cancer and facial skin damage. It is not clear how or why alcohol may have a ‘protective’ effect other than most alcohol is probably consumed indoors.

In conclusion, skin aging is related more to environment and lifestyle than genetic factors. So protect yourself from the sun starting when you are young, don’t smoke, and stay in shape…you face will thank you for it!

Barry L. Eppley, M.D., D.M.D.

Indianapolis, Indiana

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