Source - Plastic and Reconstructive Journal, 2009 by Guyuron - Looking at 180 sets of identical twins at the annual Twins Festival in Ohio These articles by plastic surgeon Dr Guyuron set out to examine risk factors for ageing that could be controlled by what doctors commonly refer to in Medicine as ‘modifiable risk factors”, sometimes as “lifestyle risk factors.” Some common examples of these are habits such as sun protection, avoiding smoking, exercising, eating minimally processed whole foods, etc. Given identical twins have the exact same genetic material, the baseline assumption was that any changes in their appearance must necessarily be due to contributions of their habits, environment and lifestyle factors. Some 180 sets of twins were looked at in these articles, one looking at some risk factors that included sun protection, smoking, weight, use of hormone replacement therapy, use of alcohol etc. And another article by the same author looked in more detail at the effect of smoking on the skin of identical twins. Look at the results below. When it comes to skin, doctors tend to harp on about some of these risk factors, including sunscreen use, direct sun exposure, smoking cigarettes, consuming alcohol, drinking enough water and even getting enough sleep and exercising. So I won’t harp here, and let the results speak for themselves. And while the jury is out on many factors, some are fairly clear and obvious. Effect of smoking on skin quality and appearance of ageing. 2. body weight, or BMI, which is a measure of how much weight a person carries. Study of these twin pairs found that under the age of 40, extra body weight was associated with the heavier twin looking older, BUT after the age of 40, more weight seemed to confer a younger appearance and after age 55, even more so. This is assumed to be because a lower body weight is also associated with more volume loss in the face, which is harder to fill with age, leading to sagging, eye bags and jowling. 3.  effect of the environment specifically sun protection, on skin quality and damage over the years. The effects of alcohol consumption, similarly, were suggestive of better skin with those who drank less on a regular basis, as was the use of HRT after menopause. So what are the take away messages? Quit smoking! Eat as healthy as is feasible for you, given your circumstances. Even if you had a childhood full of sunburn, sunbaking and sun damage, it is never too late to protect your skin now. Wear sunscreen daily, rain or shine, summer or winter. Sunscreen is additional to protective clothing including long sleeves, a hat and sunglasses. Watch your alcohol intake Get enough sleep A few extra kilograms of weight after a certain age are probably not THAT bad for your face HRT may be beneficial for your skin and in other ways, and best discussed with your doctor It is never too late to begin to care for your skin. The more damaged or neglected it is, the longer it will take to bring it to a state of health, so time, consistency and patience are key, as well as a commitment to working on it with a trusted doctor. Want to know more? Get in touch, make an appointment and let’s set up a treatment plan for you with Dr Joshi. Book Now