After about spending some time in bathtub or in the pool, we can notice that our skin on particularly finger tops and toes start to wrinkle up. This wrinkling effect is believed to have a function.

When wet, things tend to be more slippery and our sophisticated skin is designed to counteract this by wrinkling up in a pattern optimised to provide a drainage network that improves grip, much like the tires on a car according to a study. Link to original publication. However, other studies would contradict that there would be a functional benefit for so called aquatic wrinkles.

The osmosis theory
Water molecules moving trough a semipermeable membrane from a low concentration area to a high concentration area is a process called osmosis. The shrinking and expanding effects of osmosis takes place simultaneously outer layer of the skin, causing wrinkles.

The skin's outermost layer is also known as stratum corner could be responsible for this wrinkly reaction, The top layer of our skin consists of dead corneocytes. The longer these cells are attached to the skin, the bigger they are. The size of the corneocytes we actually use to objectively measure the skin's renewal and desquamation (shedding of cells) process. These dead (keratin containing) skin cells may absorb water and swell. The lower layer with living cells doesn't swell up. As top layer (which is increased in size) is still attached to the layer beneath, a wrinkly pattern is formed. The layer of dead skin cells is thicker at the palms of our hands and soles of our feet, the wrinkling effect is more evident. This response occurs more quickly in freshwater than seawater. Moreover, when we are exposed to water for a longer time, the water-repelling film on top of the outer layer of the skin may get impaired.

The sympathetic nervous system / microcirculation theory
It's known that there is a relationship between the wrinkling-effect and blood vessels constricting (narrowing) below the skin. When hands and feet are soaked in water, the nerve fibres in the skin shrink and the body temperature regulators loses volume. Therewith the top layer of the skin is pulled downward and the wrinkling pattern is formed. It is proven that wrinkling-effect response is impaired, if the nerves and/or blood vessels are damaged. Therewith the wrinkling effect can even be used to determine proper functioning of the sympathetic nervous system and/or skin's microcirculation. There is evidence that the wrinkling effect is impaired in patients suffering from diabetes: link to article. 

Regardless the cause, aquatic wrinkles disappear fast and the skin returns to normal once the water has evaporated.
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Take care.

Psoriasis occurs in many different forms and levels of severity. The first signs may appear between the age of 15 and 35 and 75% of patients are diagnosed before the age of 46 according to the World Health Organisation. As there is no cure for the disease, the highest prevalence is seen in a more mature age group age 50-69. Many of the treatments which are part of the standard treatment guidelines for psoriasis cause as a side effect premature ageing skin. For example PUVA, next to being an effective treatment, does cause (severe) photo-damage. Many patients will undergo such treatments on and off or continuously throughout their life.

Although the primary goal of dermatology is to improve the functional attributes of the skin (health) and lessen the tremendous burden psoriasis may cause, ultimately one aims to improve the skin's physical attributes (appearance).

Ageing skin is a biological degenerative process which influences the activity of collagen and hyaluronic acid producing cells (mainly fibroblasts) and leads to a decrease of skin components like collagen, hyaluron and functional elastin. Effective anti-aging skincare can support the protection of those cells and skin components (anti-oxidants and SPF) and thus slow down the fastened degenerative process. Some active ingredients (for example biologically active Glycine Saponin and Arctiin) have proven to effectively stimulate fibroblasts in the production of collagen and hyaluronic acid and thus replenish dermal components. Loss of those components and photo-damage eventually lead to visible signs of ageing.

Although ageing skin is natural, premature ageing skin isn't necessary. Most patients will probably already use a moisturising facial skincare product. It makes sense to recommend anti-ageing skincare instead to be used in conjunction with treatments which as a side effect cause premature ageing skin, particularly for exposed areas like the face. As psoriasis oftentimes doesn't occur in the face (except in the hairline), anti-ageing skincare will pose a low to no risk to aggravate facial skin and there are anti-ageing skincare products available which have proven to be suitable for psoriasis patients. 

Take care.

One of the frequently asked questions is, if it's necessary or if there is a benefit using a special eye care or cleansing products. Yes, there is!

As I mention in many of my previous posts, the right pH-level is very important for healthy skin. Skin usually prefers a pH of around 5. However there are some area's where the skin's natural pH balance is a little bit different. One of those area's is the area around the eyes. The preferred pH-level there is around 7, thus less acidic and more alkalic in comparison to your regular cleansing or care product for face or body.

This is one of the most important reasons why I would recommend to use a special eye make-up remover and eye care product, as they are adjusted to the pH level most suitable for use in the eye area. Furthermore, special eye products are tested and proven to be safe when used around the eyes, while it isn't always recommended or proven for a regular face product. 

Some care products have a tendency to "travel" or migrate into the eye area. Even when not directly applied around the eyes, they might end up there. A special eye care product can form a "barrier" and thus help to prevent that unwanted products move to the eye area and cause irritation. I would particularly recommend the use of an eye cream when using other products containing gold standard anti-ageing active ingredients like Vitamin A, C (or derivatives of both), Hydroxy Acids (Alpha, Beta or Poly), when you have experienced some sensitivity of the eyes or eye area in the past or have a more problematic skin type.

Eye care products preferably should not contain Vitamin C (L-Asorbic Acid or related) as it requires a low pH value of <4 to be active and do it's job properly. Eye care products with Vitamin C therewith are either too acidic to be used in the eye area or alternatively too alkalic for the Vitamin C to be effective. Safe to use in the eye area are products containing Hyaluronic Acid. Although  "Acid" is in the name, Hyaluronic Acid isn't acidic. One of it's key functions is attract and bind water, which usually has a pH of ~7.

Take care!