The skin is the largest, most complex, immune organ that challenges the practicing aesthetician today. Due to its interface function between the body and the environment, the skin is chronically exposed to both endogenous and environmental pro-oxidant agents, leading to premature aging and impaired cellular function. Compelling evidence of premature aging suggests that oxidative stress is the major cause involved in the damage of the skin’s cellular constituents i.e.; keratinocytes, melanocytes, Langerhans, Merkle, mast, fibroblasts, etc. and their DNA, cell membrane lipids, and proteins. The skin’s natural antioxidant network protects these cells against oxidative injury and prevents the production of oxidation products such as 4-hydroxy to 2-nonenal or malonadehyde, which are able to induce protein damage, apoptosis or release of pro-inflammatory mediators, such as cytokines. Inflammatory cytokines exist within the interstitial space in normal and inflamed skin, and are protein mediators. Cytokines govern the inflammatory phase that clears cellular and extra cellular matrix debris. However, the repair process is not always 100 percent, and when oxidative stress overwhelms the skin’s natural antioxidant capacity and the subsequent modifications of cellular redox apparatus lead to an alteration of cell homeostasis and a generation of degenerative processes. One common fear is premature aging of the skin. Aging is a basic biological process common to all living organisms. Its biological mechanisms have yet to be elucidated in detail; however aging is usually understood as an irreversible, progressive loss of homeostatic (cellular balance) capacity. Given this fact, let it not be said the most influential generation dedicated to combating this issue is the infamous Baby Boomer age group. It is this powerful generation fueling the energy to battle aging and demanding skin care products and treatments that produce results. Healthy skin cells mean healthy skin, inside and out. They communicate their needs for nutrition, hormone regulation, cleansing, excretion, defense, repair, identification, etc. Their function is integral to the connective tissue and cosmetic appearance of the skin. Playing a critical role in premature cellular aging is the stratum corneum (SC), housing the final stages of the cells life, and providing a stable environment to keep them healthy. The SC is the outermost layer of the epidermis and its health depends upon the presence of certain lipids in precise associations with cellular proteins. The main components of the SC are phospholipids, glucosyl ceramides, cholesterol (20-25 percent), cholesterol ester, fatty acid (20-25 percent), and triglycerol. For pliability and barrier repair, the SC depends upon the correct balance of lipids and water-soluble substances such as ceramides. Ceramides are important in the construction of the lipid barrier and are imperative to the barrier function, or cohesion-adhesion, of the SC. Ceramides are indigenous in a healthy SC and provide the majority of long-chain fatty acids that make up the majority of linolec acid. Premature aging and mature changing skin lose these valuable constituents throughout the day, via natural desertion, and the daily cleansing process. The critical loss of valuable lipid components command replenishment of ceramides at least twice daily, as part of a nourishing skin care program to combat premature aging. A prudent professional will ensure the application of only human identical ceramides in both the clinical environment and for home care. In addition to ceramides, Hylauronic acid (HA) is critical to battle premature and mature skin aging. HA is a member of the class of amino-sugars containing polysaccharides known as the glycosaminoglycans, aka (GAGS), widely distributed in body tissues. During formation of soluble collagen and the collagen fiber, glycosaminoglycans become bound to peptide chains. These promote the ability of collagen to retain water by holding the soluble fibers apart. HA remains the most effective, anti-aging, moisturizing nutrient for the skin with no reported skin reactions or irritations known. It is the safest indigenous skin agent and the most beneficial to cellular health. HA is able to bind 1000 times its weight in water and acts like a moisture magnet to maintain extra cellular fluidity. As an intercellular ground substance, HA fills the space between the collagen and elastic fibers and is necessary to keep collagen hydrated. HA promotes moisture retention. It also penetrates the skin’s surface with increased water absorption to assist in diminishing wrinkles and treating dry, premature, and mature aging skin. This valuable constituent supports the natural protective mechanism of the skin and can eliminate active oxygen free radicals (ROS) produced by ultraviolet radiation in the epidermis. The most important activity of HA is that it acts as a regulator of cell behavior, influencing cellular metabolism. The skin care professional must apply to the skin as an essential step in a clinical treatment and for home care. HA should be used twice daily with ceramides as an additive to regular continuance of skin care. This application will reduce the signs of premature aging, increase cellular action, and boost skin health. Another premature and mature age related concern is the decrease in the epidermal cellular turnover that is approximately 30-50 percent between the third and eight decade (age 30 – 80) of a skin’s life. One important note is how the epidermal Langerhans cell, largely responsible for recognition of foreign antigens in the skin and the third most important cellular resident in the epidermis, decreases 25-50 percent between early and late adulthood, and substantially contributes to the age-associated decrease in cutaneous immune responsiveness. Photo damage (UVR) exacerbates the loss of Langerhans cells, contributing to the premature aging of the skin. The amount of dermal mast cells likewise decreases with age. One theory related to cellular aging is the Hayflick Theory. The Hayflick limit theory of aging, so called after its discoverer Dr. Leonard Hayflick, suggests that the human cell is limited in the number of times it can divide. Part of this theory could be affected by cell waste accumulation, or toxins collected in the cells brought on by lifestyle imbalances such as stress, smoking, foods, drugs, etc. In 1961, Dr. Hayflick theorized that the human cells ability to divide is limited to approximately 50 times, after which they simply stop dividing and hence die. Each time a cell divides, it duplicates itself of poorer quality than the time before, and thus this eventually leads to cellular dysfunction, aging, and then death. Cell death, however, is the natural order of the life of skin. Strange as it may seem, each day billions of cells kill themselves. Indeed it’s fundamental to our health. Failure of cells to die can lead to problems like cancer, among other serious disorders. Even in the fetus, programmed cell death plays a critical process, helping to shape the developing body. One of the most important reasons for cell death is to get rid of dangerous cells, those that could be harmful to the rest of the organism. Also, positive and negative selection occurs among cells of the immune system. Cells that are infected by a virus can sometimes recognize the infection and kill themselves before the virus has time to replicate and spread to other cells, therefore maintaining steady vigilance to keep the skin healthy. Dr. Hayflick also showed that nutrition has an effect on cells, with overfed cells dividing much faster than underfed cells. Studies have indicated vitamins and their derivatives play an important role in the war against aging cells. There are four important elements a cell needs: nourishment, proliferation, function, and protection. Professional skin care must mirror the needs of the cell to produce healthy skin, and part of an anti-aging skin care program should include naturally based nutritional supplements. Healthy skin from within is a direct result of good nutrition, influencing cellular health. Only 9 percent of Americans eat a healthy, balanced diet, therefore supplementation is important and accounts for up to 50 percent of a constructive skin care program. Unhealthy eating generates free radicals, leading to premature aging skin. One now very famous theory for aging is the “Free Radical Theory of Aging” discovered in 1954 by Dr. Denham Harman, MD, at the University of Nebraska. When referring to premature aging skin, the term free radical has become synonymous with this condition. The expression, free radical, describes any molecule that has a free electron and this matter causes it to react with “healthy molecules” in a destructive manner. Because the free radical molecule has an extra electron, it creates an extra negative charge. This unbalanced energy makes the free radical bind itself to another balanced molecule as it tries to steal electrons. In doing so, the balanced molecule becomes unbalanced, and thus a free radical itself. An example would be to visualize bumper cars at a carnival ride and how disorderly they become as they impact one another. This is how the destruction manifests internally with the cells accelerating the aging process prematurely. Free radicals are known to attack the structure of cell membranes, the gatekeeper, which then create metabolic waste products. Such toxic accumulations interfere with cell communication, disturb DNA, RNA, and protein synthesis, low energy levels, and generally impede vital chemical processes. There is also a natural production of free radicals within the body. This is a result of the production of energy, particularly from the mitochondria, the energy organelle of the cell. The simple process of eating, drinking and breathing forms free radicals from the energy production cycles, as the body produces the universal energy molecule Adenosine Triphosphate (ATP). ATP, a product of the mitochondria, stores readily available chemical energy in two of its chemical bonds and is necessary for cellular homeostasis. Although most aestheticians would rather extract a lesion than understand a complex science like free radical theory of aging, ATP, homeostasis, etc, the truth of skin care today lies in the fact that we are obligated to learn the complex culprits that influence premature skin aging so we can initiate appropriate clinical remedies and continuance of home skin care for optimal results. Aestheticians must surrender to the fact that they are professionally responsible to raise the bar of skin treatments and continuance of home care for clients to combat these negative intrinsic and extrinsic effects that impact the skin and facilitate restoration function to unhealthy cells. Every skin care professional should approach caring for this complex immune organ using science based knowledge rather than anecdotal and clever marketing manipulations calculated to trick even the most savvy aesthetician or physician. Protecting the skin against the overload of inflammatory environmental assaults that bring on premature aging means the aesthetician and physician must select “professional only” products where the company employs the skin as a model for their product formulations. In conclusion, to obtain results to increase cellular health, professional only skin care products should contain a well organized system of both chemical and enzymatic antioxidants, peptides, and AHA’s coupled with skin indigenous barrier repair and stratum corneum lipids capable of synergistic action to mimic a younger acting skin. Christine Heathman, Master Aesthetician, CME, LMT is the Founder and CEO of Glymed Plus. With over 20 years of practicing clinical aesthetics, her experience with the medical profession is well established. As a licensed professional she holds three licenses in aesthetics, one in California, a Master License in Utah and one in Europe. As the Director of Education for the Gly-Med Institute of Skin Sciences in Spanish Fork, Utah, Christine directs and provides the skin care professional with exceptional training. Her dedication to education is well established in the skin care industry and is known on a global basis for exceptional schooling in advanced skin care. For more information, please contact her via e-mail at This email address is being protected from spambots. You need JavaScript enabled to view it. .Want to read more? Subscribe to one of our monthly plans to continue reading this article.