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Vandiver et al. Plast Aesthet Res 2020;7:63 Plastic and
DOI: 10.20517/2347-9264.2020.159 Aesthetic Research

Review Open Access

Aging skin and non-surgical procedures: a basic
science overview

Amy R. Vandiver , Sara R. Hogan 1,2
1
1 Division of Dermatology, University of California Los Angeles, Los Angeles, CA 90095, USA.
2 David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.
Correspondence to: Dr. Amy R. Vandiver, Division of Dermatology, University of California Los Angeles, 200 Medical Plaza Suite
450, Los Angeles, CA 90095, USA. E-mail: avandiver@mednet.ucla.edu
How to cite this article: Vandiver AR, Hogan SR. Aging skin and non-surgical procedures: a basic science overview. Plast Aesthet
Res 2020;7:63. http://dx.doi.org/10.20517/2347-9264.2020.159
Received: 1 Aug 2020 First Decision: 7 Aug 2020 Revised: 10 Sep 2020 Accepted: 12 Oct 2020 Published: 6 Nov 2020

Academic Editor: James E. Zins Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Skin aging is a major cosmetic concern and associated with extensive changes in skin function and structure. The
understanding of the basic science underlying skin aging is rapidly progressing, anchored around nine fundamental
hallmarks of aging defined in 2013. Here we present the evidence for the relevance of each hallmark of aging
to skin aging, emphasizing the uniquely prominent roles of oxidative damage and the extracellular matrix in
photoaging. We review the existing evidence for how established treatments of skin aging target each fundamental
hallmark and discuss targets for potential future treatments.

Keywords: Aging, photoaging, intrinsic aging, antiaging, rejuvenation

INTRODUCTION
Skin aging is associated with extensive changes in the structure and function of all aspects of the skin and
serves as a major risk factor for multiple pathologies including atopy, impaired wound healing, infection
[1-5]
and malignancy . In addition to functional concerns, the aging of sun-exposed skin, with the face in
particular, is a major cosmetic concern prompting patients to seek cosmetic procedures. While therapies
to reduce or prevent aging of sun-exposed skin have been present for decades, our understanding of
the basic science underlying aging is rapidly evolving, shedding light on the mechanisms of established
treatments and identifying new treatment targets and methods. In this article, we will discuss the current

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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