Skin Focus: Connective Tissue

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Skin Focus: Connective Tissue
Translated from an article published in German by Dr K Kreft-Weyergans

In the Cosmetics Industry, we pay attention mostly to the condition of the skin, and its appearance.

But what would our largest organ (the skin) be, without connective tissue?

The Connective Tissue plays a significant role in determining how our client feels about him- or herself when they look into the mirror. And it also plays a role in maintaining an attractive figure. When we study Connective Tissue more closely, we discover that it is a Superstar in the arena of beneficial facial and whole body care.

This article deals with the wide range of tasks for which Coonective Tissue is responsible, and in particular with one very specific task related to the so-called physiological or skeletal muscle pump (musculovenous pump).

The most important task of our Connective Tissue is just that - to connect. It connects the skin to our muscles, it surrounds and shapes our organs and it holds them in place. The best known connective tissue fibres are collagen and elastin. Both are chords of protein which are constantly being built-up and broken down again by enzymes in the process we know as 'protein synthesis'. This process occurs in specialised cells called Fibroblasts. Under ideal conditions, the process occurs approximately every 72 hours.


The Connective Tissue determines the appearance of the skin

Collagen is the most prevalent form of protein in the human body. It is an integral component of our blood and lymph vessels, bones, cartilage, ligaments and even our teeth! We already know of almost 30 different types of collagen fibres. The collagen Type 1 fibre is the most significant fibre responsible for the stability and elasticity of the skin.

The other types of collagen fibres make connections with various types of carbohydrates -  mostly polysccharides (sugars). These result in so-called Proteoglycans. Hyaluronic acid is one of the members of this group and is also constantly being formed and renewed in the body. The proteoglycans and hyaluronic acid bind a large amount of water. For this reason, they also play a definitive role in determining the appearnace of our skin. Whether the skin will appear smooth and firm therefore depends on the connective tissue fibres, and also the space between the cells - in other words the extra-cellular space. This space between cells is called the extra-cellular matrix (ECM) and forms an intrinsic part of the connective tissue. In addition, cartilage and bone also collectively form part of the connective tissue.  Some publicationts add fat and even muscles to secial forms of connective tissue.


Connective Tissue create the Look

Our connective tissue also has additional functions. In the subcutaneous fatty tissue, collagen fibres surround the fat cells. When the connective tissue is firm, the shape and size of the fat cells is controlled. They are therefore only able to absorb a certain amount of nutrients and lipids. If a person then eats more than he or she requires, the surplus nutrients are stored in the small intestine. The small intestine now grows in volume and length, resulting in the so-called 'beer-belly'. In people who begin to develop visible fatty deposits in problem areas such as for example around the midrif, legs or bum, the connective tissue clearly is no longer firm or supportive enough. Women are more often affected by this than men. This is only partly due to genetics, according to which, women tend to have longitudinally arranged collagen fibres in their connective tissue, while men tend to have connective tissue with cross-linked collagen fibres. The perfect example is the mediteranean constitutional type, which is depicted by the Venus of Willendorf.

This type of build may have been seen as the beauty-ideal for many centuries, but this genetic disposition is only carried by about one third of women. In other body-types, the condition is acquired.      

Fig 1: The Venus of Willendorf (approx. 30 000BC) is the perfect depiction of the Mediterranean constitutional type. Her weak connective tissue cannot hold her fat cells in shape, so that fat deposits are able to form on the tummy but also on the legs and bum.  

Don Hitchcock, CC BY-SA 4.0 <>, via Wikimedia Commons    

The structure of the collagen fibres (longitudinal or cross-linked) has further implications for another physioogical function - the muskulo-skeletal pump.


Crucial for Lymph flow

The rigid tensile forces of the connective tissue also enable it to hold our muscles and our skin together. This in turn, is important for our lymph- and blood vessels because with every movement, our muscles contract and then relax and expand again, exercising pressure on the vessels. This is particularly important for the lymph vessels, as their contents are rhythmically propelled (pumped) by the action of the muskulo-skeletal pump. In this way, waste products and other particles dissolved in the lymph, are pumped from one lymph-valve to the next. The one-way lymph valves are all arranged to move the lymph from the extremities towards the body. This is the only way in which solid residual and waste particles are able to reach the excretory organs for further detoxification end eventual excretion.

When the connective tissue is longitudinally arranged and becomes weak, this pumping action is no longer effective. No matter how much you move and 'pump' your muscles, a significant part of the force generated by the muskulo-skeletal pump is lost, as the counter-pressure of the dermis is no longer strong enough. The result - lymphflow decreases and the solid particles of metabolic waste are no longer removed effectively. Toxins and acids also remain lodged in the cells and the inter-cellular spaces where they build up over time resulting in the external appearance of cellulite. Cellulite is therefore due to weak connective tissue and the resulting reduced function of the muskulo-skeletal pump.


Causes and Effects

Nowadays, however, weak connective tissue, local fatty deposits and cellulite are no longer primarily the domain of the mediterranean constitutional type as more than 90% of modern women suffer from cellulite! More than a third of all adults are extremely overweight and no longer only store their fat reserves in their abdominal space, but also carry additional ressrves throughout their fatty tissue. In addition, more and more men - especially the younger generation - are diagnosed with cellulite. This did not occur in the past, and is seen as a direct result of our modern life-style which is known for too little exercise and an unbalanced diet which does not supply sufficient of - amongst others - the vitamins required for the production of collagen. These include Vitamin C as well as the anti-oxidants Vitamin E and Beta-carotene which protect the skin cells from oxidative damage.

Environmental factors such as smoking, pollution, UV-rays, Blue light from cellphones, electrosmog or stress can all lead to a reduction in the production of collagen fibres. In this way, environmental  factors contribute to premature ageing and the dysfunction of the muskulo-skeletal pump.

Once acids, metabolic waste products and toxins begin to accumulate in the fat cells or in the inter-cellular matrix, a viscious circle quickly arises. The enzymes which are constantly regenerating the connective tissue through the production of fresh collagen fibres, are no longer able to fulfill their function once they have been poisoned or if the blood can no longer buffer the acidity in the inter-cellular space effectively. These problems are self-made. And that is why there is a solution.


Connective Tissue Tightening? Yes please!

What is this proposed solution supposed to look like? Naturally there are skincare products available which are designed to try to tighten the connective tissue, starting with complexion creams containing collagen. In addition, these creams and lotions also often bind moisture at the surface of the skin, to improve the supply to, and care of, the extracellular matrix. Products containg caffeine, L-Carnitin or Co-Enzyme Q10 are aiming to imrpove blood flow which may assist in improving collagen production. Certain massage-techniques combined with specialised products aim at improving the flow of lymph, thereby assisting in the detoxification of tissues and cells.

A thorough comsultation offering healthy lifestyle advice egarding a balanced and/or non-acidic diet together with exercise, is at least as important as a physical therapy. The most well-known therapies include ultrasonic-, SPM- and gliding wave massage. Passive vessel training during which both the blood flow and the venous-lymphatic return are stimulated, resulting in the cleansing of the tissue fluids, will also helpt to regenerate the connective tissue.


The Often Forgotten Organ

Clearly, there are several different therapies and methods available to tighten connective tissue. We should remember to view it holistically and communicate the options accordingly. The Connective Tissue is often a forgotten organ. We should use the time an opportunity during a consultation or advisory conversation, to explain the intricate relationship between the appearance of the skin, body shape and the condition of our connective tissue.

The same is true of our social media activities. Here we have an opportunity to generate added value by using our posts to generate clarity and understanding about the anatomy and function of connective tissue.

Connective Tissue is the Superstar. It needs more followers that are prepared to modify their lifestyle in order to achieve a better condition for the organ. This is the very best way of preventing premature ageing and to get one's body shape back 'into shape'.

Dr K Kreft-Weyergans
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