Aging Skin

As we grow older, we see and feel certain changes in our skin, the body’s largest and most visible organ .It
becomes drier, more wrinkled and spots and growths appear. The skin tends to heal more slowly.

Some of these changes are natural, unavoidable and harmless. Others are itchy or painful, and some such as
skin cancers, are serious and require immediate medical attention. Many problems can be prevented whether
avoidable or not, health endangering or merely cosmetically undesirable, most unwanted aging-associated skin
problems can be addressed by therapies now available.

Wrinkles
As skin ages, it loses its elasticity. Collagen and elastin, the tissues that keep the skin supple, weaken. The skin
becomes thinner and loses fat, so that it looks less plump and smooth. While all these changes are taking place,
gravity is also at work, pulling at the skin , causing it to sag.

Can Wrinkles Be Avoided?
How wrinkled your skin becomes depends largely on how much sun you have been exposed to in your lifetime.
The sun is the major cause of unwanted changes in the skin with aging .Cigarette smoking can also contribute to
wrinkles. Wrinkles also depend on your parents the tendency to wrinkle is inherited.

The good news is some wrinkles can be prevented. To avoid wrinkles caused by the sun, beginning childhood,
always wear a sunscreen with an SPF of at least 15, a hat with a brim and other protective clothing when in the
sun. Don’t deliberately sunbathe and limit sun exposure between 10 am and 3 p.m. If you have already sun-
damaged your skin, you will still benefit from beginning sun protection as an adult. Over the counter “wrinkle”
creams and lotions may help dry skin and make if feel better, but they do little or nothing to reverse wrinkles

Treatments for Aging Skin
There are some promising treatments for aging skin. Retinoic acid, a cream that has been used successfully
in treating acne, has been shown to improve the surface texture of the skin, reduce irregular pigmentation,
and increase dermal collagen. It is currently the only treatment approved by the FDA as safe and effective for
reversing some of the effects of sun damage. Alpha hydroxy acids also show promise in reversing some of the
effects of the sun. Creases caused by facial expressions such as squinting, frowning or a dermatologist, using
what are called dermal fillers,. A naturally produced toxin can also be used to relax the small muscles and thus
eliminate fixed expression lines like frown markers.

None of these remedies can guarantee eternally youthful skin, but they can improve the overall appearance
of your skin . Severely wrinkled skin can be improved with surgery, lasers or chemical peels. Before you
undertake any home-treatments or surgery, discuss your options with your dermatologist.

Dry Skin
As we age, our skin becomes drier. This can result in flaky and itchy skin, especially in cold,dry,windy
climates .Milder cases of dry skin can be managed with a moisturizer used after bathing, while the skin is still
damp.Oils may be added to the bath water, but then the tub can become dangerously slippery.

Petrolatum, an ingredient in many lotions,creams and ointments is an excellent moisturizer.Many moisturizers
contain chemicals such as urea, alpha hydroxy acids, lactic acid, or ammoniukm lactate to reduce scaling and
help the skin hold water.Some of these chemicals can irritate the skin, however.Your dermatologist can help
you decide which is best for you.

Bathing less often and using milder soaps or a soap substitute, or soaking in a tub of warm water without soap
can help relieve dry skin.Hot water is more irritating to dry skin than simply warm water. After bathing and
drying off a moisturizer such as petrolatum or lanolin should be applied immediately to seal in moisture.

If dry skin continues to be a problem consult your dermatologist. Severe flaky, itchy and cracked skin may be a
sign of a more serious problem.

Skin Lesions
Skin growth and lesions become more common as we age. They may range from harmless seborrheic warts
liver spots or age spots to skin cancers that require immediate treatment.Most are caused by years of sun
exposure.

Among the most common are red, scaly spots called actinic keratoses . If ignored, they may become skin
cancers that eventually need to be removed surgically . In the early stages they can be removed by applying a
chemotherapy cream or freezing with liquid nitrogen.

Squamous cell carcinoma typically develops on the rim of the ear,the face, the lips or the back of hands.These
skin cancers can destroy normal tissue and occasionally spread to internal organs.

The most common form of skin cancer is basal cell carcinoma .It usually appears as a small, shiny ,flesh bump
on the head neck or chest.It more common in older fair-skinned people with blond or red hair and blue or green
eyes. Untreated,these skin cancers can bleed and crust over They grow slowly and rarely spread to other parts of
the body.When treated early squamous cell and basal cell skin cancers have a95 percent cure rate.

Malignant Melanoma is a less common but more serious form of skin cancer. This skin cancer usually appears
as a dark brown or black mole-like growth with irregular borders and variable colors.Men over the age of 50 are
at the highest risk for melanoma, but it can affect anyone of any age. Melanoma has been associated with severe
childhood sunburns.The most frequent sited for melanoma are the upper back in both men and women, the chest
and abdomen in men and the lower legs of women.

Any change in an existing mole could be a sign of melanoma and should be examined immediately by a
dermatologist. Melanoma can spread to other organs and can be fatal.

Other Growths
Several other skin growths are common in older individuals.These include:

“Age spots” or “liver spots” – These flat, brown areas are called lentigines. They have nothing to do with
the liver- they are caused by the sun and usually appear on the face,hands,back and feet.They are generally
harmless, although large flat irregular dark areas can be a form of melanoma and require evaluation and
treatment. Commercial “fade” creams will not make lentigines disappear ,but effective prescription medications
and laser therapies are available.

Seborrheic Keratoses – These brown or black raised spots or wart-like growths look like they were stuck on the
skin surface.They are not cancerous and are very common in older people.If annoying , they can be removed
easily.

Cherry Angiomas- These are harmless,small, bright red domes created by dilated blood vessels.They occur in
more than 85 percent of middle-aged and elderly people,usually on the trunk . Electrocautery or laser therapy
removes these spots.

“Broken capillaries” or Telangiectosia – These dilated facial blood vessels are usually related to sun
damage.They respond to the same treatments as angiomes.

Skin Diseases
Some skin diseases more common in older people are shingles ( herpes zoster), varicose veins, leg ulcers and
seborrheic dermatitis.

Shingles/ Herpes Zoster – Shingles is an inflammation of a nerve caused by the same virus as chicken pox.
Early symptoms are localized pain, headache or fatigue. Shingles can affect people of all ages, but is more
common (and painful) in older adults.

The virus attacks a nerve root and follows the course of that nerve.It results in lines of blisters on the
scalp,face,trunk or extremities .The disease usually only affects one side of the body.

Shingles can become serious and cause complications.A dermatologist should be contacted immediately if
shingles is suspected, especially if the condition appears near the eyes ,as treatments are most effective if started
within 3 days of onset.

Seborrheic Dermatitis – The signs of seborrheic dermatitis are redness and greasy- looking “scales” on the
skin it usually affects areas of the skin with a high concentration of oil glands, such as the scalp, sides of the
nose,eyebrow,eyelids,behind the ears, and the middle of the chest. It occasionally affects other areas such as the
navel,breasts,buttocks and skin folds under the arms.

Seborrhea dermatitis can be successfully treated and may even go away on its own, but it tends to recur.
Frequent shampooing and washing are very helpful and your dermatologist may prescribe topical medications,
including low-strength cortisone preparations and special shampoos.

Varicose Veins – These are enlarged leg veins that appear blue and bluging. They are common in older
individuals. The veins become twisted and swollen when blood returning to the heart against gravity flows back
into the veins through a faulty valve. This condition is rarely dangerous.

The aching associated with varicose veins can be eased by avoiding standing for long periods, by keeping feet
elevated when sitting or lying down and by wearing support hose or elastic bandages. More severe cases can be
treated with surgery. Injections or laser therapy may remove smaller varicosities.

Varicose Ulcers- The same sluggish blood flow that results in varicose veins can cause varicose ulcers,
also known as venous or stasis ulcers. When a crack or cut occurs in the skin of the leg, it may fail to heal
because of poor blood flow. The injury can develop into an ulcer or a shallow wound that may contain pus or
infection .The ulcers may last for months or even years, healing poorly.

Varicose ulcers often develop at the ankles. They may be accompanied by swelling and red, itchy, scaly skin
around the ulcer. Another cause of ulcers on the legs is poor blood flow in the arteries. This condition is
associated with medical disorders such as arteriosclerosis, hypertension and diabetes.

Bruising (Purpura) – Many seniors complain of black and blue marks or bruises, particularly on the arms
and legs. These are usually a result of the skin becoming thinner with age and sun damage. Loss of fat and
connective tissue weakens the support around blood vessels, making them more susceptible to injury. Bruising
in areas always covered by clothing should be evaluated. Bruising sometimes is caused by medications that
interfere with blood clotting or internal disease.

Itching – A very common problem with aging skin is itching. Although often associated with dry skin, itching
also has other causes. Elderly skin appear to be more sensitive to fabric preservatives, wool,plastics,detergents,
bleaches, soaps and other irritants. Identifying and limiting exposure to the cause is important. Prolonged
itching may lead to lack of sleep and fatigue. Your dermatologist can often offer some medical remedies for
itching if moisturizing alone is ineffective.

Although most of the changes we experience in our skin as we age are harmless, there are certain signs of
more serious problems that shouldn’t be ignored. See your dermatologist if you notice any of the following
symptoms:

Symptom  A scaly red spot A change in color, Shape or size of a mole Any new skin growth Bleeding in a mole or Other growth Excessive dryness and itching that doesn’t respond to moisturizers Vague or sharp local pain or headache followed by the formation of groups of blisters Bulging or tender veins in Leg A sore that fails to heal

May Indicate Skin cancer Dermatitis, Psoriasis, Internal problems Shingles varicose veins Skin cancer, Circulatory Problem. Diabetes