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Skin changes are among the most visible signs of aging. Evidence of increasing age includes wrinkles and sagging skin. Whitening or graying of the hair is another obvious sign of aging.
Your skin does many things. It:
- Contains nerve receptors that allow you to feel touch, pain, and pressure
- Helps control fluid and electrolyte balance
- Helps control your body temperature
- Protects you from the environment
Although skin has many layers, it can generally be divided into three main parts:
- The outer part (epidermis) contains skin cells, pigment, and proteins.
- The middle part (dermis) contains skin cells, blood vessels, nerves, hair follicles, and oil glands. The dermis provides nutrients to the epidermis.
- The inner layer under the dermis (the subcutaneous layer) contains sweat glands, some hair follicles, blood vessels, and fat.
Each layer also contains connective tissue with collagen fibers to give support and elastin fibers to provide flexibility and strength.
Watch this video about:Components of skin
Skin changes are related to environmental factors, genetic makeup, nutrition, and other factors. The greatest single factor, though, is sun exposure. You can see this by comparing areas of your body that have regular sun exposure with areas that are protected from sunlight.
Natural pigments seem to provide some protection against sun-induced skin damage. Blue-eyed, fair-skinned people show more aging skin changes than people with darker, more heavily pigmented skin.
AGING CHANGES
With aging, the outer skin layer (epidermis) thins, even though the number of cell layers remains unchanged.
The number of pigment-containing cells (melanocytes) decreases. The remaining melanocytes increase in size. Aging skin looks thinner, paler, and clear (translucent). Pigmented spots including age spots or "liver spots" may appear in sun-exposed areas. The medical term for these areas is lentigos.
Changes in the connective tissue reduce the skin's strength and elasticity. This is known as elastosis. It is more noticeable in sun-exposed areas (solar elastosis). Elastosis produces the leathery, weather-beaten appearance common to farmers, sailors, and others who spend a large amount of time outdoors.
The blood vessels of the dermis become more fragile. This leads to bruising, bleeding under the skin (often called senile purpura), cherry angiomas, and similar conditions.
Sebaceous glands produce less oil as you age. Men experience a minimal decrease, most often after the age of 80. Women gradually produce less oil beginning after menopause. This can make it harder to keep the skin moist, resulting in dryness and itchiness.
The subcutaneous fat layer thins so it has less insulation and padding. This increases your risk of skin injury and reduces your ability to maintain body temperature. Because you have less natural insulation, you can get hypothermia in cold weather.
Some medicines are absorbed by the fat layer. Shrinkage of this layer may change the way that these medicines work.
The sweat glands produce less sweat. This makes it harder to keep cool. Your risk for overheating or developing heat stroke increases.
Growths such as skin tags, warts, brown rough patches (seborrheic keratoses), and other blemishes are more common in older people. Also common are pinkish rough patches (actinic keratosis) which have a small chance of becoming a skin cancer.
EFFECT OF CHANGES
As you age, you are at increased risk for skin injury. Your skin is thinner, more fragile, and you lose some of the protective fat layer. You also may be less able to sense touch, pressure, vibration, heat, and cold.
Rubbing or pulling on the skin can cause skin tears. Fragile blood vessels can break easily. Bruises, flat collections of blood (purpura), and raised collections of blood (hematomas) may form after even a minor injury.
Pressure ulcers can be caused by skin changes, loss of the fat layer, reduced activity, poor nutrition, and illnesses. Sores are most easily seen on the outside surface of the forearms, but they can occur anywhere on the body.
Aging skin repairs itself more slowly than younger skin. Wound healing may be up to 4 times slower. This contributes to pressure ulcers and infections. Diabetes, blood vessel changes, lowered immunity, and other factors also affect healing.
COMMON PROBLEMS
Skin disorders are so common among older people that it is often hard to tell normal changes from those related to a disorder. More than 90% of all older people have some type of skin disorder.
Skin disorders can be caused by many conditions, including:
Other causes of skin changes:
- Allergies to plants and other substances
- Climate
- Clothing
- Exposures to industrial and household chemicals
- Indoor heating
Sunlight can cause:
- Loss of elasticity (elastosis)
- Noncancerous skin growths (keratoacanthomas)
- Pigment changes such as liver spots
- Thickening of the skin
Sun exposure has also been directly linked to skin cancers, including basal cell cancer, squamous cell carcinoma, and melanoma.
PREVENTION
Because most skin changes are related to sun exposure, prevention is a lifelong process.
- Prevent sunburn if at all possible.
- Use a good quality sunscreen when outdoors, even in the winter.
- Wear protective clothing and a hat when needed.
Good nutrition and adequate fluids are also helpful. Dehydration increases the risk of skin injury. Sometimes minor nutritional deficiencies can cause rashes, skin lesions, and other skin changes, even if you have no other symptoms.
Keep skin moist with lotions and other moisturizers. Do not use soaps that are heavily perfumed. Bath oils are not recommended because they can cause you to slip and fall. Moist skin is more comfortable and will heal more quickly.
RELATED TOPICS
Reviewed by Jabeen Begum on October 08, 2021
Our skin is at the mercy of many forces as we age: sun, harsh weather, and bad habits. But we can take steps to help our skin stay supple and fresh-looking. How your skin ages will depend on a variety of factors: your lifestyle, diet, heredity, and other personal habits. For instance, smoking can produce free radicals, once-healthy oxygen molecules that are now overactive and unstable. Free radicals damage cells, leading to, among other things, premature wrinkles. There are other reasons, too. Primary factors contributing to wrinkled, spotted skin include normal aging, exposure to the sun (photoaging) and pollution, and loss of subcutaneous support (fatty tissue between your skin and muscle). Other factors that contribute to aging of the skin include stress, gravity, daily facial movement, obesity, and even sleep position.
As we grow older, changes like these naturally occur:
- Skin becomes rougher.
- Skin develops lesions such as benign tumors.
- Skin becomes slack. The loss of the elastic tissue (elastin) in the skin with age causes the skin to hang loosely.
- Skin becomes more transparent. This is caused by thinning of the epidermis (surface layer of the skin).
- Skin becomes more fragile. This is caused by a flattening of the area where the epidermis and dermis (layer of skin under the epidermis) come together.
- Skin becomes more easily bruised. This is due to thinner blood vessel walls.
Changes below the skin also become evident as we age. They include:
- Loss of fat below the skin in the cheeks, temples, chin, nose, and eye area may result in a leaner look, loosening skin, sunken eyes, and a "skeletal" appearance.
- Bone loss, mostly around the mouth and chin, may become evident after age 60 and cause puckering of the skin around the mouth.
- Cartilage loss in the nose causes drooping of the nasal tip and accentuation of the bony structures in the nose.
Exposure to sunlight is the single biggest culprit in aging skin.
Over time, the sun's ultraviolet (UV) light damages certain fibers in the skin called elastin. The breakdown of elastin fibers causes the skin to sag, stretch, and lose its ability to snap back after stretching. The skin also bruises and tears more easily and takes longer to heal. So while sun damage may not show when you're young, it will later in life.
Nothing can completely undo sun damage, although the skin can sometimes repair itself. Lasers can also help reverse some of the damage. It's never too late to begin protecting yourself from sun exposure and skin cancer. You can delay changes associated with aging by staying out of the sun and making a habit of using sunscreen with zinc oxide as a physical blocker and an SPF of 30 or more. A sunscreen with iron oxide blocks visible light (that leads to pigmentation problems) and blue light (that causes skin aging, similar to UVA light). Also, wear clothing to cover skin exposed to the sun, such as long-sleeved shirts, pants, broad-brimmed hats, and sunglasses.
Gravity, facial movement, and sleep position are the secondary factors that contribute to changes in the skin. When the skin loses its elasticity, gravity causes drooping of the eyebrows and eyelids, looseness and fullness under the cheeks and jaw (jowls and "double chin"), and longer ear lobes. Facial movement lines become more visible after the skin starts losing its elasticity (usually as people reach their 30s and 40s). Lines may appear horizontally on the forehead, vertically on the skin above the root of the nose (glabella), or as small curved lines on the temples, upper cheeks, and around the mouth. Sleep creases result from the way the head is positioned on the pillow and may become more visible after the skin starts losing its elasticity. Sleep creases are commonly located on the side of the forehead, starting above the eyebrows to the hairline near the temples, as well as on the middle of the cheeks. Sleeping on your back may improve these sleep creases or prevent them from becoming worse. Smokers tend to have more wrinkles than nonsmokers of the same age, complexion, and history of sun exposure. Dry skin and itching are common in later life. About 85% of older people develop "winter itch," because overheated indoor air is dry. The loss of oil glands as we age may also worsen dry skin. Anything that further dries the skin (such as overuse of soaps or hot baths) will make the problem worse. If your skin is very dry and itchy, see a doctor because this condition can affect your sleep, cause irritability, or be a symptom of a disease. Some medicines make the itchiness worse.