Cynthia had always been proud of her skin, especially her summer tan. But, as years went by, she saw her skin getting more fine lines and wrinkles. Cynthia began to worry about what other skin problems she might have. What are those brown spots on her hands and arms?
Your skin changes with age. It becomes thinner, loses fat, and no longer looks as plump and smooth as it once did. Your veins and bones can be seen more easily. Scratches, cuts, or bumps can take longer to heal. Years of sun tanning or being out in the sunlight for a long time may lead to wrinkles, dryness, age spots, and even cancer. But, there are things you can do to protect your skin and to make it feel and look better.
Dry Skin and Itching
Many older people suffer from dry spots on their skin, often on their lower legs, elbows, and lower arms. Dry skin patches feel rough and scaly. There are many possible reasons for dry skin, such as:
- Not drinking enough liquids
- Spending too much time in the sun or sun tanning
- Being in very dry air
- Smoking
- Feeling stress
- Losing sweat and oil glands, which is common with age
Dry skin also can be caused by health problems, such as diabetes or kidney disease. Using too much soap, antiperspirant, or perfume and taking hot baths can make dry skin worse.
Some medicines can make skin itchy. Because older people have thinner skin, scratching can cause bleeding that may lead to infection. Talk to your doctor if your skin is very dry and itchy.
Here are some ways to help dry, itchy skin:
- Use moisturizers, like lotions, creams, or ointments, every day.
- Take fewer baths or showers and use milder soap. Warm water is less drying than hot water. Don't add bath oil to your water. It can make the tub too slippery.
- Try using a humidifier, an appliance that adds moisture to a room.
Bruises
Older people may bruise more easily than younger people. It can take longer for these bruises to heal. Some medicines or illnesses may also cause bruising. Talk to your doctor if you see bruises and don't know how you got them, especially on parts of your body usually covered by clothing.
Wrinkles
Over time, skin begins to wrinkle. Things in the environment, like ultraviolet (UV) light from the sun, can make the skin less elastic. Gravity can cause skin to sag and wrinkle. Certain habits, like smoking, also can wrinkle the skin.
A lot of claims are made about how to make wrinkles go away. Most of them don't work. Some methods can be painful or even dangerous, and many must be done by a doctor. Talk with a doctor specially trained in skin problems, called a dermatologist, or your regular doctor if you are worried about wrinkles.
Age spots, once called "liver spots," are flat, brown spots often caused by years in the sun. They are bigger than freckles and commonly show up on areas like the face, hands, arms, back, and feet. Using a broad-spectrum sunscreen that helps protect against two types of the sun's rays (UVA and UVB) may prevent more age spots.
Skin tags are small, usually flesh-colored growths of skin that have a raised surface. They become common as people age, especially for women. They are most often found on the eyelids, neck, and body folds such as the armpit, chest, and groin.
Age spots and skin tags are harmless, although sometimes skin tags can become irritated. If your age spots or skin tags bother you, talk to your doctor about having them removed.
Skin Cancer
Skin cancer is a very common type of cancer in the United States. The main cause of skin cancer is the sun. Sunlamps and tanning booths can also cause skin cancer. Anyone, of any skin color, can get skin cancer. People with fair skin that freckles easily are at greatest risk. Skin cancer may be cured if it is found before it spreads to other parts of the body.
There are three types of skin cancers. Two types, basal cell carcinoma and squamous cell carcinoma, grow slowly and rarely spread to other parts of the body. These types of cancer are usually found on parts of the skin most often exposed to the sun, like the head, face, neck, hands, and arms. But they can happen anywhere on your body. The third and most dangerous type of skin cancer is melanoma. It is rarer than the other types, but it can spread to other organs and be deadly.
Check your skin once a month for things that may be signs of cancer. Skin cancer is rarely painful. Look for changes such as a new growth, a sore that doesn't heal, or a bleeding mole.
A = Asymmetry (one half of the growth looks different from the other half)
B = Borders that are irregular
C = Color changes or more than one color
D = Diameter greater than the size of a pencil eraser
E = Evolving; this means the growth changes in size, shape, symptoms (itching, tenderness), surface (especially bleeding), or shades of color
See your doctor right away if you have any of these signs to make sure it is not skin cancer.
Keep Your Skin Healthy
Some sun can be good for you, but to keep your skin healthy, be careful:
- Limit time in the sun. It's okay to go out during the day, but try to avoid being in sun during peak times when the sun's rays are strongest. For example, during the summer, try to stay out of the sun between 10 a.m. and 4 p.m. Don't be fooled by cloudy skies. The sun's rays can go through clouds. You can also get sunburned if you are in water, so be careful when you are in a pool, lake, or the ocean.
- Use sunscreen. Look for sunscreen with an SPF (sun protection factor) number of 15 or higher. It's best to choose sunscreens with "broad spectrum" on the label. Put the sunscreen on 15 to 30 minutes before you go outside. Sunscreen should be reapplied at least every 2 hours. You need to put sunscreen on more often if you are swimming, sweating, or rubbing your skin with a towel.
- Wear protective clothing. A hat with a wide brim can shade your neck, ears, eyes, and head. Look for sunglasses that block 99 to 100 percent of the sun's rays. If you have to be in the sun, wear loose, lightweight, long-sleeved shirts and long pants or long skirts.
- Avoid tanning. Don't use sunlamps or tanning beds. Tanning pills are not approved by the U.S. Food and Drug Administration (FDA) and might not be safe.
Your skin may change with age. But remember, there are things you can do to help. Check your skin often. If you find any changes that worry you, see your doctor.
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For More Information About Skin Care and Aging
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 skinSkin 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.
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