The Natural Aging Process of Skin

HealthAfter50 | Nov 9, 2017

Reviewed by Edward E. Wallach, M.D.

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Aging affects the skin in ways you can’t always see in the mirror. The normal aging process—combined with a lifetime of sun exposure—leads to skin that becomes thin, lax, and easier to tear, making it vulnerable to disorders and diseases and weakening its ability to protect you. You can promote your own skin health by seeing your doctor promptly for expert advice if you suspect you have any of the following skin conditions.

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Natural aging: part 1

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Natural aging of skin is marked by:

  • A slowing of cell turnover—when new skin cells replace old—resulting in a progressive loss of skin cells, making skin more fragile and susceptible to injury and infection.
  • Reduced blood flow to the skin, which leads to increased bruising and slower healing.
  • Loss of subcutaneous fat, which makes up the bottom layer of skin that serves as insulation, making it harder to conserve heat and absorb shocks.
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Natural aging: part 2

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  • A decrease in the number of sweat glands, which compromises the body’s cooling system.
  • Repeated exposure to ultraviolet rays from the sun accelerates certain changes to the skin and causes additional damage. The more damage, the more vulnerable skin becomes to disorders, sometimes serious enough to affect your quality of life. Experts also warn that some dermatological changes may be signs of more serious underlying conditions and shouldn’t be overlooked.
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Xerosis: part 1

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Xerosis, simply put, is very dry skin. Anyone can get dry skin, but older adults are more susceptible. They’re also more likely to take medications that can dry skin. Preventing and soothing dry skin is important because xerosis is an underlying cause of other skin disorders, such as eczema or an infection. Without extra care to retain proper moisture balance, dry skin can become rough, scaly, flaky, and itchy and appear gray or ashen in people with dark skin tones.

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Xerosis: part 2

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Dry skin is itchy, and scratching tears it. Continued itching and scratching can cause a condition called lichenification—hardened, thickened, leathery patches. Dry skin cracks easily, may bleed or weep, and heals slowly, allowing germs to enter through breaks and cracks, causing infection. In this case, simply remoisturizing is unlikely to correct it. To treat it, you may need a prescription cream or ointment to tame the itch, and treatment to heal an infection or other condition.

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Pruritus: part 1

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Pruritus, or itchy skin, is one of the most common skin complaints of older adults. The itching itself may be related to xerosis, a drug side effect, or a symptom of another problem, such as eczema or shingles. Determining the cause of the itching is important. Itchy skin without a rash may signal an underlying condition such as iron deficiency, lymphoma, or problems with thyroid, liver, or kidney function.

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Pruritus: part 2

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To treat it, a hypoallergenic lubricating lotion may relieve itching. A lotion that contains menthol, camphor, or phenol may provide relief in the form of a cooling sensation. Your doctor may prescribe a topical agent with corticosteroids or lidocaine (a local anesthetic). More severe cases may require short-term antihistamines.

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Asteatotic eczema

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Asteatotic eczema is a form of xerosis. With this eczema type, the skin rash appears as scaly plaques with interconnected fissures, giving the appearance of cracked porcelain. The rash typically occurs on the lower legs (called eczema craquelé) but may also surface on the upper arms, thighs, or lower back. To treat it, try moisturizing and avoiding environmental irritants that exacerbate the condition, such as very cold air or very hot bathwater.

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Seborrheic keratosis

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A seborrheic keratosis is a usually harmless skin growth, tumor, or lesion on skin where hair grows, such as the head, neck or trunk. It can vary in appearance; are usually tan to dark brown; and have a rough, wart-like surface that can make them appear “stuck” on the skin. A doctor should examine the growths to rule out cancer. To treat it, many people have them removed for cosmetic reasons, but removing them may be medically necessary if they bleed, itch, cause pain, or obstruct vision.

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Contact dermatitis

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Contact dermatitis refers to a condition where the skin becomes red and inflamed, resembling a burn, in response to contact with an irritant or an allergen. The decreased immune response associated with aging makes allergic-related dermatitis less likely. However, you may find that you become more sensitive to irritants like fragrances. To treat it, eliminate the offending triggers. Common culprits include nickel, fragrances, and ingredients found in some perfumes, cosmetics, and toiletries.

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Bullous pemphigoid

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Bullous pemphigoid appears as a sometimes-itchy rash of large blisters that come and go on either normal or inflamed skin, often in the creases of the arms and legs. It’s considered an autoimmune disorder but thought to be harmless. Certain medications, such as furosemide (to reduce water retention) and enalapril (to treat high blood pressure or heart failure), may trigger the condition. To treat it, try oral or topical corticosteroids.

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Venous insufficiency

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Venous insufficiency may cause redness or skin color changes in the legs or ankles, varicose veins, leg ulcers, or a hardening of the skin called lipodermatosclerosis. It is a chronic vascular condition that impedes blood flow in the legs. It’s not a dermatological disorder, but its symptoms can make it appear so. To treat it, try compression stockings and elevation of the affected limb. Topical steroids or antibiotics may be prescribed to treat the skin-affecting symptoms.

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Shingles

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Shingles (herpes zoster) appears as a painful, blistering skin rash triggered by a form of previously dormant varicella-zoster virus, the same virus that causes chickenpox. It can last for two weeks and eventually crusts over, but nerve pain can persist. To treat it, antiviral drugs are most effective when used within three days of the rash’s appearance. Additional therapies may treat ongoing pain. The best treatment is prevention: ask your physician for a shingles vaccine if you’re over 60.

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Actinic keratosis: part 1

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Actinic keratosis develops as a dry, flat, scaly spot and is caused by cumulative sun damage. The rough-textured lesion feels hard and calloused and can range from the size of a pinhead to larger than a quarter. Color may be skin tone to reddish brown. Actinic keratoses take years to develop and appear on sun-exposed areas, such as the face, scalp, neck, and hands. People who develop numerous actinic keratoses tend to have repeated occurrences throughout life.

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Actinic keratosis: part 2

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To treat it, actinic keratoses or any skin lesions should never be dismissed as “just age spots.” They have the potential to become squamous cell carcinoma, a serious form of skin cancer. See your doctor for evaluation and treatment.

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Skin cancer: part 1

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Skin cancers are the most common cancer type in the world, with more than 2 million cases diagnosed in the United States each year. Most people get skin cancer from too much sun (or tanning beds). Fortunately, when most skin cancers, such as basal cell cancers, are caught early, they can be cured. Even potentially more serious types, such as squamous cell cancer and melanoma, have high cure rates when detected at an early stage.

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Skin cancer: part 2

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To treat it, any new, growing or changing skin growths or moles, especially those that bleed, itch or cause pain, should be checked out by a doctor, who can recommend treatment, if needed.