DermBlog

Aging Skin

Craig Kraffert, MD

As people grow older, their skin develops changes in both appearance and texture. It becomes drier, more wrinkled and various growths may appear. The skin also tends to heal more slowly.

Some of these skin changes do not cause symptoms and are harmless. Others can be itchy or painful and some, such as skin cancers, are serious and need prompt medical treatment. Many skin problems and conditions associated with aging can be postponed or prevented, and most can be treated by methods currently available.

Dry Skin

As skin ages, it becomes progressively drier. This can result in flaky and itchy skin, especially in cold, dry or windy climates. Milder cases of dry skin can be managed with moisturizer application after bathing, while the skin is still damp.

If dry skin continues to be a problem, a dermatologist consultation is appropriate as severe flaky, itchy and cracked skin may be a sign of a more serious problem. Excessive dryness or itching that doesn’t respond to moisturizers may indicate dermatitis, psoriasis or, on rare occasions, may be the sign of internal problems.

Wrinkles

Proteins, such as collagen and elastin, that keep the skin supple decrease in quantity or function as the skin ages. This results in decreased skin elasticity. The skin also becomes thinner and loses fat, so it appears less plump and smooth. In addition to these changes, gravity constantly pulls down on skin, causing it to sag over time.

The degree of wrinkling is determined by several factors including cumulative lifetime sun exposure and cigarette smoking history. Genetic factors such as skin pigmentation level and variability in cellular biology also play a role in the rate and degree of wrinkle formation.

Skin Lesions

Localized skin growths become more common as skin ages. These can range from harmless brown velvety “seborrheic warts” or flat brown “liver or age spots” to skin cancers that require prompt medical treatment. The following skin findings in a skin growth may in some cases suggest the possibility of skin cancer:

1) A red scaly patch

2) A change in the color, shape or size of a mole

3) A newly formed skin growth, particularly if it doesn’t look like other localized skin growths on the skin surface

4) Bleeding in a mole or other growth

5) A sore that fails to heal

Skin Diseases

There are several skin diseases that occur more commonly in aging skin including shingles, varicose veins, leg ulcers and seborrheic dermatitis.

Shingles (Herpes Zoster): After childhood chicken pox, the chicken pox virus lies dormant in the body. Shingles occur when the chicken pox virus is reactivated in a nerve branch. During the reactivation process, the nerve root is inflamed as the virus reproduces within it. The virus usually spreads from the nerve to the area of skin served by the nerve. This results in blisters appearing in crops along the path of the nerve, usually in a linear fashion.

Early shingles symptoms include localized pain, headache or fatigue. Shingles usually affects only one side of the body. This condition can be serious and is more likely to cause complications such as chronic pain if not treated promptly.

Today, a shingles vaccine is available that greatly reduces the risk of developing shingles as well as the severity of symptoms if it does occur. This vaccine should be carefully considered for those over 60 years of age.

Varicose Veins: These are enlarged leg veins that appear blue and bulging. The veins become twisted and swollen when blood returning to the heart flows back into the veins through a faulty valve. This condition is rarely dangerous.

The aching associated with varicose veins can be eased by the avoidance of prolonged, motionless standing, elevation of the feet when sitting or lying down, and by wearing support hose or elastic bandages. More severe cases can be treated by newer minimally invasive procedures generally referred to as endovenous ablation.

Leg Ulcers: The disturbance of blood flow that results in varicose veins may sometimes cause varicose ulcers, also known as venous or stasis ulcers. When patients with a tendency to form venous ulcers receive minor trauma in a susceptible area of the leg, a sore sometimes forms and spontaneously enlarges. This may result in an ulcer or shallow wound that may contain pus-like discharge. Sometimes these wounds become infected. These ulcers sometimes last for months or even years, especially if left untreated. Leg ulcers may sometimes be associated with other medical disorders such as arteriosclerosis, hypertension and diabetes.

Seborrheic Dermatitis: Redness and greasy-looking “scales” on the skin are signs of seborrheic dermatitis. This condition usually affects areas of the skin with a high concentration of oil glands, such as the scalp, sides of the nose, eyebrows, 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. Safe and effective treatment exists for seborrheic dermatitis, but unfortunately, it is not curable.

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