AGING CHANGES IN THE SKIN
Authors: Dr. Anuradha Kapoor
Aging changes are a group of common conditions and developments that occur as people grow older. 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:
Your skin does many things. It:
Fig 1:Normal skin:3 layers of normal skin
fig 2: detailed diagrame of epidermis layer:
Although skin has many layers, it can generally be divided into three main parts:
SKIN CHANGES WITH PROCESS OF AGING
As we grow older, changes like these naturally occur:
Changes in dermis:
Changes in The subcutaneous fatlayer
Fig 4: AGING CHANGES IN SKIN
Fig 5:
Fig 6: skin changes according to age
CHANGES BELOW THE SKIN Also become evident as we age. They include:
BECAUSE OF ABOVE AGING PROCESSES SKIN CHANGES IN FACE:
CAUSES OF SKIN AGING:
How your skin ages will depend on a variety of factors: your lifestyle, diet, heredity, and other personal habit. There are other reasons, too. Many things cause our skin to age. Some things we cannot do anything about; others we can influence
1. Intrinsic aging OrNatural aging processand genetic makeup,
One thing that we cannot change is the natural aging process. It plays a key role. With time, we all get visible lines on our face. It is natural for our face to lose some of its youthful fullness. We notice our skin becoming thinner and drier. Our genes largely control when these changes occur. The medical term for this type of aging is “intrinsic aging.”
2. Extrinsic aging.
We can influence another type of aging that affects our skin. Our environment and lifestyle choices can cause our skin to age prematurely. The medical term for this type of aging is “extrinsic aging.” By taking some preventive actions, we can slow the effects that this type of aging has on our skin.
Causes of extrinsic aging: Skin changes are related to
ENVIRONMENTAL FACTORS:
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). 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. Sun and Your Skin 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. So, 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 , covering up, wearing a hat, and making a habit of using sunscreen.
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.
NUTRITION, AND LIFESTYLE CHANGES:
Lack of healthy nutriens in diet
Findings from a few studies suggest that eating plenty of fresh fruits and vegetables may help prevent damage that leads to premature skin aging. Findings from research studies also suggest that a diet containing lots of sugar or other refined carbohydrates can accelerate aging.
Sedentary lifestyle lack of Exercise: Findings from a few studies suggest that moderate exercise can improve circulation and boost the immune system. This, in turn, may give the skin a more-youthful appearance.
Drinking alcohol: Alcohol is rough on the skin. It dehydrates the skin, and in time, damages the skin. This can make us look older.
Smoking: 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.If you smoke, stop. Smoking greatly speeds up how quickly skin ages. It causes wrinkles and a dull, sallow complexion.Smokers tend to have more wrinkles than nonsmokers of the same age, complexion, and history of sun exposure.
OTHER FACTORS: Gravity, facial movement, and sleep position are the secondary factors that contribute to changes in the skin.
Effect of gravity: 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.
Effect of repetativefacial movement :Repetitive facial expressions:
Avoid repetitive facial expressions. When you make a facial expression, you contract the underlying muscles. If you repeatedly contract the same muscles for many years, these lines become permanent. Wearing sunglasses can help reduce lines caused by squinting. 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.
Effect of sleep position.
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.
Rough handling of skin:
Cleanse your skin gently. Scrubbing your skin clean can irritate your skin. Irritating your skin accelerates skin aging. Gentle washing helps to remove pollution, makeup, and other substances without irritating your skin.
Wash your face twice a day and after sweating heavily. Perspiration, especially when wearing a hat or helmet, irritates the skin, so you want to wash your skin as soon as possible after sweating.Apply a facial moisturizer every day. Moisturizer traps water in our skin, giving it a more youthful appearance.
Stop using skin care products that sting or burn. When your skin burns or stings, it means your skin is irritated. Irritating your skin can make it look older.
EFFECT OF CHANGES OF SKIN ON GENERAL HEALTH OF A PERSON
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:
Sunlight can cause:
Sun exposure has also been directly linked to skin cancers, including basal cell cancer, squamous cell carcinoma, and melanoma.
PREVENTION: prevention is better than cure. So here applies the theory of prevention for skin also. Because most skin changes are related to sun exposure, prevention is a lifelong process. There are ways to reduce premature skin aging:
Prevent sunburn if at all possible.The sun plays a major role in prematurely aging our skin. Protect your skin from the sun every day. Whether spending a day at the beach or running errands, sun protection is essential. You can protect your skin by seeking shade, covering up with clothing, and using sunscreen that is broad-spectrum, SPF 30 (or higher), and water-resistant. You should apply sunscreen every day to all skin that is not covered by clothing.Apply self-tanner rather than get a tan. Every time you get a tan, you prematurely age your skin. This holds true if you get a tan from the sun, a tanning bed, or other indoor tanning equipment. All emit harmful UV rays that accelerate how quickly your skin ages.Use a good quality sunscreen when outdoors, even in the winter.Wear protective clothing and a hat when needed.
Eat a healthy, well-balanced diet. Findings from a few studies suggest that eating plenty of fresh fruits and vegetables may help prevent damage that leads to premature skin aging. Findings from research studies also suggest that a diet containing lots of sugar or other refined carbohydrates can accelerate aging.
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.
If you smoke, stop. Smoking greatly speeds up how quickly skin ages. It causes wrinkles and a dull, sallow complexion.
Avoid repetitive facial expressions. When you make a facial expression, you contract the underlying muscles. If you repeatedly contract the same muscles for many years, these lines become permanent. Wearing sunglasses can help reduce lines caused by squinting.
Drink less alcohol. Alcohol is rough on the skin. It dehydrates the skin, and in time, damages the skin. This can make us look older.
Exercise most days of the week. Findings from a few studies suggest that moderate exercise can improve circulation and boost the immune system. This, in turn, may give the skin a more-youthful appearance.
Daily skin routine: Cleanse your skin gently. Scrubbing your skin clean can irritate your skin. Irritating your skin accelerates skin aging. Gentle washing helps to remove pollution, makeup, and other substances without irritating your skin.
Wash your face twice a day and after sweating heavily. Perspiration, especially when wearing a hat or helmet, irritates the skin, so you want to wash your skin as soon as possible after sweating.Apply a facial moisturizer every day. Moisturizer traps water in our skin, giving it a more youthful appearance.
Stop using skin care products that sting or burn. When your skin burns or stings, it means your skin is irritated. Irritating your skin can make it look older.
Note: Some anti-aging products prescribed by a dermatologist may burn or sting. When using a prescription anti-aging product, this can be okay. Just be sure to let your dermatologist know.
Never too late to benefit
Even people who already have signs of premature skin aging can benefit from making lifestyle changes. By protecting your skin from the sun, you give it a chance to repair some of the damage. Smokers who stop often notice that their skin looks healthier. If signs of aging skin bother you, you may want to see a cosmetologist or cosmetic dermatologist. New treatments and less-invasive procedures for smoothing wrinkles, tightening skin, and improving one’s complexion are giving many people younger-looking skin.
Aging changes are a group of common conditions and developments that occur as people grow older. 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:
Your skin does many things. It:
- Detects cutaneous sensations, Contains nerve receptors that allow you to feel touch, pain, and pressure
- Helps control fluid and electrolyte balance
- Excretes and absobs substances
- Helps control your body temperature
- Protects you from the environment
- Stores blood
- Synthesize vit D
Fig 1:Normal skin:3 layers of normal skin
fig 2: detailed diagrame of epidermis layer:
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 blood vessels, nerves, hair follicles, and oil glands. The dermis provides nutrients to the epidermis. This layer also contains connective tissue with collagen fibers to give support and elastin fibers to provide flexibility and strength.
- The inner layer under the dermis (the subcutaneous layer) contains sweat glands, some hair follicles, blood vessels, and fat.
SKIN CHANGES WITH PROCESS OF AGING
As we grow older, changes like these naturally occur:
- Skin becomes rougher.
- Skin develops lesions such as benign tumors.
- Skin becomes more transparent. This is caused by thinning of the epidermis (surface layer of the skin).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.
- As a result Aging skin looks thinner, paler, and clear (translucent). Large pigmented spots, including age spots, liver spots, or lentigos, may appear in sun-exposed areas.
- 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.
Changes in dermis:
- Skin becomes slack. The loss of the elastic tissue (elastin) in the skin with age causes the skin to hang loosely.
- 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. Skin becomes more easily bruised. This is due to thinner blood vessel walls.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, usually 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.Dry skin and itching is 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
Changes in The subcutaneous fatlayer
- The subcutaneous fatlayerthins 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 medications are absorbed by the fat layer. Losing this layer changes the way that these medications work.
- The sweat glands produce less sweat. This makes it harder to keep cool. Your risk for overheating or developing heat stroke
- Growths such as skin tags, warts, rough patches (keratoses), and other blemishes are more common in older people.
Fig 4: AGING CHANGES IN SKIN
Fig 5:
Fig 6: skin changes according to age
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 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.
BECAUSE OF ABOVE AGING PROCESSES SKIN CHANGES IN FACE:
- The appearance of the face and neck typically changes with age.
- Loss of muscle tone and thinning skin gives the face a flabby or drooping appearance.
- In some people, sagging jowls may create the look of a double chin.
- Your skin also dries out and loses the underlying layer of fat so that your face no longer has a plump, smooth surface.
- To some extent, wrinkles cannot be avoided. However, sun exposure and cigarette smoking are likely to make them develop more quickly.
- The number and size of blotches and dark spots on the face increase as well. These pigment changes are largely due to sun exposure.
- Missing teeth and receding gums change the appearance of the mouth, so your lips may look shrunken.
- Loss of bone mass in the jaw reduces the size of the lower face and makes your forehead, nose, and mouth more pronounced.
- Your nose may also lengthen slightly.
- The ears may lengthen in some people (probably caused by cartilage growth). Men may develop hair in their ears that becomes longer, coarser, and more noticeable as they age. Ear wax becomes drier because there are fewer wax glands in the ears and they produce less oil. The hardened ear wax can block the ear canal and affect your ability to hear.
- Eyebrows and eyelashes turn gray.
- As in other parts of the face, the skin around the eyes gets wrinkles, creating crow's feet at the side of the eyes.
- Fat from the eyelids settles into the eye sockets. This can make your eyes look sunken.
- The lower eyelids can slacken and bags can develop under your eyes. Weakening of the muscle that supports the upper eyelid can make the eyelids droop. This may limit vision.
- The outer surface of the eye (cornea) may develop a grayish-white ring. The colored portion of the eye (iris) loses pigment, making most very elderly people appear to have gray or light blue eyes.
CAUSES OF SKIN AGING:
How your skin ages will depend on a variety of factors: your lifestyle, diet, heredity, and other personal habit. There are other reasons, too. Many things cause our skin to age. Some things we cannot do anything about; others we can influence
1. Intrinsic aging OrNatural aging processand genetic makeup,
One thing that we cannot change is the natural aging process. It plays a key role. With time, we all get visible lines on our face. It is natural for our face to lose some of its youthful fullness. We notice our skin becoming thinner and drier. Our genes largely control when these changes occur. The medical term for this type of aging is “intrinsic aging.”
2. Extrinsic aging.
We can influence another type of aging that affects our skin. Our environment and lifestyle choices can cause our skin to age prematurely. The medical term for this type of aging is “extrinsic aging.” By taking some preventive actions, we can slow the effects that this type of aging has on our skin.
Causes of extrinsic aging: Skin changes are related to
- Environmental factors,
- Nutrition, and lifestye
- Other factors Other factors that contribute to aging of the skin include
- Stress,
- Comorbidities
- Gravity,
- Daily facial movement,
- Obesity, and
- Even sleep position.
ENVIRONMENTAL FACTORS:
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). 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. Sun and Your Skin 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. So, 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 , covering up, wearing a hat, and making a habit of using sunscreen.
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.
NUTRITION, AND LIFESTYLE CHANGES:
Lack of healthy nutriens in diet
Findings from a few studies suggest that eating plenty of fresh fruits and vegetables may help prevent damage that leads to premature skin aging. Findings from research studies also suggest that a diet containing lots of sugar or other refined carbohydrates can accelerate aging.
Sedentary lifestyle lack of Exercise: Findings from a few studies suggest that moderate exercise can improve circulation and boost the immune system. This, in turn, may give the skin a more-youthful appearance.
Drinking alcohol: Alcohol is rough on the skin. It dehydrates the skin, and in time, damages the skin. This can make us look older.
Smoking: 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.If you smoke, stop. Smoking greatly speeds up how quickly skin ages. It causes wrinkles and a dull, sallow complexion.Smokers tend to have more wrinkles than nonsmokers of the same age, complexion, and history of sun exposure.
OTHER FACTORS: Gravity, facial movement, and sleep position are the secondary factors that contribute to changes in the skin.
Effect of gravity: 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.
Effect of repetativefacial movement :Repetitive facial expressions:
Avoid repetitive facial expressions. When you make a facial expression, you contract the underlying muscles. If you repeatedly contract the same muscles for many years, these lines become permanent. Wearing sunglasses can help reduce lines caused by squinting. 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.
Effect of sleep position.
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.
Rough handling of skin:
Cleanse your skin gently. Scrubbing your skin clean can irritate your skin. Irritating your skin accelerates skin aging. Gentle washing helps to remove pollution, makeup, and other substances without irritating your skin.
Wash your face twice a day and after sweating heavily. Perspiration, especially when wearing a hat or helmet, irritates the skin, so you want to wash your skin as soon as possible after sweating.Apply a facial moisturizer every day. Moisturizer traps water in our skin, giving it a more youthful appearance.
Stop using skin care products that sting or burn. When your skin burns or stings, it means your skin is irritated. Irritating your skin can make it look older.
EFFECT OF CHANGES OF SKIN ON GENERAL HEALTH OF A PERSON
- As you age, you are at increased risk for skin injury. Your skin is thinner, more fragile, and you lose 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:
- Blood vessel diseases, such as arteriosclerosis
- Diabetes
- Heart disease
- Liver disease
- Nutritional deficiencies
- Obesity
- Reactions to medicines
- Stress
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: prevention is better than cure. So here applies the theory of prevention for skin also. Because most skin changes are related to sun exposure, prevention is a lifelong process. There are ways to reduce premature skin aging:
Note: Some anti-aging products prescribed by a dermatologist may burn or sting. When using a prescription anti-aging product, this can be okay. Just be sure to let your dermatologist know.
Never too late to benefit
Even people who already have signs of premature skin aging can benefit from making lifestyle changes. By protecting your skin from the sun, you give it a chance to repair some of the damage. Smokers who stop often notice that their skin looks healthier. If signs of aging skin bother you, you may want to see a cosmetologist or cosmetic dermatologist. New treatments and less-invasive procedures for smoothing wrinkles, tightening skin, and improving one’s complexion are giving many people younger-looking skin.