Mature Skin

As you grow older, you will see and feel changes in your skin.

You cannot avoid skin changes associated with natural aging. However, there are skin changes you can prevent. There are even diseases, such as skin cancer, that need medical attention. Your dermatologist can be a partner in helping you keep your skin healthy and looking its best as it ages.

Whether a health risk or just unsightly, age-related skin conditions can be evaluated and treated, if necessary, by your dermatologist.

WHAT CAUSES WRINKLES?

Wrinkles are one of the most common skin changes that occur with age. The fibers underneath the skin that provide structure — collagen and elastin —begin to weaken with age. The skin also loses fat, which provides the plumped, smooth appearance in younger skin. This loss of structure and underlying fat causes the skin to fold and wrinkle.

Ultraviolet light (UV) exposure – from the sun or indoor tanning – is the major cause of wrinkles and other common age-related conditions in the skin. How wrinkled your skin becomes depends largely on how much UV you have been exposed to in your lifetime. Your family genes and smoking can also contribute to wrinkles.

HOW CAN I PREVENT SUN DAMAGE TO MY SKIN?

Recent studies have shown that daily use of sunscreen appears to significantly slow the process of skin aging among middle-aged men and women. Even those individuals with significant sun damage showed some skin improvements after using sunscreen daily.

Every day, apply a broad-spectrum (protects against the sun’s UVA and UVB rays), water-resistant sunscreen with a Sun Protection Factor (SPF) of 30 or higher. Seek the shade between 10 a.m. and 2 p.m. when the sun’s ray are at their strongest. Wear protective clothing, including a wide-brimmed hat, sunglasses, and long-sleeved shirts and pants when in the sun. Reapply sunscreen every 2 hours during sun exposure (or every 80 minutes if in water).

WHAT ELSE DO DERMATOLOGISTS RECOMMEND TO REDUCE THE APPEARANCE OF AGING SKIN?

In addition to sunscreen, talk with your dermatologist about the best treatment options. No product or treatment can treat all signs of skin aging. Focus on one or two skin concerns that bother you the most.

Look for over-the-counter products that include the following anti-aging ingredients:

Retinoids (stimulate collagen production)
- There is a prescription retinoid, tretinoin, which has been approved by the U.S. Food and Drug Administration for aging
Antioxidants (prevent free radical damage)
- Vitamin C, Vitamin E, idebenone, ferulic acid, phloretin, Coenzyme Q10
Hydroxy Acids (exfoliate dead or damaged skin cells)
- AHAs (Alpha Hydroxy Acids)
- BHAs (Beta Hydroxy Acids)

Peptides, Growth Factors and Stem Cell Extracts (promote turnover of aging skin cells)

Dermatologists also have a variety of treatments available in their offices. Your dermatologist can talk about the rejuvenation treatments that are right for you based on your age, health, skin type and amount of UV damage. Some examples of treatments can include:

• Soft-tissue fillers

Injections that can reduce the appearance of folds and hollows due to aging skin and loss of volume and

• Botulinum toxin

Injections that can reduce the appearance of lines and wrinkles caused by muscles of facial expression, especially on the forehead, between the eyebrows, and around the

• Chemical peels

Chemical solution that removes the outer layers of skin to stimulate new growth, improving skin tone, texture, and fine lines and wrinkles.

• Laser and Light rejuvenation

Lasers can treat uneven skin tone and texture, address pigment changes, tighten the skin, reduce the appearance of visible broken blood vessels, and remove unwanted
Light technology can treat skin discoloration, wrinkles and improve skin

WHY IS MY SKIN SO DRY?

As we age, our skin becomes drier. This can result in flaky and itchy skin, especially in cold, dry, and windy climates.

Mature skin also appears to be more sensitive, especially to wool, detergents, bleaches, and soaps.

If your skin is mildly dry, you should use a daily moisturizer. The best time to apply it is right after bathing while your skin is still damp. Look for moisturizers or ointments that contain the ingredients petrolatum, urea or ammonium lactate. These ingredients can help the skin hold water and reduce scaling.

You can also relieve dry skin by taking short showers and baths (5- to 10-minutes), using warm, not hot, water, and mild, fragrance-free soaps or cleansers.

If excessive itching due to dry skin is leading to a lack of sleep and fatigue, see your dermatologist. Itching may also be a sign of an internal disease, and severe flaky and cracked skin may be a sign of a more serious skin condition, such as psoriasis or dermatitis.

WHAT SKIN CONDITIONS AND DISEASES ARE COMMON AS I AGE?

Unless noted, most of these skin conditions and diseases do not need treatment. If you are bothered by the appearance of a skin condition, talk with your dermatologist about treatment options. Treatments may be considered cosmetic and may not be covered by insurance.

Age spots

Age Spots

Flat, brown spots on the face, hands, back, and feet caused by sun exposure
Can look like melanoma, the deadliest form of skin cancer. Ask your dermatologist to examine
Over-the-counter “fade” creams will not eliminate or reduce the appearance of age

Actinic keratoses

Actinic Keratoses

Red or brown scaly spots that are precancerous growths
Treatment: When caught early, your dermatologist can remove them by freezing with liquid nitrogen (cryosurgery), using a chemical peel, scraping it out (curettage), applying a chemotherapy cream, or by laser resurfacing. When caught late, actinic keratoses can develop into squamous cell carcinoma, a type of skin

Skin Cancer

Though the risk of skin cancer increases as you get older, skin cancer can happen at any age. If you notice anything on your skin itching, changing, or bleeding, see your dermatologist immediately.

• Basal cell carcinoma

Most common form of skin cancer
Small, red, shiny bump or a red, bleeding spot on the head, face, nose, neck, or chest
More common in older fair-skinned persons with blonde or red hair and blue or green eyes
Grows slowly and rarely spreads to other parts of the body. Untreated, these skin cancers can grow wide and deep, destroying skin tissue and

• Squamous cell carcinoma

Rough, scaly sore that doesn’t heal, or heals and returns on sun-exposed parts of the body such as the rim of the ear, the face, the lips, or the back of the
Untreated, these skin cancers can destroy normal tissue and sometimes spread to lymph nodes and internal organs.

• Melanoma

Deadliest form of skin cancer
Most often appears as a dark brown or black mole-like growth on the skin with uneven borders
Appears on the upper back in men and women, the chest and stomach in men, and the lower legs of
In people of color, the bottom of the foot is where 30 to 40% of melanomas are

• Skin Cancer Treatment

When caught early, skin cancer is highly
Your dermatologist will consider the type of skin cancer, the size and location of the skin cancer, and your health to determine the best treatment.

Treatments can include surgical removal, including excision, Mohs surgery or curettage and electrodesiccation (scraping and burning).
When surgery is not an option, other treatments can include immunotherapy, cryosurgery, chemotherapy, photodynamic therapy or

Melanoma

Seborrheic Keratoses

Non-cancerous, tan, brown, or black raised spots with a wart-like appearance

Shingles/Herpes Zoster

Early symptoms are pain or burning in one area of the body, headache and fatigue
Painful in older adults as the virus attacks a nerve root and follows the path of that nerve, causing a line of painful blisters on the
Typically affects one side of the body and lasts several
Treatment: See your dermatologist as soon as you think you have Treatments are most effective if you start them within 3 days of your symptoms beginning. A preventative vaccine is also available.

Herpes zoster/shingles

Seborrheic Dermatitis

Common condition that causes a red rash with greasy-looking “scales”
Rash forms where the skin is oily, such as the scalp, sides of the nose, eyebrows, eyelids, behind the ears, and the middle of the chest
Can go away on its own, yet it does tend to recur. Frequent shampooing and washing are helpful, and your dermatologist may prescribe topical cortisone creams or antifungal creams and

Seborrheic dermatitis

Cherry Angiomas

Harmless, small, bright-red raised bumps created by dilated blood vessels
Occur most often on the chest, back, and waistline

Varicose Veins

Enlarged blue leg veins caused when blood returning to the heart against gravity flows back into the veins through a faulty valve.

Seldom serious; may hurt if the veins become twisted and swollen
To ease pain, do not stand for long periods of time, keep your feet raised when sitting or lying down, and wear support hose or elastic
Treatment: Your dermatologist may recommend a treatment called sclerotherapy for larger varicose veins, or laser therapy to remove smaller varicose veins and spider

Varicose Ulcers

Sores that can appear on the legs or ankles when a crack or cut occurs in the skin and does not heal due to poor blood flow in the veins

Injury can develop into an ulcer, which is a shallow wound that may contain pus and become infected

May last for months or even years
Associated with smoking and with medical disorders such as arteriosclerosis (hardening of the arteries) and high blood pressure
Treatment: Your dermatologist can provide special bandages and tips on wound care that may speed

Bruising

As the skin becomes thinner with age and sun damage, you may notice more bruising on your arms and legs
- Loss of fat and connective tissue weakens the support around your blood vessels, making them more prone to injury
Bruising can also be affected by medicine that interferes with your blood clotting, or due to a disease

TALK WITH YOUR DERMATOLOGIST

Dermatologists can effectively reduce the signs of aging skin and offer treatments for skin disease. Talking with a dermatologist can help you make an informed decision about what treatments will be best for you.

A board-certified dermatologist is a medical doctor who specializes in diagnosing and treating the medical, surgical, and cosmetic conditions of the skin, hair and nails. To learn more about aging skin or find a dermatologist in your area, visit aad.org or call toll free (888) 462-DERM (3376).

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

American Academy of Dermatology

P.O. Box 1968, Des Plaines, Illinois 60017AAD Public Information Center: 888.462.DERM (3376) AAD Member Resource Center: 866.503.SKIN (7546) Outside the United States: 847.240.1280

Web: aad.org

Email: mrc@aad.org