STORY BYSkin, whether we like it or not, changes with age.
Spots, dots, wrinkles, sags and a litany of other skin complaints appear in the mirror, seemingly overnight.
None of us is immune to this biological certainty, but education and care can help minimize the ravages of time.
As we age, we lose muscle tone and fat, which causes a flabby or droopy look resulting in sagging jowls, double chins and even a lengthening of the nose and ears. Our skin thins, too. And that’s not all.
“Collagen and elastin, the two substances that form the foundation for the structure of our skin, decrease, causing the skin to lose firmness,” says Asra Ali, M.D., assistant professor of dermatology at The University of Texas Medical School at Houston. Shrinking bones contribute to the look of excess, sagging skin, too. Oil and sweat secretions slow down, making it harder for skin to retain moisture. Estrogen loss in post-menopausal women further dries out the skin. We wrinkle.
Unfortunately, there is no way to stop the aging process, no matter what literature’s Dorian Gray claimed. Pharmaceutical and cosmetic companies, however, have developed literally thousands of treatments to help slow it down, from antioxidant creams to major plastic surgery.
But what about skin changes beyond wrinkles and sagging? What else can we expect when we look in the mirror?
One common problem with aging skin is rosacea, a chronic skin condition also referred to as adult acne. “It differs from the acne most of us experienced as teenagers since it’s not related to the bacteria p. acnes,” Ali says.
Symptoms include flushing, red patches, visible blood vessels and small pimples on the face, along with a burning sensation on the eyelids and in the eyes. Fair-skinned people between ages 30 and 60 are most likely to develop rosacea, and doctors don’t know what causes it. Flare-ups are often caused by sun exposure, exercise, hot weather, stress, spicy foods, hot water and alcohol.
Antibiotic creams or pills are usually used to treat the pimples, and some people with severe cases may require prescription drugs such as Accutane to control the inflamed areas. Other possible treatments are laser therapy, dermabrasion (refinishing the skin's top layers through a method of controlled surgical scraping) and cryosurgery (a freezing process that destroys the outer layer of skin cells while leaving the dermis intact.)
The eyes are treated with oral antibiotics and topical corticosteroids. Patients need to identify what causes the flare-ups and eliminate it from their lives as much as possible. Rosacea outbreaks can also be limited by avoiding the sun and heavy cosmetics and by using products specifically made for sensitive skin.
People can spend thousands of dollars to maintain a line-free face, but neglect another part of the body which can announce one's age just as loudly – the hands. Wrinkled hands with age spots (also called lentigines) are often a dead giveaway of a person’s age. Age spots are small pigmented areas similar to freckles that occur in sun-exposed skin, usually after 40.
To help keep hands looking young, use a specially formulated hand cream with sun block at least once a day. To treat age or “liver” spots, dermatologists can use Retin A to help lighten small spots over time. Hydroquinone, a bleaching cream, often is used to lighten the spots, but some European scientists have questioned the drug’s safety in recent years. Liquid nitrogen, laser treatment, and chemical peels are some other options.
The best way to avoid age spots is to stay out of the sun. “Sun exposure is one of the most common environmental sources for aging the skin,” Ali says. “It increases the risk for skin cancer and photo-aging.”
We are exposed to sunlight more than we realize. Even those who daily wear sunscreen on their faces don’t think to apply it to their arms and hands.
“Proper sunscreen use requires application half an hour prior to sun exposure, UVB and UVA blocking abilities and continual reapplication throughout the day,” Ali advises.
That wart you’re treating may not be a wart at all. If you are a female nearing middle age, it could be a skin tag–a small, benign condition that manifests as a tiny piece of skin that projects from the surrounding area, sometimes on a stalk. Skin tags can be smooth or irregular, flesh-colored or deeply pigmented. They can occur almost anywhere, but are most common on the eyelids, neck, armpits, upper chest area, and groin.
“A couple of years ago, I noticed what I thought was a wart on the skin just outside my left armpit,” patient Marie Lentos, 34 says. “I bought wart remover and used it, but nothing happened.” She grew more self-conscious about the blemish, and finally took scissors from the medicine cabinet and just cut it off.
Ali highly discourages this type of self-removal in a non-sterile environment. “It’s important to know what kind of lesion it is before cutting it off the body,” Ali cautions. “Sometimes a clinical evaluation isn’t enough, and the lesion has to be sent for tests.” Also, doing procedures in a doctor’s office minimizes the risk of infection.
Appropriate removal of skin tags include freezing with liquid nitrogen, tying off with a thread or suture to cut off blood supply to the tag, or excision by someone trained in removing tags safely and cleanly.
As our skin thins with age, dilated blood vessels become more visible. These blood vessels appear as red, domelike formations on the skin called cherry angiomas. They are completely harmless, but are often cosmetically unattractive. If a patient wants a cherry angioma removed, it can be done surgically, using lasers, by cauterization or by freezing the angioma.
More than 90 percent of all seniors have some type of skin change. Some are unavoidable, but most of them can be minimized by being kind to your skin.
Last Updated: 10-18-2005Editorial Board | Legal Disclaimer | Privacy & Security | Contact Us
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Dr. Asra Ali is a former assistant professor of dermatology at the UT Medical School.
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Packing Bag Lunches Safely
If you pack lunches for your child to take to school, be careful that you do not accidentally expose them to foodborne illness.
Bagged lunches, especially those containing perishable foods, need to be packed and handled properly in order to keep the food safe. In general, perishable foods should not be left at room temperature for more than two hours. If left out too long, the temperature of the food can enter the danger zone where bacteria grow most rapidly, which is between 40 and 140 degrees Fahrenheit.
Below are some tips to help families pack bagged lunches safely:
Before eating lunch or snacks at school, make sure your child washes his or her hands with soap and warm water for at least 20 seconds. If your child's school does not have a handwashing program in place, encourage them to adopt a such a program, as handwashing is one of the best ways kids and parents can protect health and stop the spread of germs.
