Common problems of aging skin

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Authors: Neil A. Fenske, Leonard D. Grayson and Victor D. Newcomer
Date: Apr. 15, 1989
From: Patient Care(Vol. 23, Issue 7)
Publisher: MJH Life Sciences Media
Document Type: Article
Length: 3,078 words

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As the skin loses its ability to defend itself, the cumulative damage from ultraviolet radiation increases, While intrinsic aging changes may be unavoidable, measures taken throughout life can limit the damage.



Intrinsic aging: Numerous structural and functional changes combine to age the skin, resulting in thinning, fragility, and loss of elasticity. Circulation and innervation decrease, and the structural attachment between the dermis and epidermis deteriorates. A variety of neoplasia appear on the skin as a part of the aging process. Benign growths include seborrheic keratoses, cherry angiomas, and skin tags. A common premalignant lesion is the actinic keratosis, which appears on areas of chronic sun exposure.


Aging of the skin is a process involving intrinsic structural and functional changes in combination with extrinsic factors such as exposure to ultraviolet (UV) light, wind, or thermal extremes (see "Aging and the skin," page 226). As it ages, the skin becomes thinner-at times almost like parchment-and inelastic. Because the structural attachments between epidermis and dermis break down, the epidermis can actually tear away with slight trauma, as when a person is pulled across a bed or adhesive tape is removed abruptly. With age, dermal and epidermal circulation becomes less efficient and vascular walls become thinner. As a result, elderly people tend to bruise easily.

The most common benign lesions of aging skin are acrochordons, also known as skin tags. These are found in areas of skin laxity and friction such as the armpits and groin, and beneath the breasts in women. Skin tags generally develop before age 40 in women, but after age 50 in men. Seborrheic keratoses are wartlike growths that first appear as flat, brown lesions, but may become large, verrucous, and cosmetically compromising. They are harmless, however, and can simply be scraped off with a curette or removed with liquid nitrogen.

Cherry angiomas (De Morgan's spots) are benign proliferations of the capillaries, usually seen on the trunk. Areas of mottled pigmentation most often found on the lateral aspects of the neck, known as poikiloderma of Civatte, typically result from excessive sun exposure. This discoloration is most common among women who play golf or other outdoor games.

A common premalignant skin lesion is the actinic keratosis, which develops on areas of the body that have been chronically sun-exposed.* Solar lentigines, though usually considered benign, may occasionally develop into malignant melanoma. Some patients today are concerned by the small red papules of senile ectasia, mistaking these harmless lesions for Kaposi's sarcoma. Senile ectasia is not premalignant.



Skin cancer: The aging process predisposes the skin to development of carcinoma. There is a 20% loss of remaining melanocytes per decade after age 30, lessening the skin's ability to protect itself from ultraviolet (UV) light. T-cell function is diminished, Langerhans' cells are lost, and the overall inflammatory response is muffled. Sun exposure is responsible for 90% of all skin cancer, but risk also depends on skin color, sex, and where the person lives. Basal cell carcinoma usually remains localized, but squamous...

Source Citation

Source Citation
Fenske, Neil A., et al. "Common problems of aging skin." Patient Care, vol. 23, no. 7, 1989, p. 225+. Accessed 10 Apr. 2021.

Gale Document Number: GALE|A7593733