Skin Care and Aging
Your skin changes as you get older. You may notice that it becomes thinner and no longer looks as plump and smooth as it once did. On this page, you will learn about how skin changes as you age, how to protect your skin, and signs of skin diseases to look out for.
How does skin change as you age?
With aging, the outer layer of the skin gets thinner, paler, and less stretchy (elastic). Because blood vessels get more fragile with age, older adults tend to bruise more easily. Also, older adults may produce less sweat and oil from the glands in their skin.
Many factors influence how aging affects your skin. Age-related changes such as a loss of elastic fibers (elastin) and collagen cause the skin to look older, develop wrinkles, and be more fragile. Hormonal changes, such as those that occur with menopause, can cause the skin to become thinner and drier. Certain chronic health conditions that are more common in older adults, such as diabetes, kidney disease, heart disease, and atherosclerosis, can also have symptoms that affect the skin.
The sun is another major contributor to skin aging. The sun emits ultraviolet (UV) light, which can damage skin cells. In the short term, the damage can cause a sunburn. Over time, however, UV damage adds up, leading to changes in skin texture, premature skin aging, wrinkles, and sometimes skin cancer.
Dry skin and itching
Many older people develop dry spots on their skin, often on their lower legs, elbows, and lower arms. Dry skin patches may itch and feel rough and scaly. There are many possible reasons for dry skin. In addition to the changes that come with aging, drinking too little water, spending too much time in the sun, living in a dry environment, and smoking can all cause the skin to feel dry and rough.
Taking hot baths and showers, or using too much soap, antiperspirant, or perfume, can make dry skin worse. Talk to your doctor if your skin is very dry and itchy.
Here are some ways to manage dry, itchy skin at home:
- Use moisturizers such as lotions, creams, or ointments every day.
- Use mild soap and warm (not hot) water when bathing or showering. Don’t add bath oil to your water — it can make the tub slippery and increase the risk of falling.
- Try using a humidifier, an appliance that adds moisture to a room.
Bruises
Older people may bruise more easily than younger people, and it can take longer for these bruises to heal. Some medicines or illnesses may also cause bruising. Talk to your doctor if you see bruises and don’t know how you got them, especially on parts of your body usually covered by clothing.
While accidental bruises are common in older adults, they can also be a sign of elder abuse. If you suspect someone is being abused, seek help. Learn more about elder abuse.
Age spots and skin tags
Age spots, once called “liver spots,” are flat, brown spots on the skin often caused by years of exposure to the sun. Age spots are bigger than freckles and commonly show up on the face, hands, arms, back, and feet. Wearing a hat in the sun and using a broad spectrum sunscreen that protects against two types of the sun’s rays — UVA and UVB — can help prevent more age spots from forming.
Skin tags are small, usually flesh-colored growths of skin that have a raised surface. They become more common as people age, especially in women. They are most often found on the eyelids, neck, and body folds such as the armpits, chest, and groin.
Age spots and skin tags are harmless, although skin tags can become irritated from friction. If your age spots or skin tags bother you, talk to a doctor about treatment options.
What skin changes should I look out for?
While some skin changes are normal in aging — such as some dryness, bruising, wrinkles, age spots, and skin tags — others may be signs of a serious skin condition.
Skin cancer
Skin cancer is very common in the United States. Anyone, of any skin color, can get skin cancer. Older adults and people with fair skin that freckles easily are at greatest risk. Exposure to UV light from the sun is one of the major risk factors for skin cancer. UV light from sunlamps and tanning booths can also contribute to skin cancer risk.
There are several types of skin cancer. Two of the most common types, basal cell carcinoma and squamous cell carcinoma, grow slowly and are usually found on parts of the skin most often exposed to the sun, including the head, face, neck, hands, and arms. Basal cell carcinoma usually doesn’t spread to other parts of the body, but squamous cell carcinoma can. Both of these types of skin cancer can usually be cured if detected early, but treatment may have side effects and can leave scars.
The rarest and most dangerous type of skin cancer is melanoma. Of all types of skin cancer, melanoma causes the most deaths because of its tendency to spread to other parts of the body, including vital organs like the brain and liver.
Check your skin each month for changes that may be signs of cancer. Skin cancer is rarely painful. Look for changes such as a new growth, a sore that doesn’t heal, or a bleeding mole. If you notice anything unusual, talk to your doctor or visit a dermatologist. Regular skin checks by a doctor are also important for people who have already had skin cancer.
Other common skin conditions in older adults
Skin cancer isn’t the only skin condition that can affect older adults. Other common skin conditions include:
- Shingles. Shingles, which is caused by a virus called herpes zoster, is a disease that triggers a painful skin rash. Learn about how shingles affects the skin.
- Rosacea. Rosacea is a condition that causes reddened skin and a rash, usually on the nose and cheeks, sometimes accompanied by a sense of tingling or burning.
- Autoimmune conditions. Autoimmune skin conditions (such as psoriasis and scleroderma) occur when your body mistakenly attacks its own cells. Psoriasis is a chronic disease that causes patches of thick, red skin with silvery-white scales that itch or burn. Scleroderma causes inflammation and thickening of the skin and other areas of the body.
- Skin infections. Older adults are more likely to develop skin infections, especially if they have poor circulation or diabetes, or are taking certain medications. Skin infections can be caused by bacteria, viruses, fungi, or parasites. They often cause rashes, swelling, itching, and pain.
Talk with a doctor if you think you might have a skin condition. Most of these conditions can be treated or managed.
How can I protect my skin?
These tips can help keep your skin healthy:
- Limit time in the sun. Try to avoid being in the sun during times when the sun’s rays are strongest. For example, during the summer, try to stay out of the sun between 10 a.m. and 4 p.m. Even when skies are cloudy, it’s important to be careful. The sun’s UV rays can go through clouds.
- Use sunscreen. Look for sunscreen with an SPF (sun protection factor) of 15 or higher. It’s best to choose sunscreens with “broad spectrum” on the label. Put the sunscreen on 15 to 30 minutes before you go outside. Sunscreen should be reapplied at least every two hours. You need to put sunscreen on more often if you are swimming, sweating, or rubbing your skin with a towel.
- Wear protective clothing and sunglasses. A hat with a wide brim can shade your neck, ears, eyes, and head. Look for sunglasses that block 99% to 100% of the sun’s rays. If you are planning to be in the sun, wear loose, lightweight, long-sleeved shirts and long pants or long skirts.
- Avoid tanning. Don’t use sunlamps or tanning beds. Use caution and talk to your doctor before using tanning lotions or creams. Sunless tanning sprays and lotions often contain a chemical called dihydroxyacetone (DHA), which may be dangerous if it gets into your mouth, nose, or eyes. Tanning pills are not approved by the FDA and might not be safe.
Your skin may change with age. But remember, there are things you can do to manage these changes. Check your skin often. If you find any changes that worry you, see your doctor.
How to care for aging skin
You will find other tips in chapter two.
Caring for aging skin means focusing on hydration, sun protection, and gentle treatments. Here are some tips to help maintain healthy, vibrant skin.
- Cleanse gently: Use a mild cleanser once daily to remove dirt and oil without stripping your skin of its natural moisture. Avoid harsh soaps, which can be too drying.
- Moisturize regularly: As skin gets drier with age, applying a moisturizer can help keep it hydrated and smooth. Apply a fragrance-free moisturizer daily after showering, and whenever your skin feels dry. A moisturizer containing hyaluronic acid or glycerin can be particularly beneficial.
- Use sunscreen every day: Sun protection is one of the most important steps for slowing skin aging. Ultraviolet (UV) exposure accelerates the breakdown of collagen and elastin. It also causes DNA damage that may lead to skin cancer. Apply a broad-spectrum sunscreen with at least SPF 30 every morning, even on cloudy days and in the winter.
- Add antioxidants: Skin care products with antioxidants like vitamin C can help protect skin from environmental damage. Vitamin C protects the skin from damage caused by free radicals, which are unstable molecules that break down skin cells. It helps brighten the skin, even out skin tone, and reduce the appearance of dark spots by inhibiting excess pigment production.
- Exfoliate gently:Exfoliating once or twice a week can remove dead skin cells and help your skin look more refreshed. For anti-aging benefits, chemical exfoliation (using topical products applied to your skin) is a better option than physical exfoliation (such as using a loofa or textured washcloth). Retinoids, alpha and beta hydroxy acids, and salicylic acid are all chemical exfoliants. Take care to use exfoliants as described in the directions. Applying too much or more often than indicated can lead to raw, irritated skin.
Age spots
The medical term for an age spot is solar lentigo. They are also called liver spots or sun spots. These are flat brown, black, or gray spots that often appear on areas exposed to the sun, like the face, hands, and shoulders. They are common in people over age 50, but younger people can get them with enough sun exposure.
While age spots are harmless, they can be a cosmetic concern for some people. Here are a few options to reduce their appearance.
- Topical products: Creams and lotions with ingredients like hydroquinone, retinoid, or vitamin C can help fade age spots over time. Look for products labeled “brightening” or “spot corrector” and only apply as directed. Topical medications that contain higher strengths of these ingredients can be prescribed by a dermatologist.
- Chemical peels: A dermatologist or other licensed professional can apply a chemical solution containing topical alpha-hydroxy acids, tricholoroacetic acid, or glycolic or lactic acid to the skin. Chemical peels remove the top layer of the skin, reducing the appearance of age spots.
- Laser treatments: Laser therapy targets pigmented cells, helping to fade age spots. This is a more intense option and may require several sessions. Lasers should be cautiously used for people with very dark skin tones, and are unsuitable for those with certain skin conditions, pregnant women, and people who are prone to scarring. If you have a history of cold sores (herpes simplex) on the treatment area, you may need to avoid or take extra precautions with laser treatments.
Age spots that have any irregularities, including changes in shape, color, and size, should be evaluated because these can be signs of skin cancer.
Wrinkles
Wrinkles are lines and creases that form in the skin, usually around the eyes, mouth, and forehead. They develop as the skin loses elasticity, and can deepen with repeated facial expressions, sun exposure, and gravity.
Retinoids are one of the most effective options for wrinkles. “Retinoids” refers to a range of vitamin A-based skin care products. They boost collagen, improve skin thickness, and smooth the outer layer of the skin. Retinoids such as tretinoin (Retin-A) and tazarotene (Avage, Tazorac) are available by prescription. Topical products containing retinol or retinal, which are types of retinoids, are widely available in over-the-counter products.
Treatment options used for age spots, including lasers and chemical peels (see above), can also be helpful for wrinkles. A few more invasive treatment options include:
- Neuromodulators: Neuromodulator injections like botulinum toxin (Botox) temporarily relax certain muscles in the face to smooth out wrinkles and lines. They work by blocking signals from the nerves to the muscles, which stops the muscles from contracting as much. This helps reduce wrinkles caused by facial expressions; the effects last about three to six months.
- Soft tissue fillers: Fillers such as hyaluronic acid gels are injected into targeted areas of the face to smooth out wrinkles and restore fullness in areas like the cheeks and lips. Results are immediate and can last from six months to two years.
- Microneedling: This procedure uses tiny needles to create small injuries in the skin. This encourages collagen production and can help smooth facial wrinkles.
Discuss potential risks associated with these treatment options with your dermatologist or other licensed clinician.
Crow’s feet
Crow’s feet are the fine lines that develop around the outer corners of the eyes. Because the skin around the eyes is thin, it’s often one of the first areas to show signs of aging.
Treatment options for crow’s feet are the same as those for wrinkles. Lifestyle choices also impact when crow’s feet appear and how deep wrinkles become. Some factors to consider:
- Sun exposure and sunscreen: In addition to daily sunscreen, wear sunglasses or hats to protect your eyes from UV rays. This also reduces squinting, which helps prevent crow’s feet.
- Managing stress: Emotions like anger, sadness, and anxiety lead to facial expressions that contribute to crow’s feet. Learning to manage stress can reduce these fine lines and wrinkles.
- Smoking: Need another reason to quit? Smoking accelerates the development of crow’s feet by reducing blood flow to the skin and breaking down collagen and elastin.
Undereye bags
Undereye bags, or dark circles, refer to skin darkening, puffiness, or swelling under the eyes, which can make you look tired. This common concern is usually caused by weakened muscles and tissues around the eyes. Other factors, such as lack of sleep, genetics, and fluid retention, can make undereye bags more noticeable.
Options for addressing undereye bags range from simple makeup to hide them, to fillers and skin resurfacing, or even surgery for more severe cases.
Here are some tips to reduce the appearance undereye bags:
- Keep it cool: Applying a cold compress to your undereye area can temporarily reduce puffiness.
- Use an eye cream with caffeine: Topical caffeine can help reduce dark circles under the eyes by addressing swelling and discoloration from leaky blood vessels. Studies show that caffeine gels can penetrate the skin and improve puffiness and pigmentation around the lower eyelid.
- Give peptides a try: Peptides, which are found in many eye creams, are often used to reduce dark circles. They work in different ways: some stimulate collagen and elastin, while others block enzymes that break down skin structure, and carrier peptides deliver nutrients that help repair and strengthen the skin.
- Sleep on your back: Sleeping on your back with your head slightly elevated may help prevent fluid buildup around the eyes, reduce puffiness, and lessen the appearance of dark circles.