How to Care for Aging Skin


Some of us embrace wrinkles and lines as a natural part of aging, while others are dismayed by the prospect. See more healthy aging pictures.
©iStockphoto.com/digitalskillet

For the first part of your life, you probably didn't care that much about your skin. You might remember wiggling around, anxious to get into the pool or run down the beach, while your mother attempted to smear sunscreen on your body. Sure, getting sunburned hurts, but otherwise, it didn't matter much to you. But skin changes as you get older -- just ask any adolescent whose baby-smooth, flawless exterior has been transformed by the arrival of acne. Even then, you might be worried more about how that pimple affects your chances of a date than the actual health of your skin.

Just about everything that you do to your skin during the course of your lifetime will leave some lasting impression, but the internal aging process is something that happens naturally. Wrinkles, thinning, sagging and dryness are all part of this process. As your skin ages, it doesn't replace itself as quickly. Elastin and collagen, the proteins that keep your skin strong and elastic, are produced more slowly. And you can't stop these changes from happening. Even at what age they start largely depends on your genes -- if your mother started getting wrinkles in her 30s, it's likely that you will, too.

External aging, however, is due to the factors we can control, like those childhood sunburns. Exposure to the sun definitely ages your skin -- and it can have even more devastating consequences beyond wrinkles, age spots and a leathery look. Smoking, your diet and repetitive facial expressions also play a part. If you furrow your brow a lot, for example, you'll probably get wrinkles on your forehead.

In this article, we'll look at all of the ways that you can prevent some of the side effects of aging skin, as well as learn how to treat different skin conditions associated with aging skin. Let's start with the basics: a skin care regimen.

A Good Basic Skin Care Regimen for Any Age

It's never too early to start learning how to take good care of your body.
It's never too early to start learning how to take good care of your body.
©iStockphoto.com/Mlenny

If you check out the skin care aisle at your local drugstore, you might get overwhelmed, but taking care of your skin doesn't have to mean buying a ton of products or spending a lot of money. All you really need is a cleanser, a moisturizer and a sunscreen. Whether you choose to use other products is entirely up to you.

Keep in mind that taking care of your skin isn't just about facial skin. The skin on your body is very different from the skin on your face. If you have oily facial skin but are prone to dry skin on your arms, a single soap isn't going to work for both. Aging skin also tends to be thinner and more delicate on the face and hands. You may want to use a nonsoap cleanser on these areas. Soaps sometimes contain harsh detergents that strip away too much of your skin's natural oils, leaving it dry and tight.

Many people don't think that they need to use a moisturizer because they have oily skin, but you need to restore whatever moisture has been removed through washing or external aging factors like the sun. If you have oily skin, look for a light, oil-free moisturizer lotion. People with dry skin need heavier creams. There are also heavy creams for areas of the body that are especially prone to dryness and flaking, such as the elbows, knees and heels. The skin is thicker in these places and is exposed to a lot of stress.

Sunscreen should be worn daily, no matter what your plans. You probably know to apply it to your face, ears and neck, but your arms and hands can also suffer from exposure. The skin on the back of your hands sometimes shows signs of aging faster than facial skin because it tends to be neglected. The American Academy of Dermatology recommends using a sunscreen with an SPF (sun protection factor) of at least 15, but if you know that you burn easily or you're going to spend an extended amount of time in the sun, go with a higher number. You can usually find moisturizers with added sunscreen.

A Plan for Healthy Skin

Sun exposure is one aging factor you have control over.
Sun exposure is one aging factor you have control over.
©iStockphoto.com/Hanis

One of the biggest things you can do to keep your skin healthy is to avoid the sun, or more specifically, the ultraviolet radiation given off by the sun. Although we often associate sunburns with warm-weather activities like swimming or playing sports, you can just as easily get a sunburn in the winter. In addition to using sunscreen, you can minimize sun damage, called photoaging, by wearing hats and cover-ups when outside for long periods of time. Extreme photoaging can also lead to skin cancer, which can be fatal.

While you're avoiding the sun (and tanning beds, too) you should put down your cigarette. The repetitive facial expressions that you make when you smoke -- pinching your lips around the cigarette, squinting when the smoke blows into your eyes -- cause wrinkles. In addition, nicotine damages the collagen and elastin in your skin and reduces the blood flow in the vessels near its surface.

In addition to stuff you shouldn't do, there are some things you should. Want to know why people say they need their "beauty sleep"? The sleep you're not getting can show up on your face. In addition to looking tired, you can end up with under-eye circles. Some dermatologists suggest that sleeping on your back is better for your skin, because the pillow puts wrinkles on your face.

A healthy diet in general can also keep your skin looking and feeling good. Staying hydrated, for example, improves blood circulation. A diet full of a wide variety of fruits and vegetables will also contribute to skin health, especially foods high in:

  • Vitamin A - found in dairy products, carrots and sweet potatoes
  • Vitamin C - found in citrus fruits and bell peppers
  • Vitamin E - found in sunflower seeds, avocados and olive oil
  • Selenium - found in tuna, walnuts, Brazil nuts and oatmeal
  • Omega-3 fatty acids - found in oily fish (like salmon), flaxseed, pecans and hazelnuts

In the next section, we'll check out just a few of the ways that you can treat cosmetic conditions associated with aging.

Erasing Wrinkles?

Even if you do follow a skin care regimen, there's no way to stop its aging process entirely. No matter what, you're going to get some wrinkles at the very least. You can accept these changes as they come, get plastic surgery or try options that fall somewhere in between the two.

Wrinkles are the biggest skin complaint, and they can appear as early as your 20s depending on your genes. Most people first start noticing "laugh lines" around their mouths or "crow's feet" around the eyes We also get frown lines on our forehead. All of these wrinkles are due to repetitive facial movements -- laughing, squinting, frowning. There are many products available to counteract them, but little scientific research to back up their wrinkle-erasing claims.

Most over-the-counter wrinkle creams contain the same kinds of ingredients. Antioxidants are thought to counteract wrinkles by neutralizing free radicals -- oxygen molecules that destroy skin cells. Antioxidant ingredients include retinol, a vitamin A compound; tea extracts; and a plant compound called kenetin. Kenetin is also supposed to increase collagen growth. Many creams also contain hydroxy acids, like alpha and beta hydroxy, that remove dead layers of skin to expose new, ideally smooth, skin underneath. Anti-wrinkle creams have their own potential side effects: increased risk of sunburn, irritated skin and rashes. Results, if any, won't be permanent; you'll have to keep using the cream, which can be costly.

If you visit a dermatologist's office, you have even more options, and the results are likely to last longer than over-the-counter treatments. Some of these treatments may also be administered by a plastic surgeon. Dermatologists can prescribe creams with a stronger vitamin A compound known as tretinoin or retinoic acid (brand name Renova). Retinoic acid can also help lighten age spots.

Skin Treatments for Aging, from Acids to Lasers

Beyond creams, the dermatologist may recommend a treatment to remove damaged layers of skin and expose smoother, more even skin:

  • Chemical peels are meant to smooth out wrinkles and improve uneven skin tone and texture. A light chemical peel is done with hydroxy acids, while a deep peel uses phenol, a toxic acid. All peels can be painful and make the skin very sensitive, requiring time to heal. Light ones may require repeated applications. Deep chemical peels require sedation, can take months of healing and may make skin incredibly sun-sensitive for the rest of your life. On the other hand, results can last for decades.
  • Laser resurfacing is used to treat age spots as well as wrinkles and acne scars. A laser directed at specific areas on the face destroys the top layer of skin and stimulates collagen growth. It can be mild and localized to just a few areas, or deep and performed over the entire face. Treatments may require anesthesia, depending on their extent. Skin after laser resurfacing is sensitive and can be itchy and irritated. It can also stay pink for months afterwards and develop patches that are lighter or darker in tone. Results tend to improve up to a year after surgery and can last for years.
  • Dermabrasion is another technique to remove layers of skin and reduce the appearance of wrinkles, age spots and scars. It essentially involves sanding down the top layer of skin -- imagine a rotating sander with a layer of fine sandpaper. Typically, people are given anesthetics to numb the skin. As with other skin resurfacing treatments, the skin is left pink, irritated and highly sensitive to the sun. Changes in skin tone can also follow, and so can thickened patches of skin. Sometimes repeated treatments are necessary to obtain the desired result, or dermabrasion is used in conjunction with other things.
  • An alternative to removing layers of wrinkled skin is to inject substances to fill them in or otherwise temporarily reduce their appearance. Hyaluronic acid, a lubricant that is part of our connective tissue, is injected in wrinkled areas around the eyes, nose, mouth and forehead to "plump up" the wrinkles. Brand names include Restalyne and Juvaderm. Typically, results last for about six months. Dermatologists also inject collagen. Injected fillers cause the skin to swell and bruise, and it typically takes time for the area to look normal as opposed to overfilled. They can cause scars and infections. Botox is another injectable treatment, which temporarily paralyzes the muscles on the forehead where wrinkles form.

So far, we've only talked about dealing with the cosmetic issues associated with aging skin. There are also more serious skin conditions that can impact skin as we age.

Serious Skin Conditions that Go Beyond the Cosmetic

Bedsores are a serious worry for people in wheelchairs and hospital beds.
Bedsores are a serious worry for people in wheelchairs and hospital beds.
©iStockphoto.com/helenecanada

While we may not be happy that we have them, wrinkles don't really hurt anything but our ego. In addition to cosmetic concerns, there are more serious skin conditions that we may encounter as we age. We've talked about the importance of sunscreen to prevent skin cancer, and this can't be emphasized enough, but some skin conditions may be less well-known.

Dry skin is often more of an annoyance than anything else. But extremely dry skin goes beyond just being itchy and flaky -- it can crack and bleed. People with extremely dry skin can get ulcers -- places where the top layer or even lower layers of the skin have rubbed off completely. This opens up the possibility of infection, and depending on health and age, can become an extremely serious problem. People with skin at this extreme need more than a thick moisturizing lotion. They need to avoid taking hot showers or baths and use mild cleansers to avoid drying out the skin. In addition, running a humidifier to keep the air moist and treating cracked skin with antibiotic ointment can help prevent infections.

Another kind of ulcer affects people who have limited mobility: bedsores, also known as pressure ulcers. These occur when parts of the body are under extreme pressure for long periods of time, like with a person who can't shift positions in bed or in a wheelchair without assistance. Circulation is cut off, damaging the skin and underlying tissue. A mild bedsore can quickly turn into something much worse. Stage I bedsores are red, hot patches that heal soon after the pressure is relieved. Stage IV bedsores are deep wounds that penetrate to the bone and can lead to life-threatening infections such as sepsis, cellulitis and cancer. Sometimes bedsores are treated through removal of dead tissue or the use of antibiotics, but prevention is key -- staying clean and dry and moving or being shifted often.

People who have limited mobility may also suffer from skin rashes such as "prickly heat," or miliaria. This looks like patches of small red blisters and occurs when the sweat ducts on the skin's surface get clogged. Skin with prickly heat is red, irritated and itchy, and usually the worst areas are where skin rubs against skin, such as the underarms. The skin should be kept clean, cool and dry, and sweating should be avoided -- a little air conditioning goes a long way. Powders and other products to absorb moisture also help, as does frequent movement.

While you may never experience any of these more serious skin conditions, it's important to be aware of all of the things that may impact your skin as it ages. After all, it's your body's biggest organ. Caring for aging skin can require more diligence, but it is possible to have healthy skin for a lifetime.

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