Protecting skin from sun can help appearance of aging
DEAR DOCTORS: I’m 59 years old and have noticed that my skin is already getting fragile. I know it’s a natural part of aging, but I didn’t expect it to happen so soon. I’d like to know what causes skin to change with age, and also hear thoughts on caring for older skin.
DEAR READER:
You’ve raised a topic that’s popular with many of our readers. What’s interesting is questions about changing skin come from all age groups. Young adults in their 20s are discovering their first wrinkles. In the 30s and 40s, a loss of elasticity becomes an issue. People in their 50s, 60s and beyond ask about thinning and fragile skin, which is the subject of your letter. This age range illustrates how our skin, which is our largest organ, continually changes throughout our lifetimes.
When you look at the skin, you’re seeing just one of three complex layers. The topmost, known as the epidermis, varies in thickness depending where on the body it is located. It is divided into five sub-layers, or strata, composed of specialized cells, proteins and other structures. The epidermis gives skin its color, contributes to immune response, holds water and continuously generates new cells to replace those that are dying or dead. Below the epidermis lies the dermis. Strong and elastic, it’s the thickest of the skin’s three layers. The dermis
houses blood vessels, oil glands, hair follicles, sweat glands, lymphatic vessels and nerves. The deepest layer of the skin, known as the hypodermis, is made up of fat cells and connective tissue. It helps keep us warm and contributes
to structure.
When it comes to how skin ages, genetics plays a big role. Environmental and lifestyle factors are also important. This includes exposure to sunlight, air pollution, smoking, drug use, certain medications and general health. What the individual does — and doesn’t do — to take care of their skin also has an effect. Protecting skin from the spectrum of ultraviolet light emitted by the sun is key to keeping it strong and healthy. UVA rays cause structural damage that leads to wrinkles. The slightly stronger UVB rays cause sunburn, can damage DNA and trigger cancers. This makes it important to always shield the skin from sunlight with sunscreen and clothing.
As we grow older, skin grows thinner due to agerelated physical and physiological changes taking place in its multiple layers and strata. The skin cells of the epidermis grow thinner, connective tissues in the dermis weaken and lose volume, and oil glands grow sluggish. Fat loss in the hypodermis adds to the loss of structural support. Taken together, this causes aging skin to become thin and fragile and leads to its translucent appearance.
You can’t stop skin from aging, but you can protect it. Treat it kindly, washing with gentle cleansers and a light touch. Apply moisturizers to damp skin — and be generous. Retinol creams, which stimulate collagen production, can slow thinning. However, they have side effects and are not appropriate for all skin types. Older adults should consult with their doctors before using these products. And, yes, we mentioned it already, but remember to shield your skin from the sun.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.
Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.