Appearance Changes In Aging Skin

Appearance Changes In Aging Skin

Overview

  1. color change
    • hypepigmentation (age spot, liver spot)
    • mottled skin
    • patchy skin color
  2. texture change
    • dryness
    • thinning of skin
    • rough, leathery weather-beaten (loss of smoothness of epidermis cells)
    • loss of elasticity (elastosis), skin turgor
    • sagging, laxity (loss of firmness, tightness)
    • wrinkles and fine lines
    • dull (not glowing)
    • uneven texture

Elements of the Appearance of Skin

Complexion refers to the natural color, texture, and appearance of the skin, especially that of the face. The appearance of the skin can have considerable clinical significance. The skin is readily accessible for examination (no invasive procedures needed), and its color and texture can reveal much about underlying physiology.

Color: Skin is moderately transparent. Light which penetrates the skin is reflected back from varying depths by epidermal cells, by collagen, and by blood.

Melanin produced by melanocytes and stored in basal keratinocytes contributes a yellow/brown color to the epidermis. If the epidermis is not heavily pigmented, light readily penetrates into the dermis. Collagen scatters light from the dermis without altering its color. Hence, the whiteness of “white” skin is primarily a reflection of collagen. Hemoglobin in red blood cells scatters red light and is responsible for the pinkness of unpigmented skin. The relative amount of pink in any given patch of skin reflects how closely blood approaches the base of the epidermis (i.e., how much collagen intervenes to scatter white light before red blood cells can absorb the non-red colors). Each of these elements contributes to the apparent color of skin. Variations in skin color in different parts of the body are based on variations in these elements, most especially the amount of pigment, the thickness of dermis, and the degree of perfusion in dermal capillaries.

Perhaps most significantly, blood flow through the dermis is highly variable and is regulated in response to many conditions (heat, pain, fluid balance, inflammation, emotional reaction). Resulting variations in pinkness can provide indicators of underlying physiology, both locally and systemically. Obvious examples include inflammation, overheating, dehydration, shock, and even embarrassment (i.e., blushing) .

There are six types of skin tones according to Fitzpatrick Scale

Type Definition Description
I Always burns, never tans Light, Pale white, Freckles
II Usually burns, sometimes tans Fair
III May burn, usually tans Light Brown/Medium
IV Rarely burns, always tans Olive brown
V Moderate constitutional pigmentation Brown
VI Marked constitutional pigmentation Black

Texture: Skin texture is affected by the thickness and smoothness of the epidermis, by the quality of fibers in the dermis, and by the amount of fluid in dermal connective tissue.

Because the epidermis is continually being replenished by cell divisions among basal keratinocytes and because this tissue is exposed to a variety of insults, the epidermis is especially prone to disturbances of growth. The connective tissue fibers of the skin dermis are permanent, enduring without replacement (except by repair after injury) throughout life. Although collagen is quite durable, elastin commonly deteriorates with age and loses its elasticity. This is easily demonstrated by a “pinch test”. In youthful skin, loose skin that has been pinched into a ridge quickly returns to its normal position when released. Elderly skin commonly remains in its deformed position, returning more slowly if at all.

Both edema (accumulation of excess fluid in connective tissue) and dehydration can dramatically alter the appearance of skin.

Finding the best products for your skin means you have to know what your skin type is. Normal, Oily and Dry are the three main skin types.

What are the Changes in appearance of skin when we age

The appearance of aging skin is: dryness (dehydration), thinning or thickening of the skin, loss of elasticity (elastosis), sagging skin (laxity, loss of firmness, tightness), wrinkles and fine lines,  areas of hyperpigmentation (called age or liver spots), patchy skin color (areas of irregular skin coloring), mottled skin appearance, rough (loss of smoothness of epidermal cells), leathery weather-beaten appearance, and dull (not glowing, radiant) appearance and uneven skin texture. Flaky skin is a condition where a person’s skin lifts loosely in flakes. Scaly skin is a condition of toughness or scaliness of the skin. The build up of outmost dead skin cells can clog sebaceous pores which results in dull flaky skin and can cause bumps, spots, acne bumps (blackheads, and pimples).

Patchy skin color refers to areas of irregular skin coloring. Irregular or patchy discoloration of the skin can be caused by: changes in pigment (melanin), blood vessel (vascular) changes, growth of foreign organisms on the skin. Mottling or mottled skin refers specifically to blood vessel changes in the skin which cause a patchy appearance.

Normal aging will cause epidermal cells to become thinner and less sticky. The thinner cells make the skin look noticeably thinner. The decreased stickiness of the cells decreases the effectiveness of the barrier function allowing moisture to be released instead of being kept in the skin. This causes dryness. The number of epidermal cells decreases by 10% per decade. In addition, typically, as a person ages, the sweat and oil glands of the skin also become less numerous. Sebaceous glands get bigger but produce less sebum, and the number of sweat glands decreases and become smaller in size. Both of these changes causes the skin to lose moisture and to dry out more easily.

While the oil and fat components of skin prevent evaporation and provide lubrication to the surface of skin, it is actually the intercellular matrix which contain skin’s natural moisturizing factor (NMF), along with the skin’s lipid content in skin membrane, that gives skin a good deal of its surface texture and feel. The intercellular matrix is the skin’s first line of defense against water loss. Aging skin loses water due to the crystallization of lipid membrane. When the lipid and natural moisturizing factor (such as hyaluronic acid) content of skin is reduced, we experience surface roughness, flaking, fine lines, and uncomfortable feeling. The longer the skin’s surface layer (stratum corneum) is impaired, the less effective the skin’s intercellular matrix becomes. Moreover, the skin’s healing process is impaired

Changes in the connective tissue reduce the skin’s strength and elasticity. This is known as elastosis and is especially pronounced in sun-exposed areas (solar elastosis). Elastosis produces the leathery, weather-beaten appearance common to farmers, sailors, and others who spend a large amount of time outdoors.  Skin Elasticity can be tested on your own. Pinch a large section of skin on the back of your hand, holding firmly for 5 seconds. Release and count the number of seconds for the pinched skin to return to its normal (totally flat) appearance. Skin elasticity is an indicator of potassium levels. The skin on the back of one’s hand, when pinched, should snap back like a fresh rubber band; if there is not enough potassium or too much sodium then the tissues will start to harden and return to their resting position more slowly. Skin turgor is an abnormality in the skin’s ability to change shape and return to normal (elasticity). Skin turgor is a sign commonly used by health care workers to assess the degree of fluid loss or dehydration. Decreased skin turgor is a late sign in dehydration. It occurs with moderate to severe dehydration.

Sagging skin and wrinkles, loss of elasticity are due to the change (loosen)/destruction of collagen and elstin fibers in the connective tissue of the skin and dehydration.

Some skin diseases are more often associated with aging people. Blood vessels are easier to see through the thinning skin. Also because they become dilated with age. These blood vessels may be visible as red dome-like formations on the skin (cherry angiomas), or as broken capillaries on the face (telangietasias). Many people develop senile or actinic purpura, which are purplish spots or patches on the skin created by small hemorrhages in the skin. Older skin has less protection against sun damage because protective cells called melanocytes decrease with age. Aging skin is also more likely to develop a variety of benign and pre-cancerous growths, such as seborrheic and actinic keratoses. Seborrheic keratoses often have a rough, brown appearance, and look like a wart. They are benign. Actinic keratoses are small, scaly growths on areas of the skin that have received sun exposure. They are an early sign of skin cancer.

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