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Skin Care and Aging

Americans spend billions of dollars each year on skin care products that promise to erase wrinkles, lighten age spots, and eliminate itching, flaking, or redness. But the simplest and cheapest way to keep your skin healthy and young looking is to stay out of the sun.

Sunlight is a major cause of the skin changes we think of as aging — changes such as wrinkles, dryness, and age spots. Your skin does change with age. For example, you sweat less, leading to increased dryness. As your skin ages, it becomes thinner and loses fat, so it looks less plump and smooth. Underlying structures — veins and bones in particular — become more prominent. Your skin can take longer to heal when injured.

You can delay these changes by staying out of the sun. Although nothing can completely undo sun damage, the skin sometimes can repair itself. So, it’s never too late to protect yourself from the harmful effects of the sun.

Wrinkles

Over time, the sun’s ultraviolet (UV) light damages the fibers in the skin called elastin. The breakdown of these fibers causes the skin to lose its ability to snap back after stretching. As a result, wrinkles form. Gravity also is at work, pulling at the skin and causing it to sag, most noticeably on the face, neck, and upper arms.

Cigarette smoking also contributes to wrinkles. People who smoke tend to have more wrinkles than nonsmokers of the same age, complexion, and history of sun exposure. The reason for this difference is not clear. It may be because smoking also plays a role in damaging elastin. Facial wrinkling increases with the amount of cigarettes and number of years a person has smoked.

Many products currently on the market claim to “revitalize aging skin.” According to the American Academy of Dermatology, over-the-counter “wrinkle” creams and lotions may soothe dry skin, but they do little or nothing to reverse wrinkles. At this time, the only products that have been studied for safety and effectiveness and approved by the Food and Drug Administration (FDA) to treat signs of sun-damaged or aging skin are tretinoin cream and carbon dioxide (CO2) and erbium (Er:YAG) lasers.

Tretinoin cream (Renova), a vitamin A derivative available by prescription only, is approved for reducing the appearance of fine wrinkles, mottled darkened spots, and roughness in people whose skin doesn’t improve with regular skin care and use of sun protection. However, it doesn’t eliminate wrinkles, repair sun-damaged skin, or restore skin to its healthier, younger structure. It hasn’t been studied in people 50 and older or in people with moderately or darkly pigmented skin.

The CO2 and Er:YAG lasers are approved to treat wrinkles. The doctor uses the laser to remove skin one layer at a time. Laser therapy is performed under anesthesia in an outpatient surgical setting.

The FDA currently is studying the safety of alpha hydroxy acids (AHAs), which are widely promoted to reduce wrinkles, spots, and other signs of aging, sun-damaged skin. Some studies suggest that they may work, but there is concern about adverse reactions and long-term effects of their use. Because people who use AHA products have greater sensitivity to the sun, the FDA advises consumers to protect themselves from sun exposure by using sunscreen, wearing a hat, or avoiding mid-day sun. If you are interested in treatment for wrinkles, you should discuss treatment options with a dermatologist.

Dry Skin and Itching

Many older people suffer from dry skin, particularly on their lower legs, elbows, and forearms. The skin feels rough and scaly and often is accompanied by a distressing, intense itchiness. Low humidity — caused by overheating during the winter and air conditioning during the summer — contributes to dryness and itching. The loss of sweat and oil glands as you age also may worsen dry skin. Anything that further dries your skin — such as overuse of soaps, antiperspirants, perfumes, or hot baths — will make the problem worse. Dehydration, sun exposure, smoking, and stress also may cause dry skin.

Dry skin itches because it is irritated easily. If your skin is very dry and itchy, see a doctor. Dry skin and itching can affect your sleep, cause irritability, or be a symptom of a disease. For example, diabetes and kidney disease can cause itching. Some medicines make the itchiness worse.

The most common treatment for dry skin is the use of moisturizers to reduce water loss and soothe the skin. Moisturizers come in several forms — ointments, creams, and lotions. Ointments are mixtures of water in oil, usually either lanolin or petrolatum. Creams are preparations of oil in water, which is the main ingredient. Creams must be applied more often than ointments to be most effective. Lotions contain powder crystals dissolved in water, again the main ingredient. Because of their high water content, they feel cool on the skin and don’t leave the skin feeling greasy. Although they are easy to apply and may be more pleasing than ointments and creams, lotions don’t have the same protective qualities. You may need to apply them frequently to relieve the signs and symptoms of dryness. Moisturizers should be used indefinitely to prevent recurrence of dry skin.

A humidifier can add moisture to the air. Bathing less often and using milder soaps also can help relieve dry skin. Warm water is less irritating to dry skin than hot water.

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