BY AMBER SMITH

What causes our skin to look old?

You can blame intrinsic processes, such as changes in lipid content and shortening of the capillaries, which are universal and inevitable. But the most visible signs of aging — including wrinkles and blotchiness — come from extrinsic factors, such as our sun or tanning bed exposure, smoking habits and other factors.

Ramsay Farah, MD, the chief of dermatology at Upstate, says that changes in the skin can affect the whole body.

Thermoregulation is one function of skin. “Our internal core body temperature has a lot to do with our skin,” Farah explains. “When the skin is diseased, whether it‘s in the young or in the old, that ability to regulate our core body temperature is compromised.”

The nerves in our skin undergo physiologic changes and don‘t work as well when we are old as they did when we were young. That relates to a common complaint. “The elderly tend to itch,” Farah says, providing the medical term: pruritis. “We don‘t know exactly why they itch, but it must surely have something to do with cutaneous nerve endings.”

Also, “the skin is one of the first barriers or points of contact our immune system has with the outside world,” the dermatologist says. With a depleted number of immune cells in the skin, an older person‘s immune system is less effective against germs of all types.

We can‘t stop time. So, what can we do to care for aging skin?

1. Sunscreen is still important. Older skin has less of an ability to repair DNA damage that occurs during exposure from the sun or ultraviolet light, so making sure skin is protected will help reduce that threat. And, be aware of skin changes. Decades of DNA damage can lead to skin cancers in one‘s senior years.


2. Moisturize. Farah says this is the least costly and most effective step you can take to protect your skin. Find an over-the-counter lotion or cream that contains ceramides. Blot dry after showering, leaving a little bit of water on the skin. Within three minutes, liberally apply the moisturizer.


3. Bathe using lukewarm water, with a soap such as Dove or Aveeno that contains oil. Avoid products containing perfumes because they can contribute to dry skin.


4. Use a humidifier. Moisture in our skin evaporates when the surrounding air is dry. A humidifier can combat that dryness.


5. Eat a healthy diet. Vitamins and minerals in fruits and vegetables are good for your whole body, including the skin.


6. Practice good hygiene. If an older person has become infirm, he or she may need help with this.


7. Consider hormonal therapy. Women who take estrogen supplements may improve their skin‘s ability to retain moisture.

As it ages, skin:

-- is drier because it retains less water.

-- becomes thinner and more sensitive.

-- loses the ability to regenerate quickly.

-- is more prone to inflammation.

-- has fewer immune cells.

-- loses sweat glands, decreasing the ability to regulate body temperature.

-- experiences decreased blood flow.

-- can bruise more easily because of a reduction in collagen.

-- undergoes physiological changes in the nerves.

-- may develop skin cancer from cumulative DNA damage.



This article appears in the spring 2018 issue of Upstate Health magazine. To hear a podcast/radio interview in which Farah speaks about the special needs of aging skin, click here.