Do human heads shrink with age? Separating myth from reality

While it's a common notion that your head size is set in stone after adulthood, recent research indicates a more nuanced reality. A 2017 study published in Plastic and Reconstructive Surgery highlighted that bone loss in the facial skeleton is a key contributor to the visible signs of aging. So, do human heads shrink with age?

Quick Summary

The skull's bony structure remains largely constant in size after early adulthood, contrary to what aging facial features might suggest. Changes to facial bones and soft tissues create the illusion of a smaller head.

Key Points

• No Head Shrinkage: The bony structure of the cranium does not significantly shrink after early adulthood.

• Facial Bone Loss: Resorption of the facial skeleton, particularly the maxilla and around the eye sockets, is a key driver of age-related changes.

• Soft Tissue Shifts: The loss of facial fat pads, weakened muscles, and less elastic skin cause sagging and alter facial contours.

• Illusion, Not Reality: The perceived change in head size is an illusion created by the combined effects of skeletal remodeling and soft tissue deflation.

• Multiple Contributing Factors: Dental health, hair loss, and weight changes also contribute to shifts in facial appearance over time.

• Rare Conditions: While rare medical conditions like acromegaly or Paget's disease can affect skull size, they are not part of the normal aging process.

The Truth Behind the Myth: Skull Size Versus Perception

Contrary to the common belief that our heads shrink with age, the opposite is often true, or at least, a different kind of change occurs. The human skull typically reaches its maximum size by around age 20. The bones of the cranial vault—the main part of the skull protecting the brain—fuse together at the sutures and do not undergo significant, overall shrinkage. The perception of a shrinking or changing head size is a result of complex processes involving bone remodeling and shifts in soft tissue.

Bone remodeling is a lifelong process, where old bone tissue is removed and new tissue is formed. As we age, this process can become imbalanced, with more bone being resorbed than is replaced, particularly in the facial skeleton. This bone loss, combined with other changes, is what fundamentally alters our facial appearance over time.

The Real Changes: Bone Remodeling and Soft Tissue Shifts

It's not the brain-protecting cranium that shrinks, but the facial skeleton and soft tissues that change dramatically. These alterations create the perception of a head that is either shrinking or subtly changing shape.

Skeletal Shifts and Remodeling

• Enlarging Orbits and Piriform Aperture: Studies using CT scans have shown that with age, the orbits (eye sockets) and the piriform aperture (the nasal opening) tend to increase in size. This bone resorption around the eyes and nose can make the face look more hollowed or gaunt over time.
• Midface Bone Loss: The maxilla, or upper jawbone, undergoes significant bone loss with age. This recession of the midface skeleton reduces the support for overlying soft tissues, contributing to the deepening of nasolabial folds and a less defined cheekbone area.
• Jawbone Changes: The mandible (lower jaw) also changes, particularly with tooth loss. When teeth are lost, the alveolar process—the part of the jawbone that holds the teeth—resorbs, leading to a reduced lower face height and a more recessed chin.
• Skull Thickening: In some cases, localized bone thickening can occur. A 2013 study revealed that thickening of the inner skull table can reduce intracranial volume, particularly in older women. This is thought to be related to hormonal changes or potentially a response to age-related brain atrophy.

The Impact of Soft Tissue and Skin

In addition to bone remodeling, the aging process significantly affects the soft tissues of the head and face, compounding the illusion of a changing skull.

• Fat Redistribution: The youthful 'heart-shaped' face relies on well-distributed fat pads in the cheeks. With age, this fat can diminish or descend due to gravity and weakened ligaments, leading to a flatter midface and jowling.
• Muscle Weakening: Facial muscles lose their tone over time, which, combined with reduced fat and skin elasticity, contributes to sagging skin and the formation of wrinkles and folds around the mouth and jawline.
• Reduced Skin Elasticity: The skin's natural production of collagen and elastin slows down with age. This causes skin to become thinner, drier, and less elastic, which exaggerates the facial changes caused by bone and fat loss.

Other Factors Influencing Perceived Head Size

Beyond the skeletal and soft tissue changes, several other common aging factors can influence the appearance and perception of head size and shape.

1. Hair Loss and Thinning: As hair thins or recedes, more of the scalp and forehead become visible. This can create the optical illusion of a larger, more prominent head, especially if it was previously framed by a fuller head of hair. The opposite can also occur, with hair loss making one's head appear smaller in comparison to their body.
2. Dental Health: The integrity of your jawbone and overall facial structure is directly tied to your dental health. Long-term tooth loss and gum recession can accelerate the bone resorption in the jaw, reducing the lower face height and significantly changing your profile.
3. Hormonal Changes: Fluctuations in hormones, particularly during menopause for women, can affect bone density and soft tissue. Conditions like osteoporosis, while rarely affecting the skull critically, can have an impact on facial bone health. Excess growth hormone in a rare condition called acromegaly can also cause bones to thicken, leading to a larger hat size, but this is a pathological condition, not normal aging.
4. Weight Fluctuations: Significant weight gain or loss can alter the amount of fat deposited in the face and neck. Gaining weight can give the head a fuller appearance, while significant weight loss can make the face look more gaunt, accentuating the skeletal changes.

Youthful vs. Aged Facial Structure

To better understand the shifts, consider the following comparison of general facial characteristics between a youthful and an aged face.

Feature	Youthful Appearance	Aged Appearance
Cheeks	Full, with fat pads high and prominent	Flattened, with fat pads descending and reduced in volume
Orbital Area	Round, with relatively small orbital openings	Larger, with more prominent rims and a hollowed look
Jawline	Defined, with clear angles	Blunted, with jowling and bone loss
Midface	Protruding, with strong support	Recessed, with deeper nasolabial folds
Profile	Smooth and convex facial contours	Sagging, with more angular and uneven contours

How to Manage Facial Changes and Maintain Bone Health

While you can't stop the natural progression of aging, proactive steps can help mitigate its effects on your appearance and overall bone health.

• Diet: A healthy diet rich in calcium, vitamin D, and other essential nutrients is crucial for bone density throughout the body. Omega-3 fatty acids and antioxidants also support overall health, including that of the skin and facial tissues.
• Lifestyle: Avoiding smoking and excessive alcohol consumption can help preserve bone mass and skin quality. Maintaining a healthy weight and staying hydrated are also beneficial for facial soft tissues.
• Exercise: Regular physical activity, including weight-bearing exercises, promotes bone strength throughout the body. While it won't prevent facial bone changes, it's vital for overall skeletal health.
• Cosmetic Interventions: For those concerned about appearance, various treatments exist. Dermal fillers can replace lost volume in the cheeks and around the mouth, while other procedures can address skin laxity. Understanding the root cause of these changes—often bone and tissue loss—is key to choosing the most effective approach.

For more detailed information on facial aging, explore comprehensive medical studies, such as this one on facial bone changes over time: Aging of the midface bony elements: a three-dimensional computed tomographic study.

Conclusion: Age-Related Shifts, Not Shrinkage

In summary, the notion that human heads shrink with age is a misinterpretation of the complex changes occurring in the facial skeleton and soft tissues. The skull's size remains relatively stable after early adulthood, but bone remodeling, fat loss, muscle weakening, and skin elasticity reduction all conspire to create a face that appears different. By understanding these underlying processes, we can appreciate the natural progression of aging and take informed steps to support overall health and address any aesthetic concerns, distinguishing fact from fiction.

Frequently Asked Questions

Does brain atrophy cause your head to shrink?

No, brain atrophy, or the shrinkage of brain tissue, does not cause the skull itself to shrink. Instead, studies show that in some cases, the inner skull table may thicken, reducing the intracranial volume.

Why does my hat size seem to get bigger as I get older?

An increasing hat size with age is more commonly linked to soft tissue changes, such as thickening of the scalp's subcutaneous fat layer due to weight gain. It can also be a symptom of a rare condition called Paget's disease of bone.

Can osteoporosis affect facial bones?

Yes, while severe skull fractures are rare, osteoporosis is a disease affecting all bones, including those of the facial skeleton. Bone loss in the jaw can be particularly affected, especially after tooth loss.

Do ears and noses keep growing throughout life?

Yes, the cartilage in your ears and nose continues to grow throughout your life, albeit slowly. This, combined with gravity and skin changes, can lead to a slightly larger or longer appearance over time.

What is the biggest factor contributing to a smaller-looking head with age?

The most significant contributing factor is the loss of facial bone mass and fat tissue. The recession of the midface and jawbone, combined with the descent of facial fat pads, creates a less voluminous and more hollowed facial appearance.

Is it normal for my forehead to seem larger as I age?

Yes, the forehead can appear more prominent with age due to several factors. These include a receding hairline and the downward descent of facial fat pads, which exposes more of the forehead and upper facial skeleton.

What's the difference between skull size and intracranial volume?

Skull size refers to the overall dimensions of the bony cranium, which remains relatively stable in adulthood. Intracranial volume is the space inside the skull occupied by the brain and other structures. Thickening of the inner skull table can reduce intracranial volume even if the external skull size appears unchanged.