Why Skin Changes With Age
With increasing age, several biological changes occur that affect skin health and resilience. The outermost layer of the skin, the epidermis, thins, making it more fragile. Concurrently, the production of natural oils by sebaceous glands decreases, leading to dryness and a compromise of the skin's protective barrier. This loss of elasticity and fat in the underlying layers makes skin more prone to injury and slows down the healing process, setting the stage for various skin conditions.
Common Benign Skin Conditions in Older Adults
Age Spots and Solar Lentigines
Also known as liver spots, these flat, brown spots appear most often on sun-exposed areas like the face, hands, and arms. While harmless, their presence indicates a history of sun exposure and they can be a cosmetic concern for many individuals.
Seborrheic Keratosis
These common, non-cancerous skin growths often look like warts or waxy, brown, or black pasted-on spots. They can appear on the face, chest, back, and other areas. While generally harmless, they can become irritated and itchy and may need to be differentiated from more serious conditions by a dermatologist.
Skin Tags (Acrochordons)
Small, soft, skin-colored or brownish growths that hang off the skin. They are typically found in areas where skin rubs against skin, such as the armpits, neck, and groin. Skin tags are benign and usually do not require removal unless they cause irritation.
Chronic Inflammatory and Infectious Conditions
Xerosis and Asteatotic Eczema
Xerosis, or excessively dry skin, is a very common complaint for seniors due to the reduction in sebaceous gland activity. If left untreated, the severe dryness can lead to asteatotic eczema, characterized by red, inflamed, and cracked skin that may look like cracked porcelain.
Shingles (Herpes Zoster)
Caused by the reactivation of the chickenpox virus, shingles presents as a painful, blistering rash. The risk and severity of shingles, along with its potential complication of postherpetic neuralgia (long-term nerve pain), increase significantly with age. A vaccine is available and recommended for older adults.
Fungal Infections
With reduced immune function and slower wound healing, older adults are more susceptible to fungal infections like athlete's foot (tinea pedis) and nail fungus (onychomycosis). These can be persistent and require diligent management.
Vascular and Bruising Issues
Senile Purpura
With age, blood vessels become more fragile and the protective fat layer thins, leading to easy bruising. Senile purpura appears as dark purple patches, typically on the forearms and legs, resulting from minor bumps. This is different from the bruising associated with taking blood-thinning medications.
Stasis Dermatitis
This condition affects the ankles and lower legs and is caused by poor blood circulation due to underlying varicose veins. It manifests as inflammation, skin thickening, dryness, and pigmentation changes.
Serious Concerns: Skin Cancer and Precursors
Skin Cancer (Basal, Squamous, and Melanoma)
Skin cancer is a major health concern for those over 70, primarily due to a lifetime of sun exposure.
- Basal Cell Carcinoma: The most common type, it appears as a pearly, waxy bump or a flat, flesh-colored patch on sun-exposed areas.
- Squamous Cell Carcinoma: Often presents as a firm, red nodule or a flat lesion with a scaly, crusted surface, commonly found on the face, ears, lips, and back of the hands.
- Melanoma: The most serious form of skin cancer, melanoma can develop from a new spot or an existing mole. The 'ABCDEs'—asymmetry, border irregularity, color variations, diameter greater than 6mm, and evolving—are crucial signs to watch for.
Actinic Keratosis
These are rough, scaly patches on sun-exposed skin and are considered pre-cancers. While not all actinic keratoses will progress to squamous cell carcinoma, they warrant medical attention and treatment.
Comparison of Common Senior Skin Conditions
| Condition | Appearance | Primary Cause | Risk Factors | Treatment Approach |
|---|---|---|---|---|
| Age Spots | Flat, brown spots; sun-exposed areas | UV sun damage over decades | Sun exposure, fairer skin | Topical creams, laser therapy |
| Seborrheic Keratosis | Waxy, stuck-on growths; various sizes | Unknown, genetics may play a role | Older age | Cryotherapy, removal for irritation |
| Xerosis (Dry Skin) | Flaky, rough, itchy, tight-feeling skin | Reduced oil and sweat gland function | Age, environmental factors | Moisturizers, hydration, humidifiers |
| Senile Purpura | Dark purple, easy bruising; forearms/legs | Fragile blood vessels, thin skin | Age, trauma, certain medications | Protection from injury, no specific cure |
| Shingles | Painful, blistering rash; one side of body | Reactivation of chickenpox virus | Older age, weakened immunity | Antiviral medication, vaccination |
| Skin Cancer | Varying appearance (nodules, moles) | Cumulative UV exposure, genetics | Sun exposure, age, family history | Surgery, radiation, immunotherapy |
Management and Prevention Strategies
Adopting a proactive approach can help manage and prevent many age-related skin issues. This includes using gentle, fragrance-free cleansers and thick, emollient moisturizers. Limiting hot showers, staying hydrated, and using a humidifier can combat dry skin. Consistent use of broad-spectrum sunscreen and wearing protective clothing are essential for minimizing UV damage and reducing skin cancer risk. Regular skin self-exams and professional dermatological screenings are also critical for early detection of any concerning changes, especially for individuals with a history of sun exposure or a family history of skin cancer.
Conclusion
While many skin changes are a natural part of the aging process, they don’t have to be a source of discomfort or health risk. From common cosmetic concerns like age spots to more serious issues like skin cancer, understanding what are the skin conditions for people over 70 is the first step toward effective care. By implementing protective strategies and staying vigilant with regular skin checks, seniors can maintain healthier, more comfortable skin for years to come. For more information on aging skin care, consult reliable sources like the National Institute on Aging: Skin Care and Aging.
