Aging means increased risk for skin injury, according to the National Library of Medicine. The skin is thinner, more fragile, and it loses its protective fat layer. Older people also may be less able to sense touch, pressure, vibration, heat, and cold. Aging changes in the skin, like wrinkles and sagging skin, are among the most visible signs of aging.
Deeper Dive
Although skin has many layers, it can generally be divided into three main parts:
- The outer part (epidermis) contains skin cells, pigment, and proteins.
- The middle part (dermis) contains blood vessels, nerves, hair follicles, and oil glands. The dermis provides nutrients to the epidermis.
- The inner layer under the dermis (the subcutaneous layer) contains sweat glands, some hair follicles, blood vessels, and fat.
Each layer also contains connective tissue with collagen fibers to give support and elastin fibers to provide flexibility and strength. Skin changes are related to environmental factors, genetic makeup, nutrition, and other factors. The greatest single factor, though, is sun exposure. It’s easy to see when comparing areas of the body that have regular sun exposure with areas that are protected from sunlight.
More than 90% of all older people have some type of skin disorder:
- Thinning of the outer skin layer (epidermis), although the number of cell layers remains unchanged.
- The number of pigment-containing cells (melanocytes) decreases. The remaining melanocytes increase in size.
- Aging skin looks thinner, paler, and clear (translucent). Large pigmented spots, including age spots, liver spots, or lentigos, may appear in sun-exposed areas.
- Elastosis – changes in the connective tissue reduce the skin’s strength and elasticity. This produces the leathery, weather-beaten appearance common to farmers, sailors, and others who spend a large amount of time outdoors.
- The blood vessels of the dermis become more fragile. This leads to bruising, bleeding under the skin (often called senile purpura), cherry angiomas, and similar conditions.
- The subcutaneous fat layer thins so it has less insulation and padding. This increases the risk of skin injury and reduces the body’s ability to maintain its temperature. This increases risk for hypothermia in cold weather. Additionally, certain medications are absorbed by the fat layer; losing this layer changes how these drugs work.
- The sweat glands produce less sweat. This makes it harder to keep cool. An older adult’s risk for overheating or developing heat stroke increases.
- Growths such as skin tags, warts, rough patches (keratoses), and other blemishes are more common in older people.
- Aging skin repairs itself more slowly than younger skin. Wound healing may be up to four times slower. This contributes to pressure ulcers and infections. Diabetes, blood vessel changes, lowered immunity, and other factors also affect healing.