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.
Skin Cancer
Skin cancer is the most common type of cancer in the United
States. According to current estimates, 40 to 50 percent of
Americans who live to age 65 will have skin cancer at least
once. Although anyone can get skin cancer, the risk is greatest
for people who have fair skin that freckles easily.
UV radiation from the sun is the main cause of skin cancer. In
addition, artificial sources of UV radiation ? such as sunlamps
and tanning booths ? can cause skin cancer. People who live in
areas of the U.S. that get high levels of UV radiation from the
sun are more likely to get skin cancer. For example, skin cancer
is more common in Texas and Florida than in Minnesota, where the
sun is not as strong.
There are three common types of skin cancers. Basal cell
carcinomas are the most common, accounting for more than 90
percent of all skin cancers in the United States. They are
slow-growing cancers that seldom spread to other parts of the
body. Squamous cell carcinomas also rarely spread, but they do
so more often than basal cell carcinomas. The most dangerous of
all cancers that occur in the skin is melanoma. Melanoma can
spread to other organs, and when it does, it often is fatal.
Both basal and squamous cell cancers are found mainly on areas
of the skin exposed to the sun ? the head, face, neck, hands,
and arms. However, skin cancer can occur anywhere. Changes in
the skin are not sure signs of cancer; however, it?s important
to see a doctor if any symptom lasts longer than 2 weeks. Don?t
wait for the area to hurt ? skin cancers seldom cause pain.
All skin cancers could be cured if they were discovered and
brought to a doctor?s attention before they had a chance to
spread. Therefore, you should check your skin regularly. The
most common warning sign of skin cancer is a change on the skin,
especially a new growth or a sore that doesn?t heal. Skin
cancers don?t all look the same. For example, skin cancer can
start as a small, smooth, shiny, pale, or waxy lump. Or it can
appear as a firm red lump. Sometimes, the lump bleeds or
develops a crust. Skin cancer also can start as a flat, red spot
that is rough, dry, or scaly.
In treating skin cancer, the doctor?s main goal is to remove or
destroy cancer completely, leaving as small scar as possible. To
plan the best treatment for each person, the doctor considers
the type of skin cancer, its location and size, and the person?s
general health and medical history. Treatment for skin cancer
usually involves some type of surgery. In some cases, radiation
therapy or chemotherapy (anticancer drugs) or a combination of
these treatments may be necessary.
Age Spots
Age spots, or ?liver spots? as they?re often called, have
nothing to do with the liver. Rather, these flat, brown spots
are caused by years of sun exposure. They are bigger than
freckles and appear in fair-skinned people on sun-exposed areas
such as the face, hands, arms, back, and feet. The medical name
for them is solar lentigo. They may be accompanied by wrinkling,
dryness, thinning of the skin, and rough spots.
A number of treatments are available, including skin-lightening,
or ?fade? creams; cryotherapy (freezing); and laser therapy.
Tretinoin cream is approved for reducing the appearance of
darkened spots. A sunscreen or sun block should be used to
prevent further damage.
Shingles
Shingles is an outbreak of a rash or blisters on the skin that
may cause severe pain. Shingles is caused by the
varicella-zoster virus, the same virus that causes chickenpox.
After an attack of chickenpox, the virus lies silent in the
nerve tissue. Years later, the virus can reappear in the form of
shingles. Although it is most common in people over age 50,
anyone who has had chickenpox can develop shingles. It also is
common in people with weakened immune systems due to HIV
infection, chemotherapy or radiation treatment, transplant
operations, and stress.
Early signs of shingles include burning or shooting pain and
tingling or itching, generally on one side of the body or face.
A rash appears as a band or patch of raised dots on the side of
the trunk or face. The rash develops into small, fluid-filled
blisters, which begin to dry out and crust over within several
days. When the rash is at its peak, symptoms can range from mild
itching to intense pain. Most people with shingles have only one
bout with the disease in their lifetime. However, those with
impaired immune systems ? for example, people with AIDS or
cancer ? may suffer repeated episodes.
If you suspect you have shingles, see a doctor right away. The
severity and duration of an attack of shingles can be reduced
significantly by immediate treatment with antiviral drugs. These
drugs also may help prevent the painful aftereffects of shingles
known as postherpetic neuralgia. The National Institute of
Allergy and Infectious Diseases currently is testing a shingles
vaccine at the National Institutes of Health in Bethesda,
Maryland. The vaccine they are testing is similar to the one
used to immunize against chickenpox. After the shot, some people
have had some discomfort around the area of the injection. In
addition, a few people have had a low-grade fever. For more
information about this study, call 1-800-411-1222.
Bruising
Many older people notice an increased number of bruises,
especially on their arms and legs. The skin becomes thinner with
age and sun damage. Loss of fat and connective tissue weakens
the support around blood vessels, making them more susceptible
to injury. The skin bruises and tears more easily and takes
longer to heal.
Sometimes bruising is caused by medications or illness. If
bruising occurs in areas always covered by clothing, see a
doctor.
Keep Your Skin Healthy
The best way to keep your skin healthy is to avoid sun exposure.
# Stay out of the sun. Avoid the sun between 10 a.m. and 3 p.m.
This is when the sun’s UV rays are strongest. Don’t be fooled by
cloudy skies. Harmful rays pass through clouds. UV radiation
also can pass through water, so don’t assume you’re safe if
you’re in the water and feeling cool.
# Use sunscreen. Sunscreens are rated in strength according to a
sun protection factor (SPF), which ranges from 2 to 30 or
higher. A higher number means longer protection. Buy products
with an SPF number of 15 or higher. Also look for products whose
label says: broad spectrum (meaning they protect against both
types of harmful sun rays ? UVA and UVB) and water resistant
(meaning they stay on your skin longer, even if you get wet or
sweat a lot). Remember to reapply the lotion as needed.
# Wear protective clothing. A hat with a wide brim shades your
neck, ears, eyes, and head. Look for sunglasses with a label
saying the glasses block 99 to 100 percent of the sun?s rays.
Wear loose, lightweight, long-sleeved shirts and long pants or
long skirts when in the sun.
# Avoid artificial tanning. Don’t use sunlamps and tanning beds,
as well as tanning pills and tanning makeup. Tanning pills have
a color additive that turns your skin orange after you take
them. The FDA has approved this color additive for coloring
foods but not for tanning the skin. The large amount of color
additive in tanning pills may be harmful. Tanning make-up
products are not suntan lotions and will not protect your skin
from the sun.
# Check your skin often. Look for changes in the size, shape,
color, or feel of birthmarks, moles, and spots. If you find any
changes that worry you, see a doctor. The American Academy of
Dermatology suggests that older, fair-skinned people have a
yearly skin check by a doctor as part of a regular physical exam.
About the author:
Dean Brown’s website can be found at http://nowrinkles.babymys
kin.com
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