This segment of AgingSkinNet
provides answers to some common questions about the effects of aging and
photoaging, diseases of the skin in older adults, and treatments for
aging skin. New questions will be asked and answered every month.
What is shingles, and why does it
occur only in older people?
Shingles is a condition caused by
a virus (herpes zoster) that also causes chicken pox. It is believed
that the virus causes chicken pox in childhood, then lies dormant in
nerve tissue for years or decades until it is reactivated to cause
shingles. While shingles can affect people at any age, it is more common
and often more painful in older adults.
Reactivation of herpes virus is
heralded by localized pain along the route of a nerve, as the virus
causes the nerve tissue to become inflamed. After 2 or 3 days of pain
that is often severe, the skin erupts with red and fluid-filled lesions
along the route of the affected nerve. The skin lesions resemble those
of chicken pox. As the condition progresses, new lesions continue to
form and pain continues to be severe. The active phase may continue for
a week or longer, but healing may require several weeks, especially in
older adults. In some cases, branches of the optical nerve may be
affected and vision may be impaired or even lost. A dermatologist should
be consulted immediately if shingles is suspected. Treatment with
anti-viral drugs is most effective in the early phase of shingles.
Why does the skin of older people
bruise so easily?
As people age, the skin becomes
thinner and fat padding under the skin is lost. Thus, blood vessels are
less protected from injury. An injury inflicted by mild trauma—for
example, bumping against a table or being hit by a tennis ball—may
result in a substantial bruise. In some instances, bruising may be an
indication of an underlying condition. Bruises that appear for no
apparent reason may indicate a bleeding disorder. Anti-clotting
medications may cause bleeding under the skin.
Older people often complain of
itching skin. What causes this itching?
Aging and photoaging reduce
the capacity of the skin to moisturize itself, so the skin becomes dry.
Dry skin is one of the major causes of itchiness in aging skin.
Over-the-counter moisturizing agents may relieve itching due to dry
skin. Other causes of itchy skin often require the attention of a
dermatologist. Elderly skin is sometimes more sensitive to clothing
fabrics (especially wool), soaps and detergents, and other items
encountered in everyday living. Identification of the sensitizing agents
and limiting exposure to them may reduce the itchiness. Allergies to a
host of indoor and outdoor agents may cause itching. Some medications
cause itchiness as a side effect. Severe itching as well as itching that
does not respond to moisturizing should be evaluated by a
dermatologist.
Are liver spots a sign of liver
disease?
Liver spots have nothing to do
with the liver, and they are not an indication of liver disease. They
are more correctly called "age spots" and "photoaging
spots". In medical terminology they are called lentigines or
lentigos. Their typical appearance is light to dark brown (nearly black)
flat patches on the hands, face, legs or feet. The edges of the spots
are rounded, giving them a resemblance to a large freckle. One may
appear by itself, or several may cluster together. The causes of these
spots are (1) an inherited tendency to form them, and (2) chronic sun
exposure. They can be removed by a dermatologist (Please see Treatment
of Aging Skin).
There are no effective preventive
measures for hereditary age spots. Photoaging may be prevented or
moderated by avoiding excessive sun exposure and using effective
sunscreen (Please see Prevention of Photoaging). Age spots are not
cancerous or precancerous. However, pigmented lesions that may be
similar in appearance, but have uneven rather than rounded edges, could
be melanoma and should be evaluated by a dermatologist (Please see Cancers
of Aging Skin).
Is it appropriate for a woman to
have a hair restoration procedure? Isn’t this something usually done
for men?
Hair loss is a problem affecting
about 35 million men in the United States—and about 22 million women.
Although hair transplantation and other hair restoration procedures were
at first used primarily for men to correct male pattern baldness, women
have increasingly turned to dermatologists for help in restoring a
"full head of hair" look. Inherited tendency is a major cause
of hair loss in women just as in men. Hormonal changes of pregnancy can
lead to hair loss. Other causes include stress and nutritional
deficiencies. Before a hair restoration program is undertaken by a
woman, a dermatologist must evaluate the cause(s) of hair loss and
recommend the hair restoration procedure that will be most effective
(Please see Hair Loss and Hair Restoration).
