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Skin wrinkles and blemishes

Description

An in-depth report on the treatment and prevention of skin wrinkles and blemishes.

Alternative Names

Liver spots; Pupura; Seborrheic keratoses; Cosmetic surgery; Plastic surgery

Risk Factors

Exposure to Sun in Childhood. It is estimated that 50 - 80% of skin damage occurs in childhood and adolescence from intermittent, intense sun exposure that causes severe sunburns. In spite of this now well-known effect, many people still believe that a tan in children signifies health. And even though many parents are concerned about sun exposure, they still rely too much on sunscreen and not enough on protective clothing.

The Elderly. Most people over 70 have at least one skin disorder. Many have three or four. Everyone experiences skin changes as they age, but a long life is not the sole determinant of aging skin. Family history, genetics, and behavioral choices all have a profound impact on the onset of aging-skin symptoms.

Activities Leading to Overexposure to Sunlight and Ultraviolet Radiation

Of all the risk factors for aging skin, exposure to UV radiation from sunlight is by far the most serious. Indeed, the vast majority of undesirable consequences of aging skin occur in individuals who are repetitively exposed to the sun, including the following:

• Outdoor workers, such as farmers, fishermen, construction workers, and lifeguards.
• Outdoor enthusiasts.
• Sunbathers.
• People who regularly attend tanning salons or use tanning beds. A 2002 study indicated that regular use significantly increases the risk for non-melanoma skin cancers. Fair women under age 50 were at particular risk.

Skin Types

Experts have devised a classification system for skin phototypes (SPTs) based on the sensitivity to sunlight. It ranges from SPT I (lightest skin plus other factors) to IV (darkest skin). People with skin types I and II are at highest risk for photoaging skin diseases, including cancer. It should be noted, however, that premature aging from sunlight can affect people of all skin shades.

Tanning and Sunburn History

Skin Type	Tanning and Burning History
I	Always burns, never tans, sensitive to sun exposure
II	Burns easily, tans minimally
III	Burns moderately, tans gradually to light brown
IV	Burns minimally, always tans well to moderately brown
V	Rarely burns, tans profusely to dark
VI	Never burns, deeply pigmented, least sensitive

Gender

It is commonly believed that women are at greater risk for wrinkles than men. Some evidence suggests, however, that given the same risk factors, men and women in the same age groups have comparable risks for skin photoaging. In fact, in one 1999 study, long-term sun exposure caused a greater number of wrinkles in men than in women. In a French study, the evidence of moderate to severe photoaging was observed in the following:

• In 22% of women and 17% of men between the ages of 45 and 49.
• In 36% of women and 38% of men by age 54.
• Nearly half of both men and women by age 60.

In fact, some studies report that men are more likely to develop non-melanoma skin cancers.

Smokers

According to one study, heavy smokers are almost five times as likely to have wrinkled facial skin than nonsmokers. In fact, heavy smokers in their 40s often have facial wrinkles more like those of nonsmokers in their 60s. Studies of identical twins have found smokers to have thinner skin (in some cases by as much as 40%), more severe wrinkles, and more gray hair than their non-smoking twins. And even worse, cigarette smokers are more prone to skin cancers, including squamous cell carcinoma and giant basal cell carcinomas. For more information on smoking and smoking cessation, see In-Depth Report #41 : Smoking.

• Review Date: 9/3/2006
• Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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