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Senior Skin: 5 Common Conditions

photo of modern senior woman with hand on her faceIf you’ve had the good fortune to reach the golden years, your skin likely shows signs of aging. Natural changes are dryness, fragility, looseness, and thinning. Oil glands enter retirement. In the deep skin layers, fat cells take leave. Structural proteins dwindle.

While all these changes lead to skin problems, they are treatable. In fact, many of our procedures will help you look younger! Here are five senior conditions we frequently encounter in our practice.

1. FACIAL WRINKLES AND LINES

Environmental causes of skin creases are sun overexposure and smoking. Collagen and elastin are proteins that form a scaffold for your skin. UV light warps and weakens their fibers. Without the support of these proteins, skin wrinkles and sags.

Additionally, UV rays produce free radicals, molecules that ravage the components of healthy cells. Free radicals also activate enzymes that destroy collagen. Smoking damages skin by narrowing blood vessels, depriving cells of vital oxygen and nutrients.

Treatments

Dermaplaning – gentle sweeps of a surgical blade to remove dead skin cells and facial hair, while stimulating collagen and elastin production. Licensed aestheticians perform dermaplaning in our Medical Spa.

Microdermabrasion – exfoliation by our aestheticians using microcrystals, sprayed onto skin from a wand-type tool.

Chemical Peels – professional-grade solutions that loosen dead cells, revealing healthy new skin beneath. We use various peel strengths to reduce sun damage, fine lines, and wrinkles. Peels also improve skin tone, smooth roughness, and fade dark spots.

Retinoids – topical chemicals derived from Vitamin A, leveling wrinkles and lines by spurring collagen production. By prompting blood vessel formation, retinoids improve skin color. Additionally, they fade age spots and soften rough patches.

Liquid Face Lifts – injectable drugs such as Botox erase crow’s feet, frown lines, and forehead wrinkles. Facial fillers correct creases, offset fat loss, and add volume to thin skin. Injectable gels reverse sagging and even out wrinkles, folds, and fine lines.

Laser skin resurfacing – pulsed light that eliminates wrinkles, fine lines, and sun damage, along with age spots and spider veins.

2. SEBORRHEIC KERATOSIS

This noncancerous growth can be brown, tan, or black, common on the back, shoulders, chest, and face. Since seborrheic keratoses usually arise after age 40, they’re often called wisdom spots. Isn’t that flattering?

The surface of a seborrheic keratosis is scaly, waxy, and slightly raised. The lesion is typically oval or round, and can grow to 1 inch in size. It can emerge as a single wart-like scab or a smattering of spots. Brown lesions may have a “stuck on” appearance, resembling drops of candle wax. The growths may itch. Avoid scratching, rubbing, and picking at lesions, which can trigger swelling, bleeding, and infection.

Although seborrheic keratoses don’t evolve into cancer, they can look like melanoma, a deadly form. Therefore, any growths fitting this description warrant medical evaluation. Promptly make an appointment with us if a lesion grows quickly, bleeds, and doesn’t heal. These characteristics can signal cancer.

Treatments

If seborrheic keratoses aren’t bothersome, they don’t require treatment. However, you may want us to remove them if they itch, catch on clothing, become irritated, or detract from your appearance.

Cryosurgery – freezing lesions with liquid nitrogen.

Curettage – scraping off thin, flat growths with a surgical blade.

Electrocautery – burning lesions with a low-dose electric current.

Laser – vaporizing growths with pulsed light.

3. ACTINIC KERATOSIS

This is a precancerous growth, the cumulative result of UV damage. Fair-skinned adults are most prone to actinic keratoses (AKs). A lesion starts as a rough, scaly spot in a range of colors, including red, beige, pink, gray, and brown. Eventually, it develops a white, yellow, or red crust. Over time, it can enlarge, itch, hurt, bleed, and change color.

Common sites for AKs are the nose, ears, scalp, lips, shoulders, arms, and top of the hands. Lesions can range from the size of a pinhead to a dime. AKs can also cluster and merge.

Treatments

Untreated AKs can develop into a type of cancer called squamous cell carcinoma. Since progression is unpredictable, see a dermatologist upon sighting a lesion.

Photodynamic Therapy – begins with applying a solution to an AK, increasing its sensitivity to light. After the cells have absorbed the chemical, we target the lesion with a laser or blue light, activating the solution and destroying the growth.

Prescription Medicines – for people with more than 15 AKs. Anti-cancer topical creams prevent abnormal cells from growing. As the cells die, surface skin erodes, crusts, and falls off, paving the way for new skin.

Other In-Office Procedures – cryosurgery, curettage, laser, and chemical peels.

4. AGE SPOTS

These areas of tan or brown skin are also called liver spots, although they have no bearing on liver function. They can appear as large freckles or brown patches. Age spots develop on skin areas vulnerable to UV exposure, including the face, tops of the hands, forearms, shoulders, feet, and upper back. After age 40, liver spots tend to increase in number.

Treatments

Since age spots don’t threaten health, treatment isn’t required. However, you may want to fade them for cosmetic reasons.

Prescription Medications – bleaching creams containing hydroquinone or retinoids, fading age spots over several months.

In-Office Procedures – dermabrasion, chemical peels, cryosurgery, and laser.

5. SKIN CANCER

Three types of cancer frequently affecting senior skin are basal cell, squamous cell, and melanoma.

Basal Cell Carcinoma – The typical appearance is a pearly bump, open sore, or flesh-toned scar. Common sites are the nose, face, head, neck, chest, and tops of the hands. The lesions can bleed and crust. Basal cell cancer grows slowly and rarely spreads.

Squamous Cell Carcinoma – A lesion can look like a red bump, wart, or skin patch that crusts, scales, or bleeds. Growths usually involve the lips, face, ears, neck, and tops of the hands. They can also arise from skin ulcers and scars elsewhere on the body. Squamous cell cancer is aggressive, quickly pervading surrounding tissue and possibly spreading to lymph nodes and internal organs.

Melanoma – The growth is black or dark brown, with irregular borders. Lesions often develop on the head, neck, legs, chest, abdomen, and upper back. Although people of all ages are vulnerable to melanoma, men age 50+ have the highest risk. Severe sunburns during youth make melanoma more likely. This cancer quickly spreads to other organs and can be lethal.

Suspect skin cancer if a growth follows the ABCDE Rule:

  • A – Asymmetry, with two halves of a growth appearing distinctly different
  • B – Border, with blurred or jagged edges
  • C – Color, including areas of color that are faded, dark, spreading, or multicolored, such as pink, gray, purple, red, white, and blue
  • D – Diameter, being larger than a pencil eraser
  • E – Evolving, changing in character, such as bleeding, oozing, itching, crusting, scaling, ulcerating, and enlarging

Treatments

The anti-cancer therapy chosen depends on the size and location of a lesion, its microscopic characteristics, and patient health. Options are:

Curettage and Electrodesiccation – used for superficial basal and squamous cell carcinomas, a tumor site is numbed, scraped, and targeted with electrical current.

Topical Medications – for superficial basal cell carcinomas, gels, creams, and solutions destroy cancerous cells.

Surgical Excision – the tumor site is numbed, and a football-shaped cut is made to remove the lesion. Sutures close the wound edges. For large tumors, skin grafts or flaps are also employed to seal open skin.

Mohs Micrographic Surgery – after numbing, the tumor is removed, along with a small margin of surrounding tissue. The bordering cells are evaluated microscopically for any tumor involvement. If cancerous cells are identified, the process is repeated until no further cancer is seen. This treatment is chosen for recurrent tumors, lesions with poorly defined margins, and sites where preserving healthy tissue is paramount.

Other Methods – cryosurgery, photodynamic therapy, laser, and oral medications.

SENIOR TLC

The staff of Georgia Dermatology Center in Cumming is pleased to serve seniors in the Atlanta region, including the cities of Gainesville, Roswell, Milton, Suwanee, Sandy Springs, and Alpharetta. Our skilled team, including the Medical Spa, works under the direction of Alexander Gross MD, renowned for his expertise in cosmetic and medical dermatology, skin surgery, and laser technology.

Please call us at (770) 781-5077, Monday through Friday. Give your skin the professional TLC it needs.

Note – The information in this blog cannot substitute for dermatologic evaluation and treatment. For any skin concerns, make an appointment at Georgia Dermatology Center.

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