Keeping your skin in the game

If we’re lucky enough to have healthy skin, many of us may visit a dermatologist only when we’re teenagers struggling with acne. In our 20s, 30s, and 40s we probably don’t think about our skin, even though we’re likely damaging it every day through sun exposure, stress, facial movements, obesity, and even how we sleep. As we get older we have to deal with wrinkles, spots, loss of subcutaneous support (the fatty tissue between skin and muscle), moles, skin tags and, more dangerously, a variety of skin cancers.

How our skin ages depends on a variety of factors: Lifestyle, diet, heredity, and other personal habits. For instance, smoking can produce free radicals, once-healthy oxygen molecules that are now overactive and unstable. Free radicals damage cells, leading to, among other things, premature wrinkles. Exposure to the sun also is a huge factor in skin-related deterioration.

As we age, skin becomes rougher, slacker, fragile and more transparent. We bruise more easily, the way our skin “fits” on our bones and face changes, it dries out and we become more susceptible to lesions such as benign and malignant growths or tumors. 

Exposure to sunlight is the single biggest culprit in aging skin. Over time, the sun’s ultraviolet (UV) light damages certain fibers in the skin called elastin. The breakdown of elastin fibers causes the skin to sag, stretch, and lose its ability to snap back after stretching. The skin also bruises and tears more easily and takes longer to heal. So while sun damage may not show when you’re young, it will later in life.

Nothing can completely undo sun damage, although the skin can sometimes repair itself. So, it’s never too late to begin protecting yourself from sun exposure and skin cancer. You can delay changes associated with aging by staying out of the sun, covering up, wearing a hat, and making a habit of using sunscreen.

Facial movement lines become more visible after the skin starts losing its elasticity (usually as people reach their 30s and 40s). Lines may appear horizontally on the forehead, vertically on the skin above the root of the nose (glabella), or as small curved lines on the temples, upper cheeks, and around the mouth.

Sleep creases result from the way the head is positioned on the pillow and may become more visible after the skin starts losing its elasticity. Sleep creases are commonly located on the side of the forehead, starting above the eyebrows to the hairline near the temples, as well as on the middle of the cheeks. Sleeping on your back may improve these sleep creases or prevent them from becoming worse. Also of important note, smokers tend to have more wrinkles than nonsmokers of the same age, complexion, and history of sun exposure.

Dry skin and itching is common in later life. About 85 percent of older people develop “winter itch,” because overheated indoor air is dry. The loss of oil glands as we age may also worsen dry skin. Anything that further dries the skin — such as overuse of soaps or hot baths — will make the problem worse. If your skin is very dry and itchy, see a doctor because this condition can affect your sleep, cause irritability, or be a symptom of a disease. Some medicines make the itchiness worse.

The importance of visiting a dermatologist

There are several skin lesions that are very common and benign (non-cancerous). These conditions include moles, freckles, skin tags, and discoloration. It’s important to have your physician check these skin issues regularly, and to see a dermatologist if they increase in size, are painful, change color or texture or become irritated or sensitive. Here is some basic information on the most common skin maladies:

> Moles are growths on the skin that are usually brown or black. Moles can appear anywhere on the skin, alone or in groups. Moles occur when cells in the skin grow in a cluster instead of being spread throughout the skin. These cells are called melanocytes, and they make the pigment that gives skin its natural color. Moles may darken after exposure to the sun, in the teen years, and during pregnancy.

The vast majority of moles are not dangerous. The only moles that are of medical concern are those that look different than other existing moles or those that first appear after age 30. If you notice changes in a mole’s color, height, size, or shape, you should have a dermatologist evaluate it. You also should have moles checked if they bleed, ooze, itch, or become tender or painful. The same goes for freckles.

> A skin tag is a small flap of tissue that hangs off the skin by a connecting stalk. Skin tags are not dangerous. They are usually found on the neck, chest, back, armpits, under the breasts, or in the groin area. Skin tags appear most often in women, especially with weight gain, and in elderly people.

Skin tags usually don’t cause any pain. However, they can become irritated if anything, such as clothing or jewelry rubs them. Your dermatologist can remove a skin tag by cutting it off with a scalpel or scissors, with cryosurgery (freezing it off), or with electrosurgery (burning it off with an electric current).

> A lentigo is a spot on the skin that is darker (usually brown) than the surrounding skin. Lentigines (plural) are more common among whites, especially those with fair skin. Exposure to the sun seems to be the major cause of lentigines. They most often appear on parts of the body that get the most sun, including the face and hands. Some lentigines may be caused by genetics (family history) or by medical procedures such as radiation therapy.

There are several methods for treating lentigines, including cryosurgery (freezing it off), laser surgery, and creams that are applied to the skin.

> Skin cancer is a cancer that forms in the tissues of the skin. There are several types of skin cancer. Skin cancer that forms in melanocytes (skin cells that make pigment) is called melanoma. Skin cancer that forms in the lower part of the epidermis (the outer layer of the skin) is called basal cell carcinoma. Skin cancer that forms in squamous cells (flat cells that form the surface of the skin) is called squamous cell carcinoma. Skin cancer that forms in neuroendocrine cells (cells that release hormones in response to signals from the nervous system) is called neuroendocrine carcinoma of the skin.

Most skin cancers form in older people on parts of the body exposed to the sun or in people who have weakened immune systems. Skin cancer is the most common type of cancer in the United States. Each year, more than 68,000 Americans are diagnosed with melanoma, and another 48,000 are diagnosed with an early form of the disease that involves only the top layer of skin. Also, more than 2 million people are treated for basal cell or squamous cell skin cancer each year.

Basal cell skin cancer typically occurs on the face, chest or areas exposed to the sun. It is several times more common than squamous cell skin cancer and, when caught early, easily treated and removed.

Melanoma can occur on any skin surface. In men, it’s often found on the skin on the head, on the neck, or between the shoulders and the hips. In women, it’s often found on the skin on the lower legs or between the shoulders and the hips. Melanoma is more likely than other skin cancers to spread to other parts of the body. Squamous cell skin cancer sometimes spreads to other parts of the body, but basal cell skin cancer rarely does.

Regular examinations by a dermatologist can reveal skin cancers or likely skin cancers (called pre-cancerous) in time to tend to them. As in most illnesses, the earlier skin cancer is discovered, the better the chances of removing it and limiting its spread. If you’re over 50, visit a dermatologist annually. If you’re younger and have a family history of skin cancer or any skin issues of concerns, see your doctor as well.

# # #

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!