References
The A–Z of age-related dermatological diseases
Abstract
Skin ageing is an inevitable process influenced by both intrinsic and extrinsic factors. Intrinsic aging leads to thinner, drier and less elastic skin with fine wrinkles, while extrinsic factors such as sun exposure, smoking and environmental stresses amplify these changes. Photo-ageing, in particular, causes deep wrinkles, uneven pigmentation and increases the risk of skin cancers. Age-related alterations in skin structure and function include thinning of the epidermis, reduced collagen and elastin and changes in fat distribution, all of which compromise the skin's barrier and mechanical properties. These changes not only increase the susceptibility to conditions such as xerosis, fungal infections and atopic dermatitis but also carry psychological implications. Interestingly, atopic dermatitis, often associated with childhood, has a secondary peak in older adults and may be linked to neurodegenerative conditions such as Alzheimer's disease. This article explores the interplay between skin aging, dermatological diseases, and their broader physical and emotional impacts.
No matter how dedicated someone is to their skincare regimen, no matter how much a person spends, it is impossible to turn back time. After all, skin ageing consists of two elements: chronological and extrinsic. Chronological (intrinsic) ageing manifests as stiff, dry, thin skin and fine wrinkles (Franco et al, 2022; Wahhab et al, 2024). Extrinsic factors exacerbate intrinsic ageing. Sun-exposure (photo-ageing) produces deep wrinkles, uneven pigmentation and telangiectasias (spider veins) as well as increasing the risk of several skin cancers (Wahhab et al, 2024). Other extrinsic factors that influence skin ageing include smoking, pollution, poor diet, cosmetics, sleep disturbance, stress and temperature (Franco et al 2022; Wahhab et al 2024).
Age-related changes to the skin influence the likelihood of developing certain diseases. For instance, while atopic dermatitis is an archetypal childhood disease, the prevalence of atopic dermatitis peaks twice: in childhood and at older age (de Lusignan et al, 2021). Other common dermatological diseases in older people include fungal infections, xerosis (dry skin), statis and irritant contact dermatitis, and drug adverse events (Sanders et al, 2024). In addition, dermatological ageing can be more than skin deep. Atopic dermatitis seems increase the likelihood of developing Alzheimer's disease (Woo et al, 2023). Sometimes, skin ageing imposes a psychological burden that is ‘often overlooked or frankly ignored’ (Russell-Goldman and Murphy 2020). This feature introduces the relationship between skin ageing and dermatological diseases in older people.
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