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Beauty Classics Aging Skin Metallic Text
Beauty Classics Aging Skin Image




auses Of Aging Skin

Research shows that there are, in fact, two distinct types of aging. Aging caused by the genes we inherit is called intrinsic (internal) aging. The other type of aging is known as extrinsic (external) aging and is caused by environmental factors, such as exposure to the sun’s rays.


ntrisic Aging

Intrinsic aging, also known as the natural aging process, is a continuous process that normally begins in our mid-20s. Within the skin, collagen production slows, and elastin, the substance that enables skin to snap back into place, has a bit less spring. Dead skin cells do not shed as quickly and turnover of new skin cells may decrease slightly. While these changes usually begin in our 20s, the signs of intrinsic aging are typically not visible for decades. According to recent research Structural and functional alterations caused by intrinsic aging and independent of environmental insults are now recognized in the skin of elderly individuals. Structurally the aged epidermis likely becomes thinner, the corneocytes become less adherent to one another, and there is flattening of the dermoepidermal interface. The number of melanocytes and Langerhans cells is decreased. The dermis becomes atrophic and it is relatively acellular and avascular. Dermal collagen, elastin, and glycosaminoglycans are altered. The subcutaneous tissue is diminished in some areas, especially the face, shins, hands, and feet, while in others, particularly the abdomen in men and the thighs in women, it is increased. The number of eccrine glands is reduced and both the eccrine and apocrine glands undergo attenuation. Sebaceous glands tend to increase in size but paradoxically their secretory output is lessened, The nail plate is generally thinned, the surface ridged and lusterless, and the lunula decreased in size. There is a progressive reduction in the density of hair follicles per unit area on the face and scalp, independent of male-pattern alopecia. The hair shaft diameter is generally reduced but in some areas, especially the ears, nose, and eyebrows of men and the upper lip and chin in women, it is increased as vellus hairs convert to cosmetically compromising terminal hairs. Functional alterations noted in the skin of elderly persons include a decreased growth rate of the epidermis, hair, and nails, delayed wound healing, reduced dermal clearance of fluids and foreign materials, and compromised vascular responsiveness. Eccrine and apocrine secretions are diminished. The cutaneous immune and inflammatory responses are impaired, particularly cell-mediated immunity. Clinical correlates of these intrinsic aging changes of the skin include alopecia, pallor, xerosis, an increased number of benign and malignant epidermal neoplasms, increased susceptibility to blister formation, predisposition to injury of the dermis and underlying tissues, delayed onset and resolution of blisters and wheals, persistent contact dermatitis,  impaired tanning response to ultraviolet light, increased risk for wound infections, prolongation of therapy necessary for onychomycosis, and thermoregulatory disturbances.

The signs of intrinsic aging are:

     bullet2.pngThin and transparent skin

bullet2.pngFine wrinkles

bullet2.pngLoss of underlying fat, leading to hollowed cheeks and eye sockets as well as noticeable loss of firmness on the hands and neck

bullet2.pngDry itchy skin 

bullet2.pngBones shrink away from the skin due to bone loss, which causes sagging skin

bullet2.pngGraying hair 

bullet2.pngInability to sweat sufficiently to cool the skin

bullet2.pngHair loss

bullet2.pngUnwanted hair

bullet2.pngNail plate thins, and ridges develops

Genes control how quickly the normal aging process unfolds. Some notice those first gray hairs in their 20s; others do not see graying until their 40s. People with Werner’s syndrome, a rare inherited condition that rapidly accelerates the normal aging process, usually appear elderly in their 30s. Their hair can gray and thin considerably in their teens. Cataracts may appear in their 20s. The average life expectancy for people with Werner’s syndrome is 46 years of age. 


xtrinsic Aging

  A number of extrinsic, or external, factors often act together with the normal aging process to prematurely age the skin. Most premature aging is caused by sun exposure. Other external factors that prematurely age our skin are repetitive facial expressions, gravity, sleeping positions, and smoking. 

The Sun. Without protection from the sun’s rays, just a few minutes of exposure each day over the years can cause noticeable changes to the skin. Freckles, age spots, spider veins on the face, rough and leathery skin, fine wrinkles that disappear when stretched, loose skin, a blotchy complexion, actinic keratoses (thick wart-like, reddish patches of skin), and skin cancer can all be traced to sun exposure. 

“Photoaging” describes this type of aging caused by exposure to the sun’s rays. The amount of photoaging that develops depends on: 1) a person’s skin color and 2) their history of long-term or intense sun exposure. People with fair skin who have a history of sun exposure develop more signs of photoaging than those with dark skin. In the darkest skin, the signs of photoaging are usually limited to fine wrinkles and a mottled complexion.

Photoaging occurs over a period of years. With repeated exposure to the sun, the skin loses the ability to repair itself, and the damage accumulates. Scientific studies have shown that repeated ultraviolet (UV) exposure breaks down collagen and impairs the synthesis of new collagen. The sun also attacks our elastin. Sun-weakened skin ceases to spring back much earlier than skin protected from UV rays. Skin also becomes loose, wrinkled, and leathery much earlier with unprotected exposure to sunlight.

People who live in sun-intense areas, can show signs of photoaging in their 20s. In fact, some people who live in sun-intense areas develop actinic keratoses (AKs) and skin cancer in their 20s. 

While it may seem that the signs of photoaging appear overnight, they actually lie invisible beneath the surface of the skin for years. The use of UV photography enables us to see the damage accumulating beneath the surface of the skin years before the signs of photoaging appear.

Facial Expressions. If you perform facial exercises to maintain a youthful-looking appearance, please stop. Repetitive facial movements actually lead to fine lines and wrinkles. Each time we use a facial muscle, a groove forms beneath the surface of the skin, which is why we see lines form with each facial expression. As skin ages and loses its elasticity, the skin stops springing back to its line-free state, and these grooves become permanently etched on the face as fine lines and wrinkles.

Gravity. Gravity constantly pulls on our bodies. Changes related to gravity become more pronounced as we age. In our 50s, when the skin’s elasticity declines dramatically, the effects of gravity become evident. Gravity causes the tip of the nose to droop, the ears to elongate, the eyelids to fall, jowls to form, and the upper lip to disappear while the lower lip becomes more pronounced. 

Sleeping Positions. Resting your face on the pillow in the same way every night for years on end also leads to wrinkles. Called sleep lines, these wrinkles eventually become etched on the surface of the skin and no longer disappear when the head is not resting on the pillow. Women, who tend to sleep on their sides, are most likely to see these lines appear on their chin and cheeks. Men tend to notice these lines on the forehead since they usually sleep with the face pressed face down on the pillow. People who sleep on their backs do not develop these wrinkles since their skin does not lie crumpled against the pillow.

Smoking. Cigarette smoking causes biochemical changes in our bodies that accelerate aging. Research shows that a person who smokes 10 or more cigarettes a day for a minimum of 10 years is statistically more likely to develop deeply wrinkled, leathery skin than a nonsmoker. It also has been shown that people who smoke for a number of years tend to develop an unhealthy yellowish hue to their complexion.   

These signs can be greatly diminished, and in some cases avoided, by stopping smoking. Even people who have smoked for many years, or smoked heavily at a younger age, show less facial wrinkling and improved skin tone when they quit smoking. 

For Healthier, Younger-Looking Skin
. While you cannot stop or even slow down the intrinsic aging process, you can prevent signs of premature aging by protecting your skin from the sun, quitting smoking, and eliminating facial exercises.

Dermatologists recommend comprehensive sun protection to prevent premature aging caused by the sun. Comprehensive sun protection includes:

  • Avoiding deliberate tanning, including use of indoor tanning devices.
  • Staying out of the sun between 10:00 a.m. and 4:00 p.m., when the sun’s rays are the strongest.
  • Wearing protective clothing, such as a wide-brimmed hat and long sleeves, when outdoors during the day.
  • Applying sunscreen year round. Sunscreen should be broad spectrum (offers UVA and UVB protection) and have a Sun Protection Factor (SPF) of 30 or higher. Sunscreen should be applied 20 minutes before going outdoors to all skin that will be exposed. It should be reapplied after sweating or being in water.

Treatment. If you are bothered by visible signs of aging, a number of treatments are available.Check1red.pngBEAUTY CLASSICS™ provides theCheck1red.pngDermAge™ Line of High Quality THERAPEUTIC Anti-Wrinkle Anti-Aging Products that are of Higest Efficacy, also you can prevent aging of the skin by using the Revolutionary approach of Individual Targeted Gene Based Anti-Aging Solutions provided by our Partner Company FORU Logo

Injectable fillers and botulinum toxin are suitable for people with busy lifestyles who do not want the inconvenience of a long recovery. Radiofrequency is a procedure that offers an alternative to the traditional facelift. Dermabrasion, laser resurfacing, chemical peeling, microdermabrasion, and some topical treatments can restore skin, giving it a smoother and refreshed appearance. 

Some Standard Facts About Aging Skin

We all begin to age the moment we are born, and throughout our lives the effects of aging are evident in our bodies. Up to about age 20 years, the most visually prominent effects of aging are in growth and development. Beginning in our 20s, the effects of aging begin to be visible in the skin.

Genetically programmed chronologic aging causes biochemical changes in collagen and elastin, the connective tissues that give skin its firmness and elasticity. The genetic program for each person is different, so the loss of skin firmness and elasticity occurs at different rates and different times in one individual as compared with another.

As skin becomes less elastic, it also becomes drier. The underlying fat padding begins to disappear. With loss of underlying support by fat padding and connective tissues, the skin begins to sag. It looks less supple, and wrinkles form. The skin may be itchy with increased dryness. A cut may heal more slowly.

Simultaneously with genetically programmed aging, the process of photoaging may be taking place. Photoaging is the effect of chronic and excessive sun exposure on the skin. Cigarette smoking also contributes to aging effects by the biochemical changes it brings about in skin tissues.

Photoaging interacts with chronologic aging and may appear to hasten the process of chronologic aging. In fact, photoaging may be responsible for the majority of age-associated changes in the skin’s appearance: mottled pigmentation, surface roughness, fine wrinkles that disappear when stretched, "age" or "liver" spots (lentigines) on the hands, and dilated blood vessels. Chronic sun exposure is a major risk factor for skin cancers—basal cell carcinoma, squamous cell carcinoma and melanoma.

The effects of photoaging accumulate over years of chronic sun exposure. At first, the effects may be invisible to the casual glance, even while they are on the increase. Photos taken with ultraviolet light will dramatically reveal the accumulative effects of chronic sun exposure. In the following series of photos the accumulative effects of chronic sun exposure are clearly seen. In each set of photos, the two pictures on the left were taken in ordinary light, the picture on the right in ultraviolet light:



The absolute beauty, smoothness and clarity of a yet to age baby face

 With this young girl early sun damage is evident  across the nose and cheeks as the freckles show.

You can see the age progression from the young girl to the middle age woman and the senior citizen showing the change in skin texture, wrinkling and sagging.The skin is dry, inelastic, heavily mottled, with wrinkles

As skin ages and accumulates sun damage, a number of lesions (sores or spots on the skin) become more common. These include:

  • "Age" and "liver" spots (lentigines)—flat, brown areas with rounded edges usually found on the face, hands, back and feet. They are age-related and photoaging-related, and have nothing to do with the liver. While they are unsightly, they are not dangerous. However, a large, flat, dark area with irregular borders should be examined by a dermatologist to make sure it is not melanoma.
  • Actinic keratoses—thick, warty, rough, reddish growths on sun-exposed areas of the skin. They may be a precursor to squamous cell carcinoma.
  • Seborrheic keratoses—brown or black raised spots, or wart-like growths that appear to be stuck to the skin’s surface. They are not cancerous or precancerous, and are easily removed.
  • Cherry angiomas—harmless, small, bright red domes created by dilated blood vessels. They occur in more than 85% of middle-aged to elderly people, usually on the body. A dermatologist can remove them.
  • Telangiectasias ("broken capillaries")—dilated facial blood vessels, usually related to sun damage. A dermatologist can treat them.
  • Bruising—often a result of skin having lost its fat padding and becoming more susceptible to injury. Some drugs may cause bleeding under the skin. Bruises that persist should be examined by a dermatologist.
  • Wrinkles—changes in the elastic tissue from exposure to sunlight, effects of gravity, or motion factors in the skin. A dermatologist can treat wrinkles with dermatologic surgery.
  • Skin diseases more common in older people include shingles, leg ulcers, and seborrheic dermatitis.


Is That Lesion a Symptom of Something Dangerous?


May Indicate

A scaly red spot

Skin cancer

A change in color, shape or size of a mole

Any new skin growth

Bleeding in a mole or other growth

Excessive dryness and itching that doesn’t respond to moisturizers

Dermatitis, psoriasis, other skin disease

Vague or sharp local pain or headache, followed by formation of blisters on the skin


Bulging or tender veins in the legs 

Varicose veins, associated with spider veins

Any sore on any part of the body that fails to heal

Skin cancer, diabetes, circulatory problems



Prevention of Photoaging

While you can’t slow down or stop the effects of chronologic aging, you can do something to inhibit the skin damage caused by excessive and chronic sun exposure. To avoid skin damage from sun exposure, always use a sunscreen with an SPF rating of 15 or higher such as our High Quality Pharmacist Formulary Sunscreen GenewizeSunSkinPlex™, a hat with a brim, and protective covering of arms and legs. Limit sun exposure during the 10 AM to 4 PM hours of greatest sun intensity. Avoid deliberate tanning in tanning salons or under sun lamps. If your skin is already sun damaged you can still benefit from these measures.

The skin damage caused by long-term cigarette smoke is avoided by smoking cessation.








Treatments for Aging Skin

Unless someone invents time travel, you can’t reverse the flow of time and become younger. However, with the wide array of dermatologic treatments available today, you can remove many of the effects of aging and photoaging. You can’t become younger, but you can look younger and more attractive by working with a dermatologist to choose the skin rejuvenation treatment that is right for you.

 There are many  treatments available today for skin rejuvenation. Sometimes two types of treatment may be combined to make each more effective.

Dermatologic Medical Skin Rejuvenation

Topically-applied treatments are usually most effective when skin manifestations of aging and photoaging are superficial to moderate:

  • Tretinoin, a substance in the vitamin A family, has been shown to reduce fine wrinkles, splotchy pigmentation, and rough skin associated with chronic sun exposure. Tretinoin cream 0.02% and 0.05% are the only prescription treatments approved by the Food and Drug Administration (FDA) for these indications. Other available forms of tretinoin are indicated for the treatment of acne. Talk to your dermatologist about which tretinoin formulation may be right for you.
  • Alpha-hydroxy acids (AHSs) may be used alone or in combination with tretinoin to treat mildly damaged skin. AHAs are derived from fruit and dairy products such as our Pharmacist Formulary alpha-hydroxy acid product DuraLac™ available in lotion and cream forms.
  • Over-the-counter products containing retinols (of the vitamin A family), AHA, anti-oxidants and moisturizing agents may temporarily improve the appearance of fine lines and wrinkles such as our Pharmacist Formulary  babyfaceA-RetiDermAge™ products.
  • Topical antioxidants, especially vitamins C and E, function to help cells repair damage caused by ultraviolet radiation and smoking such as our highly recommended High Quality Pharmacist Formulary frecklesC-SkinPlex™ and ageprogressionE-SkinPlex™ products.





These untouched photographs show this woman before and after six months of treatment with tretinoin cream 0.05%. Her reduction in fine lines and wrinkles is characteristic of a more dramatic improvement experienced during clinical trials. Individual results may vary.


Dermatologic Surgical Skin Rejuvenation

Chemical Peeling

Chemical peeling, also called chemexfoliation or dermapeeling, is a facial skin rejuvenation procedure that does what its name implies—it peels the skin. Its use is usually in the treatment of superficial to moderate photoaging skin damage. Mild chemical peels can be applied to people in their 20s, to prevent effects of aging from becoming apparent too early in life.

In a chemical peeling treatment, a chemical solution is applied to facial skin, causing the skin to blister and peel off over a period of days. As the treated skin blisters and peels, new skin forms to take its place. The new skin is usually smoother and less wrinkled than the old skin.

A mild chemical peel is usually all that is necessary to treat fine lines and wrinkles around the eyes and mouth. Patients with minimal skin damage often respond best to a series of light peels in combination with a skin care program including retinoids and a sunscreen protection program. A medium-depth peel is often more effective for patients with moderate skin damage, including age spots, freckles and actinic keratoses. A medium-depth peel may be combined with another treatment such as laser resurfacing to achieve maximum effectiveness.

Depending on the objectives of the treatment as determined jointly by the patient and dermatologist, the condition and type of the patient’s skin, and the degree of skin damage, the dermatologist by performing dermatologic surgery individualizes the strength of the chemical solution and the depth of the peel. Peeling solution may include one or more chemicals such as alpha-hydroxy acids, trichloroacetic acid, or carbolic acid. The procedure can be performed in the dermatologist’s office, or in an outpatient surgery center. In addition to skin rejuvenation, chemical peeling is effective in reduction of some acne scars. Peeling does not remove deep scars.

The immediate after-effect of a chemical peel is similar to a sunburn. After a mild or superficial peel, redness and scaling of the skin last 3 to 5 days. Medium-depth or deep peeling can result in redness, swelling, blistering and peeling for 7 to 14 days. Medications are prescribed to alleviate discomfort. Overexposure to sun must be avoided for a period of time to prevent sun damage while the new skin is susceptible to injury.

Chemical peeling is effective only for surface skin damage. Effects of aging in deeper tissues, such as sagging jowls and drooping eyelids, must be addressed by other procedures that can be recommended by your dermatologic surgeon.


Soft-tissue Augmentation

In soft-tissue augmentation, a substance that is compatible with the patient’s body tissues is injected under the skin to elevate irregularities such as wrinkles, pits and scars. The substances used for injection are primarily:

  • Collagen—a fibrous protein substance of all human and animal tissue. It gives toughness and structure to skin, bones, and ligaments. Most of the collagen used for soft-tissue augmentation is derived from cattle. However, for people who are allergic to bovine (cow-derived) collagen, collagen or collagen-related substances may be self-donated by the patient or obtained from a tissue donor. The dermatologist tests the patient prior to collagen injection to determine if the patient is allergic to bovine collagen. Collagen injection is usually given in a series of treatments, until the desired effect of "filling out" a wrinkle or depression is achieved. A local anesthetic minimizes discomfort from the injection needle. The effects of collagen injection may last for 3 to 12 months.
  • Self-donated body fat. Fat is harvested from the patient’s own body and prepared for the procedure called microlipoinjection. This fat-transfer procedure is sometimes called "body sculpturing". The injected body fat is used to replace fat lost from under the skin in the aging process. Defects improved by microlipoinjection include creases around the nose, mouth and chin, and the "drawn look" created by loss of fat pads in the cheeks. The improvements in appearance vary between patients. Some follow-up treatments may be necessary. Microlipoinjection is performed in an outpatient clinic. An after-effect of tissue swelling or bruising fades in a few hours to a few days.



Botulinum Toxin

Dermatologists have harnessed the potent biological effects of botulinum toxin to dramatically improve effects of aging such as frown lines, crows feet, and facial wrinkles. Botulinum toxin is the powerful agent of botulism food poisoning, but botulism cannot be contracted from cosmetic use of botulinum toxin. The toxin’s biological effects in food poisoning are to block nerve impulses transmitted from the brain to muscles, causing generalized paralysis including paralysis of muscles used in breathing.

Dermatologists use purified botulinum toxin in very tiny amounts to inject into a targeted facial muscle. The resulting nerve blockade of that muscle causes a local immobilization of muscle movement. This immobilization prevents "crinkling" and "wrinkle" lines from forming when the patient frowns or squints. Results of treatment last 3 to 4 months. To be maximally effective, treatment with botulinum toxin is repeated over several sessions and is combined with a program of muscle behavioral training to minimize "wrinkling" facial expressions. Botulinum toxin treatment may be used in combination with other procedures for facial rejuvenation to achieve a more lasting effect. A botulinum toxin treatment is accomplished in about 30 minutes in a dermatologist’s office.



Dermabrasion is a treatment with many applications in dermatology and dermatologic surgery, from removal or reduction of acne and chicken pox scars to facial skin rejuvenation. The procedure, sometimes called surgical skin planing, consists of planing off the surface layer of skin with a rapidly rotating brush. The planing action removes the skin surface, and a new layer of skin grows to replace the skin removed. The principal after-effect is redness of the skin similar to a severe sunburn; medications are prescribed to alleviate discomfort. Healing usually is complete in about 10 days. Patients must avoid sunlight for 3 to 6 months after treatment. A technique that removes less surface skin is called microdermabrasion; it is used most often for superficial skin defects and may be repeated at intervals.

Each potential candidate for dermabrasion needs thorough evaluation by a dermatologist to make certain that dermabrasion is the correct procedure for that individual and that the patient fully understands possible after-effects. For example, pigmented skin may be permanently lightened in the area of dermabrasion, and a person prone to form keloids after skin injury could be at risk for scarring. Post-procedure treatments are available to minimize most after-effects. Dermabrasion may be combined with other procedures such as soft-tissue augmentation to maximize effectiveness.

Laser Skin Resurfacing

The use of lasers in dermatology has advanced rapidly over the past 30 years. Today, lasers have a broad range of dermatologic applications, including:

  • removal or improvement of wrinkles, lines and other effects of aging and photoaging
  • treatment of superficial brown pigmented lesions such as age spots, and deep pigmented lesions such as port wine stains and birthmarks
  • removal or improvement of scars
  • removal of some skin cancers
  • removal or improvement of vascular moles
  • removal of tattoos
  • removal of warts
  • removal of unwanted hair

The principal applications of lasers in facial skin rejuvenation are reduction or removal of wrinkles, lines and age spots, to "resurface" the skin.

The laser (Light Amplification by the Stimulated Emission of Radiation) is a "light pump".  It applies principles of radiation physics to narrowly segregate light of selected wavelength and "pump" the light radiation to high intensity. These beams of selected wavelength can be varied in intensity and in the duration of emitted pulses.

For example, powerful, rapid pulses of the infrared-wavelength carbon dioxide laser can vaporize targeted skin. The pulses of the carbon dioxide laser can be directed toward resurfacing skin without bleeding. The benefits of laser skin resurfacing include bloodlessness, plus:

  • reduced risk of infection
  • precisely controlled surgical effects
  • one-day outpatient treatment in many instances

After-effects and recovery times vary with different laser procedures. A dermatologist will explain the risks, after-effects and benefits of recommended procedures.

Lasers are powerful instruments and laser surgery should be performed only by a dermatologist or dermatologic surgeon with experience in the procedure. To learn more about lasers and laser surgery, go to the Web site of the American Society for Dermatologic Surgery.


Electrosurgical Resurfacing

An alternative to laser skin resurfacing is electrosurgical resurfacing, also called "cold ablation." This technique uses a micro-electrical radio frequency to deliver a pulse of energy to the skin, removing or improving superficial to moderate skin damage. The procedure has few after-effects, and recovery from mild to moderate swelling is usually complete within a month. Electrosurgical resurfacing offers the advantage of being applicable to most skin types and colors, without loss of skin pigmentation.

Superfluous Hair Removal

Removal of superfluous hair may contribute to overall improved appearance, with or without concomitant facial skin rejuvenation. In women, especially, hair on the chin, over the upper lip, or on arms and legs can create an appearance of older age or masculinization. Traditional methods of dealing with superfluous hair include: (1) bleaching with hydrogen peroxide to make the hair less visible, (2) shaving to temporarily remove hair, (3) plucking hairs, (4) coating the skin with wax, then removing hair with the waxy coat, (5) using a chemical depilatory to "dissolve" unwanted hair, and (6) electrolysis or electrothermolysis to destroy hair follicles for relatively permanent hair removal.

Chemical depilation of facial skin may be irritating and should be performed under the guidance of a dermatologist with a depilating agent prescribed for individual needs.

The safety and effectiveness of electrolysis or electrothermolysis is dependent upon the training and skill of the operator and the equipment used. In these methods a fine electrode is inserted into each hair follicle to destroy the cells from which new hair could grow.

Laser hair removal has been proven effective in recent studies. Hair loss for two or more years has been documented, and may well prove to be long-term or permanent as patients are followed up for longer periods of time. Laser hair removal in most current use is accomplished by photothermolysis—using a laser to generate heat in hair follicles and render them incapable of growing new hair. Skin color and hair color are among factors that a dermatologist considers in determining the type of laser to use, duration of treatment, and number of treatments that may be necessary to accomplish desired results. Side effects of laser hair removal include post-treatment pain for a few hours to a few days, and skin redness. The treating dermatologist can prescribe medicines to alleviate the side effects. Laser hair removal is a procedure that should be performed only by a dermatologist experienced in the use of lasers.

Non-ablative Skin Treatments


Wrinkles, crease lines and age spots are visible effects of aging, and unwanted fat deposits are another. Despite diet and exercise undertaken to keep looking young and trim, fatty deposits may remain on the face, chin, neck, breast, abdomen, hips, thighs, buttocks, knees and ankles. A dermatologist experienced in the procedure can use tumescent liposuction to remove these localized fat deposits. Tumescent liposuction is performed only after a full medical evaluation.

This dermatologic surgery is performed in an outpatient setting, usually under local anesthesia and anti-bleeding medication. In some cases, ultrasound is used to break down and liquify fat cells in the area to be treated. Fat is removed from the targeted area with a vacuum inserted through an incision in the skin. Many patients do not require postoperative pain medication. It is usually possible for the patient to resume physical exercise 3 to 7 days after the procedure. Liposuction is not a substitute for diet, exercise or weight reduction. It complements other efforts to keep a young and trim look.  Go to the Web site for the American Society for Dermatologic Surgery for more information about liposuction.

Surgical Excision

Sometimes facial skin rejuvenation cannot be accomplished to the patient’s satisfaction by removal of surface defects. Long-term effects of gravity may affect deeper layers of tissue, with resulting sags in eyelids, forehead, cheeks, shin, and areas around the mouth. In these instances, a dermatologic surgeon should be consulted regarding the possibility of surgical procedures:

  • blepharoplasty (eyelid surgery) to correct "droopy" eyelids by removing excess fat pads and skin
  • brow lift to reduce severs lines in the forehead and raise the eyebrows
  • rhytidectomy (fact lift) to tighten and trim excess skin on cheeks, chin, neck, and around the mouth








Frequently Asked  Questions

 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 .

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. 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.

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.  




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