Overview of Skin Aging and Photoaging

Yolanda Rosi Helfrich, MD; Dana L. Sachs, MD; John J. Voorhees, MD

Disclosures

Dermatology Nursing. 2008;20(3):177-183. 

In This Article

Clinical Signs of Aging and Photoaging

Many of the skin changes commonly associated with aging, changes in pigmentation, sallowness, and deep wrinkling, are actually the result of sun exposure. Sun-exposed areas of the skin, such as the face, neck, upper chest, hands, and forearms, are the sites where these changes occur most often. As early as the 19th century, researchers noted profound differences in the facial skin of farmers and sailors as compared to that of indoor workers (Urbach, Forbes, Davies, & Berger, 1976). Outdoor laborers were noted to have thickening and brownish discoloration on light-exposed skin; these changes were also associated with an in creased number of skin cancers (Urbach et al., 1976).

The term "photoaging" was first coined in 1986 and describes the effects of chronic ultraviolet (UV) light exposure on skin (Kligman & Kligman, 1986). Clinical signs of photoaging include dryness; irregular, dark/light pigmentation; sallowness; either deep furrows or severe atrophy; telangiectases; premalignant lesions; laxity; and a leathery appearance (see Table 1 ) (Yaar, Eller, & Gilchrest, 2002). Other signs include elastosis (a coarse, yellow, cobblestoned effect of the skin) and actinic purpura (easy bruising related to vascular wall fragility in the dermis) (Gilchrest, 1990). Chrono logic skin aging, in contrast, is characterized by laxity and fine wrinkling, as well as development of benign growths such as seborrheic keratoses and angiomas, but is not associated with in creased pigmentation or the deep wrinkles that characterize photoaging (Yaar et al., 2002).

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