The Effects of Aging on Skin

The Effects of Aging on Skin

*By: Ghadah Alhammad

(Photo source:

Human skin, like all other organs, undergoes chronological aging which leads to structural and functional deteriorations. Skin changes are among the most visible and bothersome signs of aging. It has numerous clinical presentations, ranging from benign conditions like pruritus to basal and squamous cell carcinoma and malignant melanomas.

What causes the skin to age?

Skin aging is a complex biological process influenced by both intrinsic and extrinsic determinants, which contribute simultaneously to a progressive loss of skin integrity. Intrinsic aging is inevitable, and is genetically predetermined, it occurs because of accumulation of reactive oxygen species, biological aging of cells, and reduced cellular supply of nutrients and oxygen, the rate of epidermal cell proliferation slows, the skin thins and flattens, with less resistance to shearing forces and injury, water content in the stratum corneum reduces, hair thins and turns white or grey, the numbers of melanocytes and sebum production reduces, the dermis vascularity decreases. There is reduced collagen and elastin turnover and increased glycation. Subcutaneous fat diminishes, especially on face hands and feet, however it increases on thighs, waist and abdomen. Immunity declines, leading to increased risk of skin cancer. Intrinsic aging expresses on the skin as smooth, dry, pale and thin skin with exaggerated expression lines. Extrinsic aging is caused by preventable environmental triggers such as sun exposure which is the greatest single factor, where ultraviolet (UV) light leads to the generation of reactive oxygen species which then cause oxidative damage to cellular components, damages DNA, elastic tissue, collagen, blood vessels and immune cells. Other extrinsic factors include smoking, alcohol abuse, and poor nutrition. Extrinsically aged skin is characterized by photo-damage as fine lines and wrinkles, pigmented lesions, freckles and skin cancers.

Skin Aging Prevention

Many treatments and cosmetic procedures are available to treat aged skin; however, the best treatment is prevention. While natural aging is genetically determined and inevitable, extrinsic aging can be prevented and delayed. Important factors include, smoking and pollutants avoidance, good nutritional supplements and exercise two or three times a week.

Photo-protection which refers to the measures that can be taken to protect the skin from UV damage and is achieved by avoiding outdoor activities during the middle of the day, wearing sun-protective clothing such as hats and long sleeves and application of broad-spectrum sunscreens with SPF of 15 or higher to the exposed skin.

Topical pharmacological agents with anti-aging properties are another preventive mean against skin aging, they are mainly divided into two groups, the antioxidants and the cell regulators. Antioxidants such as vitamins, will reduce collagen degradation by reducing the concentration of free radicals in the tissues. Vitamins C, B3, and E are the most important antioxidants. Cell regulators, such as Vitamin A (retinol) and its derivates (retinaldehyde and tretinoin) act directly on the collagen metabolism and stimulate the production of collagen and elastic fibers.

*Medical Student
King Saud University
Riyadh, Saudi Arabia



Dermatological complication of diabetes mellitus

Dermatological Complication of Diabetes Mellitus

*By Lama Alkahtani

Diabetes mellitus is one of the fastest-growing health problems in the world. It is estimated that almost 382 million people suffer from diabetes. The prevalence of Diabetes mellitus is the highest in countries like Saudi Arabia (23.9%), Nauru (23.3%), Kuwait (23.1%) and Qatar (22.9%). Diabetes leads to a list of potentially serious complications that affect many organ systems and are responsible for the majority of morbidity and mortality associated with the disease. It is estimated that 30% of people with diabetes mellitus will experience a skin problem at a certain stage during their lifetime. Skin is affected by the acute metabolic derangements as well as by chronic degenerative complications of diabetes


Diabetic Dermopathy.

  • Lesions often begin as pink patches (0.5 to 1 cm), which become hyper-pigmented with surface atrophy and fine scale
  • Typical distribution; Pretibial and lateral areas of the calf
  • Histology shows epidermal atrophy, thickened small superficial dermal blood vessels, increased epidermal melanin and hemorrhage with hemosiderin deposits.
  • These lesions may resolve spontaneously
  • There is no definitive treatment.
  • Diabetic dermopathy may be an early sign of retinopathy mandating a more intensive ophthalmological care.–1-.jpg–1-.jpg


Diabetic bullae

  • Large, intact bullae arise spontaneously on the lower legs, feet, dorsa of the hands, and fingers on non-inflamed bases.
  • When ruptured, oozing bright red erosions result but heal after several weeks.
  • Neither trauma nor an immunologic mechanism has been implicated. Histologically, bullae show intra- or subepidermal clefting without acantholysis


Diabetic stiff skin

  • Diabetic cheiroarthropathy also known as stiffening of the skin, is a syndrome of chronic progressive stiffness of the hand secondary to contracture and tightening of the skin over the joints.
  • Clinically characterized by inability to flatten the palms against a flat surface (prayer sign).
  • The mechanism is thought to be due to long-standing uncontrolled diabetes. The high levels of glucose lead the glycosylation of collagen and other connective tissue proteins.×321.png×321.png


*Medical student

King Saud University

Riyadh, Saudi Arabia




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