We have all heard this phrase. However, today we are literally talking about your skin. The skin is the largest organ in the body and, of course the most visible. Many people notice that over the years their skin bruises more easily; wrinkles appear; minor bumps shear the skin loose; wounds heal more slowly; walking barefooted becomes uncomfortable; skin fungus is more common and “spots” of various colors start appearing in multiple areas of the body. (I will discuss the various spots and colors in a subsequent article.)

What is going on? Most people are born with skin that has a relatively thick layer of fat (especially extra padding on the palms of our hands and the soles of our feet), protective “bridges” between the outer and middle layers, an abundance of glands to moisturize and protect (oil glands, sweet glands, etc.) cells (melanocytes) to darken the skin when it is exposed to ultraviolet (UV) radiation from the sun, immune system cells to fight infection and skin cancer and many blood vessels for nourishment. With aging we lose much of this protection. Exposure to ultraviolet sun light or tanning beds hastens and worsens these losses.

After the age of about 30 the changes become more evident each year. Skin cells turnover about every 28 days before age 30 and about every 56 days by about 60 years of age. We gain fat where we don’t want it and loose it where we need it (in the soles, palms and beneath the outer skin layer). We lose the melanocytes that darken for our protection when they are exposed to UV radiation. Thus, an older person can be exposed to the sun and not tan very much, yet even more damage is occurring in the skin. For people who seek a tan this may lead them to lengthen their time of exposure and of course cause even more damage. For every year after about 30 we lose 1 percent of the collagen and 1.5 percent of the elastic fibers in the skin. The remaining collagen is often replaced with slightly abnormal tissue that is too thick. From this, the skin sags and wrinkles. Our sweat glands slowly disappear so that we can maintain our body temperate well. The disappearance of oil glands leads to dryer and dryer skin with increased wrinkling and flaking. Interestingly vitamin D production also changes thus more oral supplementation is required.

The wonderful, thick multitude of blood vessel also decreases. This decrease is hastened by untreated or poorly treated high blood pressure. As a result we heal more slowly, temperature control is worse, infections are harder to fight and nerves become poorly nourished. With the loss of nerves we lose feeling leading to easier injury. We may also get abnormal itching. With the loss of immune cells we more easily get skin cancers.

All of this MAY occur, but we can influence much of the change.

n First and foremost, the sun’s ultraviolet radiation is a major culprit. Wear sunscreen with UV A and B ratings. Even better, as much as practical, avoid excess sun exposure.

n Treat and correct underlying medical conditions such as high blood pressure, high cholesterol, and excess weight.

n Maintain your optimal weight to avoid repeated stretching and shrinking of the skin.

n Eat a balanced diet filled with fruits and vegetables.

n Discuss required vitamins and supplements with your doctor.

n Lubricate you skin with proper lotions or creams. Ask your doctor about your skin type and which are the best are for you.

n Keep your skin clean and ‘breathing’ using proper techniques and cosmetic procedures (microdermabrasion etc.) as needed. If there is a question ask your physician.

n Finally-a MUST-have your doctor do a thorough skin check from head to toe at least once a year to detect skin cancers. If these are found treat them!

Now that you are aware of the changes in your skin, you can take care of it-certainly your skin is trying its best to take care of you!

Stephen F. Scholle, M.D., Ph.D. practices Family Medicine, Dermatology and in addition has the MEDI WeightLoss program in his office. The office is in the Key Estero Center at 1661 Estero Blvd., Ste. # 1, on Fort Myers Beach. For more information, please call 239-765-0007.