Stay out of the sun for more youthful skin

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April 16, 2007

By Bill Kettler

Mail Tribune

EDITOR'S NOTE: This weekly column by reporter Bill Kettler answers readers' questions about topics of general medical interest with information provided by doctors from PrimeCare, Jackson County's independent practice association.

I have noticed that my skin has thinned as I age. Is there a good answer as to why, and what can be done to preserve general skin health?

— Paul S., Medford

Our genes and the way we live both have a profound influence on how skin ages, says Dr. Doug Naversen, a Medford dermatologist.

"We can't change the genes we inherit from mom and dad," Naversen says, "but hopefully we can choose healthy practices that don't age the skin prematurely."

The natural aging process, also known as intrinsic aging, begins in our 20s, although we may not see the results for years. The body produces less collagen, the fibrous protein in connective tissue, as well as elastin, the substance that allows skin to snap back quickly. Eventually, everybody develops fine wrinkles and the skin grows thinner.

Each individual's genes influence how quickly the aging process actually comes to the surface. Some people may appear ageless as they cruise toward their 50s; others look much older than their years.

Nongenetic factors, known as extrinsic aging, can play a huge role in how fast skin ages. If the epidermis and dermis (the outer and inner skin layers) are regularly exposed to too much sun, they will age more quickly. Ultraviolet rays are the culprits.

Physicians call this exposure to the sun "photoaging," and Naversen says "there's a tremendous amount of it," especially among farmers, ranchers and anyone else who exposes parts of their skin to the sun.

Naversen says thick leathery skin and deep wrinkles develop in places such as the neck that have been exposed to decades of strong sunshine, and physicians even have a term for it: "peasant neck."

The contrast between exposed areas and places that have been covered with even a simple cotton shirt can be staggering. "If you look three inches below the collar line on some of these folks, the skin looks 50 years younger," he says.

Fair-skinned people suffer more damage more quickly than those with darker skin. Signs of aging include dark spots (often called "age spots"), freckles, skin with a texture like leather, and small patches of thick scabby, scaly skin called actinic keratoses, as well as skin cancer.

Naversen says some drugs also can increase the sun's effect on skin, including Coumadin, aspirin and prednisone. People who take these drugs regularly have to take special precautions to avoid too much sun.

Naversen says people should try to minimize exposure to the sun between the hours of 10 a.m. to 4 p.m. during the months when the sun is most powerful. People who do go out in the sun should wear clothing to cover their skin, wear a brimmed hat, or apply sunscreen whenever they're going outdoors for a prolonged amount of time.

Dermatologists can't do much about the genetic factors that influence how skin ages, but they have several tools to eliminate the signs of aging. Lasers can be used to melt away liver spots without a scar as well as the thin "spider veins" that develop on the face and other exposed areas.

Dermatologists also can perform a variety of facial "peels" to improve the appearance of aging skin, and plastic surgeons can do skin tucks to remove neck wattles and other signs of aging. Nearly all of these procedures are considered not medically necessary by health insurance providers, so patients have to pay out of pocket for them.

Call Bill Kettler with your medical questions at 776-4492, or e-mail them to: bkettler@mailtribune.com or send them to: Mail Tribune, Ask Your Doctors, P.O. Box 1108, Medford OR 97501.

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