6 Age-Related Skin Changes—and When to See Your Doctor
It’s normal to experience age-related changes to your skin. A likely culprit? Decades of sun exposure. “Aging of the skin is really related mostly to the sun,” says Joseph L. Jorizzo, M.D., a board-certified dermatologist at Atrium Wake Forest Baptist Health in Winston-Salem, North Carolina.
Other factors can play a role, as well—including hormones. “This is especially true if you’re perimenopausal or menopausal, due to decreased estrogen and eventual loss of estrogen,” says Saakshi Khattri, M.D., a board-certified dermatologist and rheumatologist and assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai Hospital, in New York City.
How Does Skin Change with Age?
In general, says Khattri, skin loses fat and collagen over time, becoming thinner and likely more wrinkled. In most people, aging skin does not naturally look as plump and smooth as it did during the earlier decades of life.
Here are some other age-related skin changes you may notice in midlife, according to The North American Menopause Society:
- Thin skin
- Loose skin
- Changes in pigmentation (dark or light spots)
- Visible blood vessels
- Easy bruising
- Loss of elasticity
- Collagen loss
Skin Bumps and Lumps to Watch for in Midlife
There are a wide range of skin bumps and lumps that appear with age. Here are some conditions to keep on your radar.
1. Red Scaly Bump (Actinic Keratosis)
According to the American Academy of Dermatology, one of the most common skin conditions treated by dermatologists is known as actinic keratosis. Actinic keratoses typically appear as red, rough, scaly, gritty bumps which appear on areas of the skin that get unprotected, direct sun exposure, like the scalp, face, ears, lips, neck, and hands, but can appear anywhere on the body.
These spots form after years of sun or tanning bed exposure, typically in people age 50 or over, and they are a precursor to cancer. But there’s no way of knowing which actinic keratosis spots may turn into cancer. “If you had 100 of them and you watched them for 10 years, probably seven would become invasive squamous cells,” Jorizzo says.
That’s why it’s important to get them checked out. If you think you have actinic keratosis, make an appointment with a dermatologist, who will likely treat them with liquid nitrogen or topical field therapy creams such as 5-fluorouracil (Efudex) or imiquimod (Aldara) creams or treatments such as photodynamic therapy.
Your dermatologist may also recommend regular skin cancer screenings to monitor these lesions as well as others, and may recommend biopsies for those that appear suspicious for skin cancers.
2. Black or Brown Growth That Looks Like a Wart (Seborrheic Keratosis)
These skin growths commonly occur in people who are middle-aged or older. They tend to have a wartlike appearance, and may appear like spots of candle wax on the skin. They might be any color, including tan, brown, or black; the growths can appear anywhere on the body. “Many people just have one or two, but some people have literally hundreds of them,” Jorizzo says.
While seborrheic keratoses may look concerning, they’re completely benign and harmless, Jorizzo says. However, if you aren’t sure what you’re looking at, there’s no harm in asking a dermatologist to check them out.
3. Skin Tag (Acrochordon)
Acrochordons, or skin tags, are very small, soft, fleshy benign skin growths that often appear in folds of skin, such as in the neck, armpits, breasts, or groin, but can also appear anywhere on the body including eyelids. “They appear as skin-colored,” Khattri says. And they’re very common, especially with age—up to 60% of adults will develop at least one skin tag in their lifetime.
While these growths are harmless, skin tags can be cosmetically removed by a dermatologist if they’re bothersome—for example, if they become irritated or snag on clothing or jewelry—or if you don’t like them.
4. Small Red Mole (Cherry Angioma)
A cherry angioma is another common skin growth that develops in people age 30 and older. As the name suggests, these skin growths are red in color, and that’s because they’re made up primarily of blood vessels. They’re typically small—about the size of a pinhead to a quarter inch in diameter. Although they can appear just about anywhere on the body, they commonly crop up on the middle portion of the body, called the trunk or torso.
Like other common skin growths, some people may only develop a single spot, while others will have a hundred times that amount, Jorizzo says. Cherry angiomas are not cancerous, so they typically aren’t treated or removed unless they bleed. If one desires to remove them cosmetically, they can be treated by pulsed dye laser or intense pulsed light treatment, or burned off in a process called electrodesiccation.
5. Brown or Red Bump That Looks Like a Pimple or Bug Bite (Dermatofibroma)
A dermatofibroma is a small, dense skin growth that’s typically pink, reddish-brown, or skin-colored. These often appear in the wake of a bug bite or pimple or some other minor, unmemorable trauma, explains Jorizzo. A telltale sign of a dermatofibroma is that it dimples when pinched, he says.
A dermatofibroma can occur in people of all ages, but women in particular may notice them as they enter their 40s. People often mistake these skin growths as a sign of cancer, but they are benign and don't require medical treatment. They can, however, be surgically removed if desired. Often, this is not recommended, as the scar to remove the benign lesion may often be larger than the dermatofibroma itself.
6. Horn-Shaped Skin Growth (Cutaneous Horn)
While uncommon, people between the ages of 60 and 70 may develop what’s known as a cutaneous horn. As the name implies, this is a hard, horn-shaped skin growth that may vary in size (a few millimeters to several centimeters).
A cutaneous horn is made out of keratin, the same substance that makes up your nails. The horn tends to occur on areas of skin with high sun exposure. It may also grow on top of another skin lump, like a seborrheic keratosis, a wart (or verruca vulgaris), an actinic keratosis, or skin cancer (usually squamous cell carcinoma).
Your dermatologist may recommend biopsy to determine whether there’s an underlying malignancy at the base of the lesion, and then recommend proper treatment. Because of their unusual appearance, most people choose to have them removed regardless of cancer risk.
When to Call Your Dermatologist
“Everyone should see their dermatologist annually for a skin check to make sure they don’t have skin cancer,” advises Khattri. “And if you develop a new bump or lesion—that also warrants a trip to the dermatologist.”
In addition to a typical head-to-toe scan, sometimes called a skin cancer screening or full-body exam, your dermatologist may biopsy any suspicious areas to evaluate for cancer. They may also suggest removal options, such as freezing, lasers, or excisions, depending on the diagnoses.
Finding the right provider is key. Your best bet, Jorizzo says, is a dermatologist who takes the time to talk to you about your skin bumps and lumps, and who can articulate why they might want to remove some lesions and not others. “You want to go to a dermatologist who inspires confidence,” he says. After all, your skin is in their hands.
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