This segment of AgingSkinNet provides answers to some common questions about the effects of aging and photoaging, diseases of the skin in older adults, and treatments for aging skin.

1. What is shingles, and why does it occur only in older people?

2. Why does the skin of older people bruise so easily?

3. Older people often complain of itching skin. What causes this itching?

4. Are liver spots a sign of liver disease?

5. Is it appropriate for a woman to have a hair restoration procedure?

1. What is shingles, and why does it occur only in older people?
   Shingles is a condition caused by a virus (herpes zoster) that also causes chicken pox. It is believed that the virus causes chicken pox in childhood, then lies dormant in nerve tissue for years or decades until it is reactivated to cause shingles. While shingles can affect people at any age, it is more common and often more painful in older adults.
   
   Reactivation of herpes virus is heralded by localized pain along the route of a nerve, as the virus causes the nerve tissue to become inflamed. After 2 or 3 days of pain that is often severe, the skin erupts with red and fluid-filled lesions along the route of the affected nerve. The skin lesions resemble those of chicken pox. As the condition progresses, new lesions continue to form and pain continues to be severe. The active phase may continue for a week or longer, but healing may require several weeks, especially in older adults. In some cases, branches of the optical nerve may be affected and vision may be impaired or even lost. A dermatologist should be consulted immediately if shingles is suspected. Treatment with anti-viral drugs is most effective in the early phase of shingles.
   

2. Why does the skin of older people bruise so easily?
   As people age, the skin becomes thinner and fat padding under the skin is lost. Thus, blood vessels are less protected from injury. An injury inflicted by mild trauma—for example, bumping against a table or being hit by a tennis ball—may result in a substantial bruise. In some instances, bruising may be an indication of an underlying condition. Bruises that appear for no apparent reason may indicate a bleeding disorder. Anti-clotting medications may cause bleeding under the skin.
   

3. Older people often complain of itching skin. What causes this itching?
   Aging and photoaging reduce the capacity of the skin to moisturize itself, so the skin becomes dry. Dry skin is one of the major causes of itchiness in aging skin. Over-the-counter moisturizing agents may relieve itching due to dry skin. Other causes of itchy skin often require the attention of a dermatologist. Elderly skin is sometimes more sensitive to clothing fabrics (especially wool), soaps and detergents, and other items encountered in everyday living. Identification of the sensitizing agents and limiting exposure to them may reduce the itchiness. Allergies to a host of indoor and outdoor agents may cause itching. Some medications cause itchiness as a side effect. Severe itching as well as itching that does not respond to moisturizing should be evaluated by a dermatologist.
   

4. Are liver spots a sign of liver disease?
   Liver spots have nothing to do with the liver, and they are not an indication of liver disease. They are more correctly called "age spots" and "photoaging spots". In medical terminology they are called lentigines or lentigos. Their typical appearance is light to dark brown (nearly black) flat patches on the hands, face, legs or feet. The edges of the spots are rounded, giving them a resemblance to a large freckle. One may appear by itself, or several may cluster together. The causes of these spots are (1) an inherited tendency to form them, and (2) chronic sun exposure. They can be removed by a dermatologist.
   
   There are no effective preventive measures for hereditary age spots. Photoaging may be prevented or moderated by avoiding excessive sun exposure and using effective sunscreen (Please see Prevention of Photoaging). Age spots are not cancerous or precancerous. However, pigmented lesions that may be similar in appearance, but have uneven rather than rounded edges, could be melanoma and should be evaluated by a dermatologist (Please see Skin Cancer).
   

5. Is it appropriate for a woman to have a hair restoration procedure? Isn’t this something usually done for men?
   Hair loss is a problem affecting about 35 million men in the United States—and about 22 million women. Although hair transplantation and other hair restoration procedures were at first used primarily for men to correct male pattern baldness, women have increasingly turned to dermatologists for help in restoring a "full head of hair" look. Inherited tendency is a major cause of hair loss in women just as in men. Hormonal changes of pregnancy can lead to hair loss. Other causes include stress and nutritional deficiencies. Before a hair restoration program is undertaken by a woman, a dermatologist must evaluate the cause(s) of hair loss and recommend the hair restoration procedure that will be most effective (Please see Hair Loss).

All content solely developed by the American Academy of Dermatology

Supported by an educational donation provided by The Allergan Foundation.