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What are the visible signs of aging skin?

Although there's some variation in how we describe the features of aging skin, there's a general agreement in the medical community that these features include:

1. Fine lines and wrinkles. While some of this is due to aging itself, a significant factor is the amount of UV radiation that reaches our skin and damages the collagen and elastic fibers in the skin. 

2. Sagging. Think about an elderly person with jowls, and how that contrasts with the firm jawline of a 20-year-old.

3. Atrophy.  If you've spent time around elderly persons, especially those who've sustained a lot of sun damage, you'll know that their skin becomes more fragile as they age. I've treated many fair-skinned elderly patients who describe frequent bruising on their forearms. They'll tell me that all it takes is a simple bump against the wall to cause bruising. This is because our skin thins (or in medical terms, atrophies) as we age. Sun exposure speeds up this process, which is why the forearms are so frequently affected. 

4. Loss of elasticity. Someone in their 20s has tight, taut skin that bounces back when you pinch it. As you age, your skin loses that ability to bounce back.

5. Pigment changes. As we age, we accumulate a lot more freckles and dark spots. The medical term for one type of these dark spots is solar lentigos. I call these sun spots, because they're due to cumulative UV exposure catching up to us.

6. Changes in skin texture. Older skin starts to show more changes of roughness and dryness. The skin just doesn't hold onto moisture as well. And it doesn't matter how many glasses of water you drink--the loss of natural oils in the skin predisposes us to dry, rough skin as we age.

7. Changes in microvasculature. Microvasculature is the medical term for the small blood vessels in our skin. Some people report that their skin looks more "sallow" as they age, meaning that they no longer have that healthy glow or freshness of youthful skin. 

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