How to Identify and Treat Common Skin Problems

    Dry? Itchy? Inflamed? How to find relief this winter.

    Man looking at face in mirror Photo: Getty Images

    When you think of problems related to aging skin, you probably focus on wrinkles or sagging. But there’s a wide variety of skin conditions that become more common with age.

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    “The skin is the body’s largest organ, and over time, changes in the skin can lead to dysfunction and disease,” says Sarina Elmariah, M.D., an assistant professor of dermatology at Harvard Medical School.

    As we age, sun damage adds up, the skin becomes drier and less supple, and a weakened immune response can leave your skin more prone to infections. Together, these changes can create problems that go beyond appearance. Here, how to spot, treat, and prevent four common concerns.

    Fungal Infection
    What it is: A fungal infection often affects the skin on your feet and your toenails. “As people age, decreased immune function leaves them more prone to fungal infections,” says Shari Lipner, M.D., an associate professor of clinical dermatology at the Weill Cornell Medical Center in New York City. When these infections aren’t treated quickly, they can spread. “In many cases, chronic [and untreated] athlete’s foot eventually infects the nail,” she says.
    How to treat it: First consider prevention. If you go to the gym, always wear flip-flops or slides in public areas. Keep your toenails short, suggests Joel L. Cohen, M.D., a dermatologist in Colorado and associate clinical professor of dermatology at the University of California, Irvine. If you get a skin fungal infection, it can usually be treated with an over-the-counter antifungal (like those for athlete’s foot). But if the condition becomes chronic or it infects your nail, you should see a dermatologist or podiatrist.
    Actinic Keratosis
    What it is: “With age, we accumulate both benign and malignant lesions,” Lipner says. “And it can be hard to distinguish if a spot is one to worry about or not.” Commonly acquired spots include actinic keratoses (which are precancerous lesions), cherry angiomas (small red spots that generally don’t require treatment), and solar lentigines (often called sun spots or liver spots). Many of these changes result from UV damage.
    How to treat it: Experts recommend annual skin checks by a dermatologist—more often if you have a history of skin cancer or actinic keratoses. Spots that are new, changing, or not healing should be evaluated. Sun protection—seeking shade, covering up with a hat and long sleeves, wearing sunblock—is also important. “Sun exposure is cumulative, and we continue to get significant damage in later years,” says Cohen. “It’s never too late to practice good sun protection habits.”
    Contact Dermatitis
    What it is: Things that didn’t previously bother you—like wool clothing or scented lotions—may suddenly cause your skin to feel itchy, inflamed, and irritated. With repeated exposure, contact dermatitis can appear as patches of swollen, scaly, or reddened skin. “The aging immune system is more likely to mount an allergic reaction to normal stimuli,” Elmariah says.
    How to treat it: Treating the skin gently and using thick emollient creams to bolster your skin barrier will help. Experts also recommend staying away from anything that triggers an allergic reaction, for example, by switching to unscented products. Sometimes if you carefully consider where and when you developed skin irritation, you can pinpoint the cause—a necklace? a new eye cream?—then avoid it.
    Asteatotic Eczema
    What it is: This is the clinical name for something many older adults are already familiar with—dry, itchy, cracked skin that gets worse during the winter months. Your skin barrier is the protective armor that keeps moisture inside and damaging things outside. As you age, the outer layer of skin loses lipids, protein, and amino acids that it needs to function. Asteatotic eczema “is the result of the skin barrier not being intact, and the natural decrease in lipids,” Lipner says.
    How to treat it: Experts recommend limiting your time in the bath or shower to 5 or 10 minutes. Avoiding hot water and limiting the use of soap can also help. “I tell patients to skip soap on areas like your arms, legs, and back that typically aren’t really dirty,” Elmariah says. Afterward, pat your skin dry and apply a thick moisturizer to help seal in hydration.
    Left-side Fungal, Dermatitis, and Eczema photos used with permission from VisualDx. Left-side Keratosis photo: Dr. Richard P. Usatine.

    Editor’s Note: A version of this article also appeared in the December 2020 issue of Consumer Reports On Health.

    Sally Wadyka

    Sally Wadyka is a freelance writer who contributes to Consumer Reports, Real Simple, Martha Stewart Living, Yoga Journal, and the Food Network on topics such as health, nutrition, and wellness.