Ask the Doctors: Protect skin from sun and more tips to help with appearance of aging

Dear doctors: I’m 59 years old and have noticed that my skin is already getting fragile. I know it’s a natural part of aging, but I didn’t expect it to happen so soon. I’d like to know what causes skin to change with age and hear thoughts on caring for older skin.

Dear reader: Questions about changing skin come from all age groups. Adults in their 20s are discovering their first wrinkles. In the 30s and 40s, a loss of elasticity becomes an issue. People in their 50s, 60s and beyond ask about thinning and fragile skin.

When you look at the skin, you’re seeing just one of three complex layers.

The topmost — the epidermis — varies in thickness depending where on the body it is located. It is divided into five sub-layers, or strata, of specialized cells, proteins and other structures. The epidermis gives skin its color, contributes to immune response, holds water and continuously generates new cells to replace those that die.

Below the epidermis lies the dermis. Strong and elastic, it’s the thickest of the three layers. The dermis houses blood vessels, oil glands, hair follicles, sweat glands, lymphatic vessels and nerves.

The deepest layer of the skin — the hypodermis — is made up of fat cells and connective tissue. It helps keep us warm and contributes to structure.

Genetics play a big role in how skin ages. Environmental and lifestyle factors also are important, including exposure to sunlight, air pollution, smoking, drug use and certain medications.

What you do to take care of your skin has an impact.

Protecting skin from the spectrum of the sun’s ultraviolet light is key.

UVA rays cause structural damage that leads to wrinkles. The slightly stronger UVB rays cause sunburn, can damage DNA and trigger cancers.

With age, skin grows thinner due to physical and physiological changes. The cells of the epidermis grow thinner, connective tissues in the dermis weaken and lose volume, and oil glands grow sluggish. Fat loss in the hypodermis adds to the loss of structural support. This causes aging skin to become thin and fragile and leads to its translucent appearance.

To protect your skin, always shield it from sunlight with sunscreen and clothing. Wash with gentle cleansers and a light touch. Generously apply moisturizers to damp skin.

Retinol creams, which stimulate collagen production, can slow thinning but can have side effects and aren’t appropriate for all skin types. Older adults should consult with their doctors before using these.

Dr. Eve Glazier and Elizabeth Ko are UCLA Health internists.