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  • Skin aging results from both intrinsic and extrinsic factors, influenced by lifestyle choices, ethnicity, hormones, and environmental exposures.

  • Most extrinsic aging occurs because of chronic radiation exposure from multiple sources, including ultraviolet (UV) light, heat, and visible light, as well as pollution, resulting in visible manifestations of photoaging.

  • Due to the variability in skin between individuals and different ethnicities, different people will show signs of aging at different rates. However, despite these differences, protecting the skin is the best form of prevention.


  • Broad-spectrum sun-protection factor (SPF) sunscreens provide protection against both ultraviolet A (UVA) and ultraviolet B (UVB) radiation, and mineral-based sunscreens may be more helpful for a broader spectrum, including protection from visible and infrared light.

  • Pollution can also contribute to skin aging, and thus care must be taken to cleanse and protect skin from pollutants.


  • The decision to start an anti-aging regimen with topical or oral therapies is based on both the treating physician’s and the patient’s mutually agreed upon wishes. It is common to begin with topical therapies, such as nightly application of a topical retinoid.


  • Patients should be taught that photoprotection is the best form of prevention from extrinsic aging. Although sunscreens have been under scrutiny recently because of reports that they decrease vitamin D absorption, they are not used with the correct frequency and in the correct dosage to achieve this effect. Regular application of broad-spectrum SPF 30+ sunscreen is recommended.

  • Smoking and tobacco products lead to manifestations of aging at an earlier age. Therefore, patients should be counseled to avoid smoking not only for internal health benefits but also for their skin.


Among the few things that remain constant across human experience, one shared constant is the inevitability of aging. Although all organs throughout the body age, the skin shows the most discernable signs as we become older. A complex process that begins at birth, aging is a multifactorial process that results from the synergistic effects of both intrinsic and extrinsic factors. These internal and external factors and their interactions that affect individuals are known as the skin aging exposome.1 Together, these interactions lead to the visible effects we see as aging skin: thin, dry skin, fine wrinkles, uneven skin color, and sagging skin. Slight differences may be seen in the skin of different ethnicities as intrinsic and extrinsic influences may vary. As life expectancy increases and the older adult population continues to grow, the lifetime exposure to radiation, chemicals, and toxins that affect the skin also increases. With the growing older adult population, interest in the promotion of research to prevent and reverse aging and counteract the biologic process has increased. At the forefront of this are dermatologists who prioritize the care and prevention of patients with aging skin.



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