- Telangiectasia; Rosacea; Acne Rosacea
As we age, gradual degradation of the skin may result in irregular, broken capillaries on the surface of the skin. These broken capillaries (telangiectasia) are small unsightly red, purplish vessels found on the face, upper chest, neck and rarely on other parts of the body. Telangiectasia on the face are caused by anything that stimulates the circulation to flush or blush. Heredity, aging, sun and environmental exposure, hot and spicy food, exercise, alcohol, emotions, hormones, cortisone medication, skin diseases, and acne rosacea (an adult form of acne) can all lead to telangiectasia. Large patches of blood vessels on the face leading to excessive redness is often attributed to rosacea. This can be quite severe and may be accompanied by episodes of flushing that are very difficult to control. Many rosacea patients are desperate for a solution to this annoying and embarrassing problem, as topical creams and other treatments as to date are rarely effective.
- Photoaging (Sun Damage): Lentigines (Age Spots): Ephelides (Freckles); Nevi (Moles); Melasma
The second major category of skin changes is photo aging; the production of irregular pigment and color brought about by exposure to the sun. Regardless of where we live, our bodies are constantly exposed to the damaging ultraviolet (invisible) rays of the sun. Typically, individuals begin to develop freckles and sun damage spots. Lentigines (age spots) and ephelides (freckles) are tan, brown or black spots that appear over time on sun exposed areas of the skin. These spots normally occur on the face, chest, shoulders, hands and extremities. Lentigines are superficial collections of skin pigment called melanin which have accumulated within the top layer of the skin called the epidermis. Lentigines usually appear later in life and can occur in all skin types. Ephelides (freckles), often begin in childhood and are common in lighter skinned type individuals who sunburn easily. Common moles (nevi) are inherited and appear in many different sizes, shapes and colors. Abnormally dark moles which demonstrate irregularity and progressive changes in shape, size, or color are at risk for being a malignant melanoma (a serious type of skin cancer). Suspicious moles should be checked by your physician and may need to be biopsied or removed entirely. Pigmented birthmarks are common and appear in multiple varieties. Congenital pigmented nevi are brown or black moles that are usually quite large and may appear anywhere on the body. If these moles contain hair, they are called giant pigmented hairy nevi. Café-au-lait macules (coffee and cream spots) are flat, tanned patches which present at birth and rarely may be associated with some other medical condition, such as neurofibromatosis. If multiple, large, pigmented spots are present especially in the mouth or gums, there may be an association with internal medical condition (Peutz-Jaeger syndrome) which needs to be investigated further. There are a large variety of pigmented birthmarks. Melasma is a patchy brown, tan or black zone of pigment which commonly occurs on the face or neck in women. Melasma will usually darken during pregnancy, while taking birth control pills or hormones, and is made worse by sun exposure. Post inflammatory hyperpigmentation is pigmentation that appears in the skin following inflammation. It may occur after injuries, superficial burns, skin irritation, acne, or surgery, as well as from other skin conditions which cause inflammation of the skin. When the skin is inflamed and red, it is most at risk for turning deeply pigmented, especially if exposed directly to sunlight.
- Rhytids (wrinkles); Elasticity; Texture
The texture and elasticity of the skin is lost with aging as the collagen and elastin content in the skin degenerates. Fine lines and wrinkles that appear around the eyes, mouth or forehead are attributed to this gradual loss of collagen in the skin. As this process progresses deep wrinkles, furrows and loose skin develop.