As we grow older, we see and feel certain changes in our skin, the body's largest and most visible organ. It becomes drier, more wrinkled and spots and growths may appear. The skin tends to heal more slowly.

Some of these changes are natural, unavoidable and harmless. Others are annoying or painful but can be prevented or treated. Some other changes in the skin, such as skin cancers, are serious and require immediate medial attention.

WRINKLES

CAN WRINKLES BE AVOIDED?

Wrinkles also depend on your parents -- the tendency to wrinkle is inherited.

The good news is -- some wrinkles can be prevented. To avoid wrinkles caused by the sun, always wear a sunscreen with an SPF of at least 15, a hat with a brim and other protective clothing when in the sun. Don't deliberately sunbathe and limit sun exposure between 10 a.m. and 3 p.m.

Over-the-counter "wrinkle" creams and lotions may help dry skin and make it look and feel better, but they do nothing to prevent or reverse wrinkles.

TREATMENTS FOR AGING SKIN

None of these remedies can guarantee eternally youthful skin, but they can improve the overall appearance of your skin. Severely wrinkled skin can only be corrected with surgery. Before you undertake any self-treatment or surgery, discuss your options with your dermatologist.

DRY SKIN

Bath oils, which have a limited effect, should be applied after bathing. oils should not be added to the bath water since the tub can become dangerously slippery.

Petrolatum, an ingredient in many lotions, creams and ointments, is an excellent moisturizer. Many moisturizers contain chemicals such as urea, alpha hydroxy acids, lactic acid, and ammonium lactate to help the skin hold water. Some of these chemicals can irritate the skin, however. Your dermatologist can help you decide which is best for you.

Bathing less often and using milder soaps and a soap substitute, or soaking in a tub of warm water without soap can help relieve dry skin. Hot water is more irritating to dry skin than cooler water. During cold weather, soap should be used on areas where skin rubs against skin, such as armpits, genital areas and between toes. After bathing and drying off, a moisturizer such as petrolatum or lanolin should be applied immediately to seal in moisture.

If dry skin continues to be a problem, consult your dermatologist. Severe flaky, itchy and cracked skin may be a sign of a more serious problem.

SKIN LESIONS

Lesions or skin growths become more common as we age. They may range from harmless "liver" or "age spots" to skin cancers that require immediate treatment. Most are caused by years of sun exposure.

Among the most common are red, scaly spots called actinic keratoses. If ignored, they may become skin cancers and will eventually have to be removed surgically. In the early stages they can be removed by applying a cream, a topical form of chemotherapy, or by other outpatient procedures.

Squamous cell carcinoma typically develops on the rim of the ear, the face, the lips and the back of the hands. These skin cancers can increase in size and spread to internal organs.

The most common form of skin cancer, basal cell carcinoma, usually appears as a small, shiny, fleshy bump on the head, neck or chest. It's more common in older fair skin people with blond or red hair and blue or green eyes.

Untreated, these skin cancers may begin to bleed and crust over. They grow slowly and rarely spread to other parts of the body. When treated early, squamous cell and basal cell cancers have a 95 percent cure rate.

A less common but more serious form of skin cancer is called malignant melanoma. Men over the age of 50 are at the highest risk for melanoma, but it can affect anyone of any age. Melanoma has been associated with severe childhood sunburns. This skin cancer usually appears as a dark brown or black mole-like growth with irregular borders and irregular color. The most frequent sites for melanoma are the upper back in both men and women, the chest and abdomen in men and the lower legs of women.

Any change in an existing mole could be a sign of melanoma and should be examined immediately by a dermatologist. Melanoma spreads to other organs and can be fatal.

OTHER GROWTHS

"Age" or "liver spots" -- These flat, brown spots are called lentigines. They have nothing to do with the liver -- they are caused by the sun and usually appear on the face, hands, back and feet. They are generally harmless, although large flat irregular dark areas can be a form of melanoma and require evaluation and treatment. Commercial "fade" creams will not make lentigines disappear.

Seborrheic keratoses -- These brown or black raised spots or wart-like growths look like they were stuck on the skin surface. They are not cancerous and are very common in older people.

Cherry Angiomas -- These are harmless, small, bright red domes created by dilated blood vessels. They occur in more than 85% of middle-aged and elderly people, usually on the torso.

SKIN DISEASES

Shingles/Herpes Zoster - Shingles is an inflammation of a nerve caused by the same virus as chicken pox. Early symptoms are localized pain, headache or fatigue. Shingles can affect people of all ages, but is more common (and painful) in older adults.

The virus attacks a nerve root and follows the course of that nerve, resulting in lines of blisters on the skin -- on the scalp, face, trunk, or extremities. The disease usually confines itself to one side of the body.

Because the disease can become serious and cause complications, a dermatologist should be contact if shingles is suspected, especially if the condition appears near the eyes.

Seborrheic Dermatitis -- The signs of seborrheic dermatitis are redness and greasy-looking "scales" on the skin. It usually affects areas of the skin with a high concentration of oil glands, such as the scalp, sides of the nose, eyebrows, eyelids, behind the ears, and the middle of the chest. It occasionally affects other areas such as the naval, breasts, buttocks, and skin folds under the arms.

Seborrheic dermatitis can be successfully treated and may even go away on its own, but it tends to recur. Frequent shampooing and washing are very helpful and your dermatologist may prescribe topical medications, including low-strength cortisone preparations.

Varicose Veins -- These are enlarged veins that appear blue and bulging. They are common in older individuals. The veins become twisted and swollen when blood returning to the heart against gravity flows back into the veins through a faulty valve. This conditions is rarely dangerous.

The symptoms of varicose veins can be eased by avoiding standing for long periods, by keeping feet elevated when sitting or lying down and by wearing support hose or elastic bandages. More severe cases can be treated with surgery or injections.

Varicose Ulcers - The same sluggish blood flow that results in varicose veins can cause varicose ulcers, also known as venous or stasis ulcers. When a crack or cut occurs in the skin of the leg, it may fail to heal because of impaired blood flow. The injury can develop into an ulcer, a shallow wound that may contain pus. The ulcers may last for months or even years, often healing and returning.

Varicose ulcers often develop at the ankles and may be accompanied by swelling and red, itchy, flaky skin around the ulcer. Another cause of ulcers on the legs is insufficient flood supply from the arteries. This condition is associated with medical disorders such as arteriosclerosis, hypertension and diabetes.

Bruising (Purpura) - Many seniors complain of black and flue marks or bruises, particularly on the arms and legs. These are usually a result of the skin becoming thinner with age due to sun damage. Loss of fat and connective tissue weakens the support around blood vessels, making them more susceptible to injury. Bruising in areas always covered by clothing should be evaluated. Bruising sometimes is caused by medications, clotting disturbances or internal disease.

Itching - A very common problem with aging skin is itching. Although often associated with dry skin, itching also has other causes. elderly skin appears to be more sensitive to fabric preservatives, wool, plastics, detergents, bleaches, soaps and other irritants. Identifying and limiting exposure to the cause is important. Prolonged itching may lead to a lack of sleep and fatigue. Your dermatologist can offer some medical remedies for itching.

Although most of the changes we experience in our skin as we age are harmless, there are certain signs of more serious problems that shouldn't be ignored. See your dermatologist if you notice any of the following symptoms:

Symptom May Indicate