As you age, nothing functions as well as it did when you were young, including skin, a specialized organ with its own immune system. Intense sunlight does enormous damage, penetrating deep to cause changes to that immune system. It also affects hormones that keep skin youthful, which decrease with age anyway. Without the stuff that makes for dewy complexions - fat, collagen, elastin and estrogen - skin gets thinner, drier and less taut. The result is that even minor trauma, such as bruising, abrasions and burns, causes substantial damage that heals slower. Less elasticity means gravity finally wins out - jowls and lips sag, noses droop and ears elongate.
Sun, smoking and lower hormone levels may also be the reason for the strange lumps and bumps that emerge as you get older. Most are benign. The only trouble they cause is possible irritation and, well, they look bad. But unsightly ones are easy to remove with modern techniques, such as cryosurgery (destroying tissue by freezing it with liquid nitrogen), cautery (destroying tissue by searing blood vessels), lasers (zapping them directly with a single beam), bleaching creams or excision. Such treatments should be done by a board-certified dermatologist.
Here, Salt Lake dermatologist Bradley Rasmussen describes the most common benign skin disorders and what you can do about them.
* Easy bruising (purpura) - Appears mostly on arms where skin is fragile and chronically exposed to sun. Can also result from multiple medications such as aspirins and blood thinners. Bumping and shearing forces rupture tiny capillaries, which leak into the surrounding skin. Not dangerous.
* Solar lentigines - Round, dark patches on sun-exposed areas such as arms, hands, face, neck and shoulders. Commonly called "liver spots," although they have nothing to do with the liver or liver functions. Fair-skinned rather than olive-skinned people are prone to them. There is an inherited tendency toward liver spots. If unsightly, they can be bleached or removed by freezing or laser.
* Seborrheic keratosis - Slightly elevated, flat-topped, rough or waxy, wartlike bumps. Can be brown, red, white or other colors. One-quarter to 1 inch in diameter. Common on chest and back. Benign but can be confused with skin cancer. Remove by freezing.
* Cherry hemangiomas - Little red bumps, primarily on trunk. They are aggregates of blood vessels that may bleed if abraded. No treatment unless they bleed.
* Milial cysts - Tiny white bumps, 1-2 millimeters in size, they are plugged oil glands around nose and eyes. They commonly contain keratin, which can be extracted by a dermatologist.
* Sebaceous hyperplasia - Enlarged sebaceous glands common in oily skin. Clear, yellowish in color and often cauliflower-shaped, they are common on forehead, cheeks and nose. It is thought they may be caused by decreased cellular turnover, which causes crowding and enlargement of sebaceous glands, or by decreased hormone circulation.
* Skin tags - A genetic tendency found more in women than men, skin tags grow in warm, moist areas such as neck, shoulders, armpits, groin and under breasts. Essentially redundant skin, they can be removed by freezing or clipping.
* Venous lake - Round, blood-filled, purple or dark blue lesions on sun-exposed lower lips. Common but benign.
* Rosacea - Small, solid red bumps or pimples around nose, cheeks and chin that resemble acne. Triggers include weather, temperature, food, drink, drugs, stress, medical conditions, physical exertion and skin-care products. Can be mild and hardly noticeable to severe and embarrassing. Variety of treatments tailored to individuals.
* Actinic keratosis - Pre-malignant. Flaky, flat patches on sun-exposed areas such as face, ears, nose, hands and arms. If untreated, they can develop into cancer. Freezing removes top layer.
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* JANE GRAU can be contacted at jgrau@sltrib.com or 801-257-8694. Send comments to livingeditor @sltrib.com.
