RISK-FACTORS FOR REDUCED SKIN THICKNESS AND BONE-DENSITY - POSSIBLE CLUES REGARDING PATHOPHYSIOLOGY, PREVENTION, AND TREATMENT

The decline in skin thickness that occurs with aging interests many di fferent groups. Among these are pharmaceutical, cosmeceutical, and cos metic companies promoting antiaging or antiwrinkling products, geriatr icians and rheumatologists treating elderly and steroid-dependent pati ents who are ''outliving'' their skin, cosmetic surgeons, and dermatol ogists. Dermatologists are frequently asked how to prevent or slow agi ng of the skin. The answer regarding ''photoaging'' of sun-exposed ski n is obvious; the answer regarding aging of photoprotected skin is not . Although the bulk of epidemiologic literature about aging and thinni ng of photoprotected skin is from the 1970s, literature regarding risk factors for and treatment of aging and thinning of the bony skeleton is more recent. Because both skin and bone are composed of more than 7 0% type I collagen, it may be hypothesized that the pathophysiologic p rocesses involved in chronological atrophy of both tissues may overlap , thereby providing a foundation for further investigation of the skin . A better understanding of skin and bent loss may motivate the ''appe arance-conscious'' public to modify risk factors (e.g., begin exercisi ng) or select hormonal therapies (e.g., postmenopausal hormone replace ment) to reduce aging of the skin. These measures may provide addition al benefits, such as decreasing the risk of osteoporosis.