The skinny on skin

Dear Lucy: I’ve been wondering about how our skin changes as we get older, not so much in appearance—I know that all too well—but in how well it functions. For example, I don’t remember getting cracks in the skin around my fingertips during the winter when I was in my 20s and 30s (and also living in Cambridge), but now that I’m in my mid-40s, it happens every winter. It seems that something must have changed, but what? And what else do I have to look forward to? Are there things I can do to keep my skin as healthy as possible as I get older, besides moisturizing regularly and avoiding excessive sun exposure? —Wintertime Woes

Illustration of two hands with cracked skin in front of a window showing a snowy winter landscape

Dear W-squared: When it comes to aging skin, Lucy has some first-hand experience. But deciding that your question called for a more clinical and objective point of view, Lucy turned to Allison Larson, MIT Medical dermatologist and dependable source for answers to “all things skin.” 

When it comes to keeping your skin as healthy as possible, Larson says you’ve nailed it—moisturizing and avoiding sun exposure. “And,” she adds, “Don’t smoke!” Smoking doesn’t just contribute to facial wrinkles, she explains. Nicotine use also leads to more general skin damage by narrowing blood vessels in the skin’s outermost layers, which limits the flow of oxygen and other important nutrients. Other chemicals in tobacco damage collagen and elastin, causing skin to sag and wrinkle prematurely. 

Unfortunately, doing right by our skin doesn’t slow the march of time. “We have so many skin-related changes to ‘look forward to’ as we age!” Larson says with a wry laugh. “Among other things, skin loses elastin, which causes it to become slack. Loss of fat in certain areas of the face changes facial contours. The epidermis—the top layer of skin—thins, which makes skin more fragile and more susceptible to bruising. And, over time, decreased oil production causes dry skin in most older adults.”

That cracked skin on your fingertips is likely related to this dry skin, Larson notes, along with frequent exposure to detergents, soaps and/or water. Dry indoor air during the New England winter often combines with increased hand washing—it’s cold and flu season, after all—making cracked fingers a seasonal problem, especially since fingertips, along with knuckles, are the parts of the hand that dry out most quickly.

You probably won’t be surprised to learn that Larson’s number-one suggestion is to moisturize, moisturize, and moisturize some more, paying special attention to fingertips and knuckles. Choose a moisturizer that’s up to the job—this previous Ask Lucy column has some suggestions—and keep it handy, so you can use it any time your hands feel dry. Another suggestion is to make sure your hands are covered any time you go outside, even if it’s just for a few minutes. Gloves will protect your fingertips, and the rest of your hands, from the drying effects of wind and cold.

In addition, Lucy has found it helpful to step up her bedtime moisturizing routine when her hands are very dry or cracked. Try it! Before going to bed, slather your hands with extra rich hand cream—much more than you’d use during the day—then put on some cotton spa gloves, and go to sleep. The gloves will protect your sheets, keeping all the hand cream on your hands and soaking into your skin overnight. You’ll be surprised at how much better those hands and fingers will look and feel in the morning!

Lucy hopes these suggestions help in the cold winter months ahead and thanks the indefatigable Dr. Larson, as always, for her willingness to help Lucy answer this question and so many others! —Lucy

Back to Ask Lucy Information contained in Ask Lucy is intended solely for general educational purposes and is not intended as professional medical advice related to individual situations. Always obtain the advice of a qualified healthcare professional if you need medical diagnosis, advice, or treatment. Never disregard medical advice you have received, nor delay getting such advice, because of something you read in this column.