Elderly

and sun-affected skin Distinguishing between changes caused by aging and changes caused by habitual exposure to sun Robert Jackson, MD, FRCPC OBJECTIVE To review and distinguish between skin changes produced by aging and changes produced by habitual exposure to sun. QUALITY OF EVIDENCE The literature was searched from 1969 to 1999 for ar ticles on dermatoheliosis and sun-damaged skin. Surprisingly few were found comparing the difference between elderly skin and sun-damaged skin. A few articles focused on certain small aspects of sun-damaged skin. Many excellent articles described particular changes (eg, actinic keratosis), but few covered all the changes due to aging and to sun. MAIN MESSAGE Skin changes due to aging can be distinguished from those due to sun damage. All changes due to sun exposure can be grouped under the term dermatoheliosis; five parts of the skin are involved: epidermis (actinic keratosis), dermis (solar elastosis), blood vessels (telangiectasia), sebaceous glands (solar comedones), and melanocytes (diffuse or mottled brow