What Happens to the Hair, Skin, and Nails as We Age?
This study, published in the Journal of the American Academy of Dermatology(2026), reviews the age-related changes of hair, skin, and nails.
By 2045, more than 71 million Americans will be over 65, and the country will look more ethnically diverse than ever. That means the way we care for aging skin, hair, and nails has to evolve too. This article summarizes what dermatologists now know about the visible signs of aging—and, most importantly, what actually works to prevent and treat them.
Authors:
Aurore D. Zhang, BS, Michelle Lazar, MD, Eric Beltrami, MD, Rebecca C. Clawson, MD, Aref Moshayedi, MD, Andrei Sharov, MD, PhD, Vladmir Botchkarev, MD, PhD, Neelam A. Vashi, MD, Mayra B.C. Maymone, MD, DSc
Title:
Cutaneous Manifestations of Aging, CME Part 2: Approach to Aging of the Skin, Hair, and Nails
Journal:
J Am Acad Dermatol. 2026 May 22:S0190-9622(26)02730-1
Sun Damage: The Single Biggest Cause of "Aged" Skin
The scientific name for sun damage is dermatoheliosis, but you may know it as photoaging: brown spots, uneven pigment, fine and deep wrinkles, a rough or leathery feel, and precancerous "sandpaper" patches (actinic keratoses). It's caused by decades of ultraviolet exposure and shows up most strongly in fair skin, though patients of every skin tone are affected—often as brown patches (melasma), uneven color, and softer wrinkles.
The most powerful treatment is prevention. Daily broad-spectrum sunscreen—ideally a tinted mineral sunscreen, which also blocks visible light—remains the gold standard.
When damage is already present, options include:
Prescription retinoids (tretinoin and its cousins) to rebuild collagen
Intense pulsed light (IPL) for brown spots and redness (typically 3–6 sessions a month apart)
Ablative CO₂ laser resurfacing for deeper wrinkles and sun spots
Chemical peels for texture and pigment
Emerging options like topical estrogen creams, especially around menopause
Patients with darker skin need extra caution with lasers and IPL, because heat can trigger dark marks (post-inflammatory hyperpigmentation) that last months.
Wrinkles and Volume Loss
By the sixth decade, 80 to 90 percent of men and 70 to 85 percent of women have visible facial wrinkles, typically around the eyes, forehead, between the brows, and around the mouth. These come from three sources: natural aging, sun exposure, and years of repeated facial expressions.
Below is a treatment ladder, listed from simplest to most involved:
Topical retinoids and antioxidants act as your daily foundation.
Neurotoxins (Botox, Dysport, Xeomin, Daxxify, Jeuveau) relax the muscles that create dynamic wrinkles. Results begin in three to five days and last three to four months.
Microneedling, sometimes combined with PRP or growth-factor serums, gradually rebuilds collagen with minimal downtime.
Injectable fillers replace lost volume in the cheeks, temples, and around the mouth. Newer imaging studies show filler can persist far longer than we once thought—up to 15 years in some cases—so timing is highly individual.
PRP and PRFM ("natural fillers" made from your own blood) offer a softer look, particularly useful under the eyes.
Fragile, Thinning Skin (dermatoporosis)
About 30 to 37 percent of older adults—more often women—develop noticeably thin, delicate skin that tears easily, especially on the forearms and hands. You may see white "cigarette-paper" scars or purple bruises that appear from minor bumps (solar purpura). This is not just cosmetic; it can affect quality of life.
Management centers on:
Consistent sunscreen and thick barrier moisturizers
Topical retinoids to thicken the outer layer (start slowly, 3 times a week)
Serums with vitamin C, alpha hydroxy acids, DHEA, or hyaluronic acid fragments to reinforce the skin
For bruising specifically, oral citrus bioflavonoid supplements have shown up to 50% improvement in one trial
Aging hair: Thinning, Graying, and Texture Change
Between 30 and 50% of adults develop senescent alopecia, which is gradual thinning across the whole scalp, along with graying and loss of luster. Men are more often affected. Graying tends to start in the mid-30s in Caucasian patients, late-30s in Asian patients, and mid-40s in African American patients.
Evidence-based treatments include:
Minoxidil: Taken orally or applied twice a day topically. New growth appears at two to four months and only continues while you keep using it.
PRP or PRFM: Injections to the scalp, typically done in two to four initial sessions, with maintenance every six to 12 months.
Low-level light therapy (LLLT): Performed with in-office or at-home LED caps.
Exosomes: A newer regenerative option showing early promise
Aging Nails
Aging nails hold less water and develop weaker keratin, leading to brittle nail syndrome (peeling, splitting, ridging) in over a quarter of women. Onychauxis (thickening) and onychogryphosis (curved, ram's-horn nails) are also common on aging toes.
Care is straightforward: moisturize daily, avoid harsh chemicals and over-washing, protect from trauma, and—for thickened nails—professional trimming or debridement. Oral supplements (magnesium biotinate, arginine silicate, specialized bioactive compounds) have also shown modest benefit.
Take-Home Message
Aging is universal, but visible aging is largely preventable and highly treatable. The most powerful steps are the simplest: daily sunscreen, a good moisturizer, and a nightly retinoid.
Beyond that, today's toolbox—injectables, energy devices, PRP, and emerging regenerative therapies—lets us tailor a plan to your goals, skin type, and comfort level.
Schedule a Consultation Today in Bluffton, SC
Patients wanting to learn more about their hair, skin, and nail health in Bluffton, SC, today should look no further than board-certified plastic surgeon Dr. Jarrod Little. During your personalized consultation, Dr. Little and his team can analyze your health and provide more information about the best wellness treatment for you.
Reach out to Revive Palmetto Aesthetics and Plastic Surgery and schedule your visit today by calling (843) 480-0060 or contacting the experts online.
