Why Is Older Skin More Prone to Skin Cancer?

The risk of skin cancer increases with age. When it comes to skin cancer in Florida and beyond, the prevalence of basal cell, squamous cell, and melanoma skin cancers rises significantly after the age of 50 and peaks two to three decades later. Although many factors contribute to the development of skin cancer—such as lighter complexion type, red or blonde hair, blue eyes, family history, and tanning bed use—older age remains a major independent risk factor. The forces that drive this increase in skin cancer with age arise from both baseline intrinsic aging as well as extrinsic causes.

Skin cells constantly replenish themselves. With each replication cycle, DNA mutations may occur. These mutations accumulate over time, increasing the risk of abnormal cell clones, which can grow out of control and lead to malignancy. This ongoing cellular damage contributes to intrinsic aging, which affects both sun-exposed as well as sun-protected skin. 

Mechanisms to repair these DNA defects do exist. DNA repair genes can excise base-pair mutations or even stimulate the death of the defective cells to prevent unchecked growth. But this natural ability declines with age. Weaker immune surveillance therefore allows additional cellular damage with the potential for malignant transformation. 

Extrinsic aging, by contrast, is due to environmental factors, especially sun exposure. Smoking, occupational exposure to chemicals, and pollution can also contribute. Both UVA and UVB sunlight induce DNA mutations in skin cells that worsen baseline damage from intrinsic aging. Indeed, 90 percent of the wrinkling, thinning, loss of elasticity, and pigmentation seen in older skin is caused by sun exposure rather than age alone. Fair-skinned, older individuals are at particularly high risk of developing skin cancer because accumulated sun-damage magnifies the underlying DNA defects. 

We have little control over intrinsic aging, which is largely genetically determined. We can, however, control environmental exposures that increase skin cancer risk:

• Stop smoking.
• Get serious about sun protection. Wear sun-protective clothing, hats, broad spectrum sunscreen with SPF 30 or greater, and avoid sun exposure during peak hours. Make it a daily routine, not simply a weekend beach practice.
• Support your overall health and immune system with a nutritious diet, exercise, and adequate sleep.
• Consider adding topical products to your facial regimen, such as vitamin C or resveratrol, that have antioxidant properties to counteract sun-induced oxidative damage. 
• Likewise, topical retinol cream has been shown to reduce the atypical squamous cells in premalignant skin lesions. Ask your dermatologist if adding either retinol or prescription strength tretinoin cream to your nightly skin care regimen is the right choice for you.

For more information about skin cancer, contact the team at Skin Wellness Physicians. Reach out online or call 239.732.0044.