Whitmore S E, Levine M A
Department of Dermatology, The Johns Hopkins University, Baltimore, Maryland, USA.
J Am Acad Dermatol. 1998 Feb;38(2 Pt 1):248-55. doi: 10.1016/s0190-9622(98)70600-0.
The decline in skin thickness that occurs with aging interests many different groups. Among these are pharmaceutical, cosmeceutical, and cosmetic companies promoting antiaging or antiwrinkling products, geriatricians and rheumatologists treating elderly and steroid-dependent patients who are "outliving" their skin, cosmetic surgeons, and dermatologists. Dermatologists are frequently asked how to prevent or slow aging of the skin. The answer regarding "photoaging" of sun-exposed skin is obvious; the answer regarding aging of photoprotected skin is not. Although the bulk of epidemiologic literature about aging and thinning 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 70% type I collagen, it may be hypothesized that the pathophysiologic processes 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 bone loss may motivate the "appearance-conscious" public to modify risk factors (e.g., begin exercising) or select hormonal therapies (e.g., postmenopausal hormone replacement) to reduce aging of the skin. These measures may provide additional benefits, such as decreasing the risk of osteoporosis.
随着年龄增长而出现的皮肤厚度下降引起了许多不同群体的关注。其中包括推广抗衰老或抗皱产品的制药、药妆和化妆品公司，治疗老年人以及因“皮肤老化速度慢于身体其他部位”而依赖类固醇的患者的老年病医生和风湿病医生，整形外科医生，以及皮肤科医生。皮肤科医生经常被问及如何预防或减缓皮肤衰老。对于暴露于阳光下的皮肤“光老化”问题，答案很明显；而对于受光保护皮肤的老化问题，答案则不明确。虽然关于受光保护皮肤老化和变薄的大部分流行病学文献来自20世纪70年代，但关于骨骼老化和变薄的风险因素及治疗的文献则更新一些。由于皮肤和骨骼都由超过70%的I型胶原蛋白组成，因此可以推测，这两种组织随时间萎缩所涉及的病理生理过程可能重叠，从而为进一步研究皮肤提供了基础。更好地理解皮肤和骨质流失可能会促使“注重外表”的公众改变风险因素（例如开始锻炼）或选择激素疗法（例如绝经后激素替代疗法）来减少皮肤老化。这些措施可能会带来额外的益处，比如降低骨质疏松症的风险。
