How to prevent (and treat) damaged, crepey skin

January 30, 2019 Providence Health Team

Crepey skin has a thin, wrinkled surface that resembles crepe paper.

It can be caused by ultraviolet light damage, aging, genetics, dry skin, smoking and pollution, or large amounts of fast weight loss.

There are a variety of over-the-counter and prescription treatments that can help.

Maybe you’ve noticed, in recent years, that the skin on your forearms and upper chest has become thin and wrinkled. You’ve been increasingly tempted to either respond to one of those relentless infomercials offering miracle skin products or to break out your wallet at the cosmetics counter and purchase an array of expensive cleansers and moisturizers.

Hold onto your money, because there can be more economical solutions — try starting with a bottle of sunscreen, a moisturizer and a gentle soap. Barbara Fox, MD, a dermatologist at Pacific Medical Centers in Seattle, Washington, explains what causes crepey skin and some simple steps we can take to improve its appearance.

What is ‘crepey’ skin?

Crepey skin has a thin, wrinkled surface resembling crepe paper. It also demonstrates a loss of elasticity or resilience; if stretched, it does not return to its normal tone as quickly as the skin would in a child or young individual.

The most common type of crepey skin occurs in sun-exposed areas. It has a tendency to develop brown spots (also known as “liver” or “age” spots) and broken red capillaries. Another type of crepey skin occurs in non sun-exposed areas, such as the inner parts of the upper arms. It is seen more in women than men.

What causes it?

PhotodamageProlonged exposure to ultraviolet (UV) rays from outdoors, or from tanning beds, damages the support structures of the skin, including collagen and elastic fibers. Collagen can repair somewhat over time, but elastic fibers do not. The most prominent areas to display this type of damage are the scalp (for bald men), face, neck, upper chest (for women), and the forearms.

Aging. Over time, our skin loses the ability to repair and reproduce skin structures.

Genetics. Some of us age much faster than others, regardless of other factors. Fair-skinned individuals are more susceptible to photodamage, and thus may be more at risk for crepey skin.

Dry skin. As we age, our oil glands do not produce as much natural oil.

Smoking and pollution. These factors are also known to increase the signs of aging skin.

Rapid weight loss. Quickly losing a lot of weight can result in sagging skin. In time, it may tighten, but many patients with significant weight loss may need surgery to remove excess skin.

What can people do to prevent crepey skin?

Wear sunscreenThe most important thing is to use sun protection: a sunscreen with SPF of 30+ while in a northerly region like Seattle; and at least 50-70 when in a tropical climate, around water, or up in the mountains. Cover as much skin as possible with protective clothing and wear a broad-brimmed hat.

Dr. Fox interviews with Q13 and discusses the importance of applying sunscreen:

Moisturize. Ask your dermatologist which products are recommended for very dry skin. Often, those containing a phospholipid called ceramide work best to penetrate the skin, carrying moisture below the superficial skin layers and producing longer-lasting hydration. The best time to apply a moisturizer is immediately after toweling dry.

Exfoliate. Use a loofah sponge, or gentle exfoliating cleanser, once or twice weekly. Avoid overuse as this can irritate the skin. Moisturize afterwards.

Use gentle soaps or cleansers. As you age, it is important to change to a less-drying cleanser for both your face and body. Products for sensitive skin are recommended.

Eat a healthy diet. Include foods rich in antioxidants, such as red and blue berries, nuts, dark green leafy vegetables, orange vegetables, beans and whole grains. Also, foods rich in omega-3 fatty acids may be helpful. These include fish, flax seed, eggs, soybeans, spinach, walnuts and cashews.

Which over-the-counter products might help treat crepey skin?

Antioxidants like vitamins C and E. These reverse the oxidation process that causes cellular damage.

Retinoids (vitamin A derivatives). These turn skin cell layers over faster, revealing fresher, smoother, more evenly pigmented skin. Be cautious when using these products as they tend to be drying to the skin; for example, use a pea-sized amount to cover the entire face. Retinoids are offered in over-the-counter or prescription strengths.

Alpha Hydroxy Acids (“AHAs”). These have similar effects on anti-aging as retinoids, but they generally are less drying and better tolerated. The most common one is glycolic acid, which is a derivative of sugar cane. Another, lactic acid, is available as AmLactin or LacHydrin.

Beta Hydroxy Acids. The most common one is salicylic acid; these are also somewhat helpful in reducing wrinkles.

What are some misconceptions about treating aging skin?

Collagen supplementation. Collagen is a very large molecule; if ingested, collagen gets broken down and does not reach the skin intact. Alternatively, if it is rubbed onto the skin, it can’t penetrate the skin layers.

Drinking a lot of water. Drinking water is essential for our circulatory and renal system, and for keeping our inner organs well hydrated. However, it won’t repair dry or aged skin.

What treatments does a dermatologist offer?

There are many procedures to improve the appearance of crepey, aging skin. They range from less invasive procedures that have little recovery time, to more invasive procedures that may keep a person out of the public eye for several weeks.

Prescription strength medications. These include stronger retinoids like Retin-A (tretinoin), AHAs, antioxidants, and other products containing peptides.

Face peels. Applied in the office; the patient will be slightly pink and puffy for a few days before the skin peels. Multiple treatments are generally required.

Microdermabrasion. The older, dry, top layers of the skin are peeled off with an abrasive sanding wheel or abrasive spray. Dead skin cells are vacuumed away. The patient will be pink for a few days. Multiple treatments are needed.

Intense Pulsed Light (IPL). This laser-like device can help serious wrinkles, brown spots, broken capillaries, and red skin. Requires several treatments.

Botox. Used for lines on the face due to the muscles of facial expression creasing the skin.

Fillers. Used for loss of volume of the skin and filling these areas out. Can make the skin appear less wrinkled on the surface.

Lasers, radiofrequency and ultrasound devices. These are popular to tighten skin, remove wrinkles and brown spots, and “rejuvenate” skin. These treatments will generally have a slightly longer recovery time: from a few days for treatment of broken capillaries with a Pulsed Dye Laser (PDL); one week for a Fraxel laser; or up to 2 weeks for a CO2 Fraxel Laser treatment.

Surgical treatments. Facelifts, blepharoplasties (upper eyelid tightening) and neck lifts can also improve crepey skin.

 Ask your dermatologist if any of these might be helpful for you. Subscribe to To Your Health and browse more of our best skin care articles:

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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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