The skin is the barrier between vulnerable internal tissues and a plentitude of environmental factors with the potential to negatively impact those tissues . Degenerative processes inherent to aging produce the characteristic thinning, drying, and sagging of elderly skin  as well as a progressive deterioration in skin function . This process is based to some extent on ethnicity and gender . However, most visible changes in aged skin  as well as most pathological changes are due to a lifetime of exposure to external environmental insult . Degenerative processes that occur in aging skin and their clinical significance are shown in Table 54.1.
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