Aging-associated alterations in epidermal function and their clinical significance
Open accessAbstract
Chronologically-aged skin displays multiple functional changes in both the dermis and the epidermis. It appears that epidermal dysfunction, compromised permeability homeostasis, reduced stratum corneum hydration and elevated skin surface pH predispose to the development of aging-associated cutaneous and extracutaneous disorders. Improvements in epidermal function have been shown to be an effective alternative therapy in the prevention and treatment of some aging-associated cutaneous disorders, including eczematous dermatitis, pruritus, and xerosis. Recent studies demonstrated that epidermal dysfunction leads to the development of chronic, low-grade systemic inflammation, termed 'inflammaging,' which is linked to the development of aging-associated systemic disorders. Thus, correction of epidermal dysfunction could comprise a novel strategy in the prevention and treatment of aging-associated systemic disorders as well. In this review, we summarize aging-associated alterations in epidermal function, their underlying mechanisms, and their clinical significance. Regimens to improve epidermal function in the elderly are also discussed.
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Aging-related skin changes, such as decreased skin hydration, altered pH of the stratum corneum, increased transepidermal water loss, and heightened cytokine-mediated inflammation, result in skin that is more prone to environmental insults, including air pollutants, extreme temperatures, and ultraviolet radiation.
“Aging-related skin changes, such as decreased skin hydration, altered pH of the stratum corneum, increased transepidermal water loss, and heightened cytokine-mediated inflammation, result in skin that is more prone to environmental insults, including air pollutants, extreme temperatures, and ultraviolet radiation [90,91].”
From The Environmental Determinants of Skin Health: Linking Climate Change, Air Pollution, and the Dermatologic Disease Burden (2025) · cites this paper as [91]
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Experimental — accuracy not yet measuredImpairment of the epidermal barrier, reflected by increased transepidermal water loss, exacerbates skin dryness and vulnerability to environmental stressors.
“Impairment of the epidermal barrier, reflected by increased transepidermal water loss (TEWL), further exacerbates skin dryness and vulnerability to environmental stressors [6,7].”
From A Randomized, Double-Blind, Placebo-Controlled Trial Assessing the Effects of Oral Centella asiatica Extract on Skin Aging-Related Parameters in Middle-Aged Korean Women. (2026) · cites this paper as [6]
In “Compromised epidermal permeability barrier homeostasis” (page unavailable), the paper identifies TEWL as a barrier indicator but says baseline TEWL in aged skin varies by body site and other factors; it is not consistently increased. “Dysfunction in epidermal permeability barrier” links barrier disruption to greater vulnerability to harmful substances, while “Reduced stratum corneum hydration” links dryness to reduced hydration rather than establishing that increased TEWL exacerbates it. (LLM, conf=0.86)
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References 151 · Cited by 175
- Authors
- Wang, Z., Man, M.-Q., Li, T., Elias, P. M., & Mauro, T. M.
- Affiliations
- Shenyang No.7 People’s Hospital, Shenyang 110003, Liaoning, China
- San Francisco VA Medical Center (US)
- Corresponding author
- Man, Mao-Qiang
- Venue
- Aging
- Publisher
- Impact Journals, LLC
- Published
- 2020-03-27
- Volume
- 12
- Issue
- 6
- Pages
- 5551-5565
- ISSN
- 1945-4589 (ISSN-L)
- PMC
- PMC7138575
- OpenAlex
- W3013946215
- Cited by
- 175
- References
- 151
- Citations by year
- 2026: 31 · 2025: 37 · 2024: 39 · 2023: 26 · 2022: 28 · 2021: 13 · 2020: 1
- FWCI
- 2.84
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- cc-by
- Locations
- Aging (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Northern California Institute for Research and Education
- National Institutes of Health
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR061106)
- Topics
- Health Sciences › Medicine › Dermatology › Skin Protection and Aging
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmaceutical Science › Advancements in Transdermal Drug Delivery
- Keywords
- skin aging, stratum corneum hydration, skin permeability, skin pH, eczematous dermatitis, pruritus, dry skin, inflammaging, systemic inflammation
- MeSH terms
- Aged, Aging, Epidermis, Homeostasis, Humans, Inflammation, Permeability, Skin Aging
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