Yes, Your Skin Atrophies & Becomes Crepey With Age — How To Treat It

I have fairly thin skin—and, unfortunately, I mean that both literally and figuratively. I'll spare you an essay on my sensitive nature and rather go straight to the literal aspect: my attenuated complexion.

The thinness of my skin is apparent in all the obvious ways: My veins show through not just normal spots (like the forearms or back of the hands) but even places like my legs and chest. The skin under my eyes is sallow and so transparent that I have dark-purple-tinted circles constantly. My chest has begun to appear crepey and develop fine lines prematurely. I bruise at the slightest provocation. 

The truth is much more nuanced than that, so let's first have a skin anatomy lesson: The skin is made up of several layers1. The two main layers discussed in skin care are the epidermis and dermis. The epidermis is thin—it's only approximately 0.7 - 1.5 mm in thickness2.

Despite its waiflike structure, the epidermis is further composed of several more layers, including the outermost stratum corneum. This layer is made up of dead keratin, and it's what gets exfoliated during skin care routines. Within reason, it can be very beneficial to occasionally thin out this layer. 

Then there's the dermis, which is the middle layer of the skin that contains all of your skin's connective fibers, structural proteins, and other extracellular components. This layer is incredibly important for keeping skin structure firm, smooth, and vibrant.

Much of what we do in skin care and aesthetics is to support this layer—such as encouraging collagen and elastin production and protecting the skin from oxidative damage. 

Atrophy is such an ugly word—even just saying it sends shivers down my spine. The definition is even more bone-chilling: Atrophy means to "waste away" and "gradually decline in effectiveness due to underuse or neglect." Someone call A24 because that is some horror-level verbiage! 

Atrophy is most commonly used in relation to muscle health. For example, sarcopenia (from the Greek sarx, "flesh," and penia, "poverty") describes the rapid loss of muscle mass and function—or muscle atrophy. Or most folks have heard of bone density loss, commonly called osteoporosis. But those two aren't the only organ systems of the body that weaken. 

"Fundamentally, there are biological processes that lead to skin, muscle, joint, and bone aging. In terms of bone, most people have heard of the term osteoporosis.

Well, for skin there's a new term called dermatoporosis that's basically the same concept, which is chronic cutaneous insufficiency or fragility," board-certified dermatologist Anar Mikailov, M.D., tells me during an episode of Clean Beauty School.

"About 40% of individuals in their 60s and over will have some manifestation of this, and these manifestations can be both visual and functional." 

Mikailov knows a thing or two about skin aging and appearance—as he co-authored a textbook on it, Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, Ninth Edition. He's also the founder of Skintensive and KP Away, both dermatological skin care brands that target specific skin concerns such as bruising, keratosis pilaris, atrophy, and so on.

"Skin 'crepiness' is commonly used to describe aging skin that has lost elasticity, appearing thinner and more fragile, often with wrinkles," board-certified dermatologist, dermatologic surgeon, and founder of Spectrum Skin and Laser Jeremy Brauer, M.D., tells us about crepey skin. 

As noted, it comes as the result of a thinning dermal layer, which is the layer of the skin made up of collagen and elastin. So one of the best ways to support thinning skin is to address its root cause: collagen loss. 

Collagen declines due to a variety of reasons, such as UV exposure, free radical damage, inflammatory diet, restrictive diets (especially insufficient protein), stress, lack of sleep, and irritating topical products. To protect collagen, it's important to address any lifestyle factors that could be contributing to its destruction. 

This is the most important step in ensuring you keep collagen protected. UV exposure does a number on the skin—it's the no. 1 contributor to skin aging, after all. Find a sunscreen that agrees with your skin type, blends in effortlessly with your skin tone, and that you enjoy the experience of—that'll help ensure you actually apply it daily.

No matter your skin concern, antioxidants are your friend. Antioxidants neutralize free radicals, which wreak havoc on the body. And unfortunately, we are bombarded with free radicals on a daily basis, due to the normal metabolic process but also pollution, diet, stress, and overall inflammation. 

One of the best ways to ease the appearance of thin, crepey skin is to plump up the skin with hydrators. As board-certified dermatologist Hadley King, M.D., told us, "Moisturize, moisturize, moisturize—this can improve the appearance."

Look for lotions that flood the skin with hydration from multiple sources, such as humectants, emollients, and occlusives. Working together, these types of hydrators can help the skin remain moisturized for longer.