Aging in Skin of Color: Disruption to Elastic Fiber Organization Is Detrimental to Skin’s Biomechanical Function

Abstract

Skin aging is a complex process involving the additive effects of time-dependent intrinsic aging and changes elicited via skin's interaction with the environment. Maintaining optimal skin function is essential for healthy aging across global populations; yet most research focuses on lightly pigmented skin (Fitzpatrick phototypes I-III), with little emphasis on skin of color (Fitzpatrick phototypes V-VI). Here, we explore the biomechanical and histologic consequences of aging in black African-American volunteers. We found that healthy young buttock and dorsal forearm skin was biomechanically resilient, highly elastic, and characterized histologically by strong interdigitation of rete ridges, abundant organized fibrillar collagen, and plentiful arrays of elastic fibers. In contrast, intrinsically aged buttock skin was significantly less resilient, less elastic, and was accompanied by effacement of rete ridges with reduced deposition of both elastic fibers and fibrillar collagens. In chronically photoexposed dorsal forearm, significant impairment of all biomechanical functions was identified, with complete flattening of rete ridges and marked depletion of elastic fibers and fibrillar collagens. We conclude that in skin of color, both intrinsic aging and photoaging significantly impact skin function and composition, despite the additional photoprotective properties of increased melanin. Improved public health advice regarding the consequences of chronic photoexposure and the importance of multimodal photoprotection use for all is of global significance.