Physiologic, biochemical and microscopic changes in the aged skin are due to past environment, heredity and the aging process. These factors and the response of aging skin to the elements and to physical or chemical trauma cause degenerative processes which produce cutaneous lesions. Lesions most frequently seen in the aged are keratoses, skin tags, epitheliomas, lentigines, senile angiomas and purpuric eruptions of the legs. Some of these may be treated merely for cosmetic reasons, while others, such as epithelioma, may cause death if ignored. Aging skin should be protected from physical and chemical irritants.