If you're only as old as you feel, does it matter how old you look? A new study on US presidents suggests it does not. Despite the common observation that presidents seem to age rapidly over the course of their terms, research suggests that most presidents have lived at least as long as their contemporaries. Published in Journal of the American Medical Association, the study shows that presidents who died of natural causes had roughly average lifespans. Yet, side-by-side pictures of presidents—particularly modern ones—do suggest an acceleration of aging.

The apparent aging of the presidents provides some interesting points for consideration for dermatologists who provide aesthetic products and services to patients. Even as treatments for aging have grown more effective, efficient, and patient-friendly, clinicians seem to be more fully embracing a holistic approach to management of skin aging. Most dermatologists admonish their patients not to expose themselves to UV radiation, and many urge patients to quit smoking. Increasingly, dermatologists are also advising their patients to eat well, exercise, and as supported by the presidential evidence, minimize stress. Stress is known to affect the immune system, playing a role in many cutaneous diseases and perhaps skin aging. Consider rosacea, a disease that may be tied to skin aging and known to be influenced by stress. More than 14 million Americans are affected by rosacea, covered in this edition, and even more suffer from other “red face” conditions. The challenge of visible dermatoses like rosacea is that the disease itself can cause stress and anxiety for the patient, initiating a vicious cycle. More insights on this topic are also available in this issue.

Of course, stress and anxiety are popular topics this time of year, as people prepare to celebrate the holidays and look toward closing out another year. Hopefully this year has been a successful one for you and your practice. On behalf of our entire staff, I wish you the best in 2012. I thank our contributors and editors as well as our advertising supporters for making each edition possible, and I thank you for turning to Practical Dermatology month after month.