Less than two decades ago, as cosmetic dermatology truly expanded and became “mainstream,” a frequent rationale for the growth in aesthetic medicine was the demand from Baby Boomers, then in their 40s. Now some Baby Boomers are already collecting Social Security.

It is a testament to the field of cosmetic surgery (we'll cover laser and injectable advancements in next month's issue) that the number of rejuvenating treatment options has evolved to continue to meet the needs of patients who, just a few years ago, might have been brushed off as “past the age” for aesthetic improvement. Still, in reality, most of these older patients require more from their dermatologists than just a rejuvenating procedure. As discussed in this month's feature articles (p. 38, 40), individuals in later life face a slew of cutaneous complaints that may be less common in younger individuals. Older patients develop skin cancers at a higher frequency. Concomitant systemic diseases may make them more susceptible to dry skin, pruritus, or infections. And the risks for drug interactions increases in the older population. The popularity of herbal supplements and alternative therapies among some older patients further increases the risk for drug interactions.

As geriatric dermatology specialist Robert Noman, DO points out in this issue, dermatologists must be prepared to efficiently manage older patients on their terms, taking into account the individual's current and past medical history—including medication— and working with them to meaningfully address their needs and the needs of families and caregivers.

The older population continues to grow, as trends continue to show a greying of America. Some dermatologists have expressed concerns about the specialty becoming “too cosmetic,” but the realities of demographic shifts and patient demand suggest that this is not the case. For while patients entering their 60s or 70s are still candidates for aesthetic interventions, they are also highly likely to require medical dermatology services, too. The specialty has long talked about a possible provider shortage. In the not too distant future, it will become increasingly obvious whether or not there are enough dermatologists to meet the various needs of a rapidly expanding older population.