Cutaneous aging includes true aging and photo-aging due to sun exposure. A decrease in epidermal turnover rate results in epidermal atrophy and delayed wound-healing. A reduction in the number of epidermal Langerhans' cells is responsible for a decrease in delayed immune responsiveness in skin observed in the elderly. Reduced numbers of fibroblasts and mast cells are typical histologic findings in aging human dermis. Collagen bundles become fragmented, less elastic and more brittle. Telomere shortening at the end of chromosomes is probably the major mechanism of cellular senescence in skin. Common skin tumors and other major age-related changes in the skin of the elderly are described.