Aging trends worldwide indicate a gradual increase in life expectancy; healthcare providers must develop the expertise to care for old frail individuals. Older people present with multi-morbidities, are on multiple medications (both prescribed and over-the-counter), and suffer the consequences of environmental insults. Biological or physiological age seldom matches chronological (or real) age, a fact also applicable to the skin. Dermatological disorders are common in the old and contribute significantly to the physiological age, but seldom get adequate attention from healthcare providers. A thorough dermatological examination, periodically, has a reasonable yield, but is seldom done; many older persons have never visited a dermatologist for a comprehensive examination. Inadequate availability of dermatology care for the geriatric population is a problem. Further, most primary care providers do not have the expertise to determine the etiology, significance, and management of skin disorders. As one ages, there is time to develop primary dermatological illness or a skin disorder secondary to coexisting systemic disease involving the renal, hepatic, gastrointestinal, or endocrine systems. Over the lifespan, people develop skin disease consequent to several environmental insults, notably ultraviolet light. Lesions may result from one or more medications the patient is on, prescribed, or over-the-counter. Skin cancer increases with age. Protection from UV light through use of one or more measures to prevent skin cancer is most important. The World Health Organization has detailed the importance of recognizing common and rare skin disorders and emphasizes the value of a thorough dermatological examination, which the author endorses, especially in older people!