This chapter explores the intricate structure and diverse functions of the skin, describing its layers, principal cells, and multifaceted roles. Details follow on the pathophysiology of skin aging, focusing on the complex changes leading to decreased function and altered physical appearance, and examine factors that contribute to skin aging, including genetic, environmental, lifestyle, and hormonal influences. Additionally, a discussion follows on the histologic and physiologic changes that occur during skin aging, including the deterioration of elastic fibers and collagen, redistribution of adipose tissue, reduced hydration, decline in skin barrier function, and impaired wound healing. Lastly, the chapter outlines a range of interventions which can be used to prevent skin aging including preventative measures as well as noninvasive and invasive techniques. The chapter provides a comprehensive understanding of aging skin and discusses management.