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As in the rest of the body, the typical appearance of the face and neck changes with age. Muscle tone is lost, causing a flabby or droopy appearance. The jowls may begin to sag, contributing to a "double chin" in some people. The nose lengthens slightly and may look more prominent.
There is an increase in the number, size, and color of pigmented spots on the face. The skin thins, becomes dry, and develops wrinkles.
The ears lengthen slightly (probably caused by cartilage growth). The ear canal becomes increasingly itchy and dry. Men may find that the ear hairs become longer, coarser, and more noticeable.
Wax glands decrease in number and activity, and ear wax (cerumen) becomes drier. This drier wax can more easily become impacted and can block the ear canal, contributing to decreased hearing.
The bones begin to deteriorate slightly. This is most significant in the inner ear, which can cause changes in balance and hearing.
The eyebrows and eyelashes become gray. The skin around the eyelids becomes loose and wrinkled, often making a "crow's feet" pattern. The eye socket loses some of its fat pads, making the eyes look sunken and limiting eye movement.
The lower eyelids may appear baggy, and drooping eyelids are fairly common, occasionally contributing to limitations in vision. The outer surface of the eye (cornea) may develop a grayish-white ring.
The colored portion of the eye (iris) loses pigment, making most very elderly people appear to have gray or light blue eyes.
Loss of teeth can make the lips look shrunken. The jawbone (mandible) loses bone material, decreasing the size of the lower face. The forehead, nose and mouth thus look more pronounced.
Gums also recede, contributing to dental problems and changes in appearance of the mouth.
The thyroid gland can become nodular (bumpy), making it look more pronounced on the front of the neck. In some people, muscle changes can make swallowing more difficult, which affects digestion and increases the risk of choking.
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