Skin changes associated with aging often manifest as cosmetic disabilities. As the population of elderly persons continues to rise, these aging skin changes and patients' dissatisfaction with them will increasingly command the attention of the primary care physician. The cosmetic aging changes and management strategies addressed here include wrinkles, hair changes, common benign neoplasms, dyspigmentation, and telangiectasias. While none of these conditions is a direct threat to the physical well being of the patient, their psychological impact, particularly with regard to self-perception, can be significant and even profound. They therefore merit a response from physicians caring for such patients.