Photoaged skin may appear to be coarsely wrinkled, have spots of extra pigment or lost pigment, or be affected with dilated blood vessels. In that up to 40% of aging-related changes to the skin are estimated to be a result of non-genetic factors, Kathryn J. Martires, from Case Western Reserve School of Medicine (Ohio, USA), and colleagues surveyed 65 pairs of twins for skin type, history of skin cancer, smoking and drinking habits, and weight. Clinicians assigned each participant a photodamage score, graded by such characteristics as wrinkling and change in pigmentation.  Finding that smoking, being heavier, not using sunscreen, and having had skin cancer are the leading factors associated with sun damage and aging of skin on the face, the researchers urge that:  “The relationships found… may help to motivate the reduction of risky behaviors.”