Healthy and hydrated human skin has the capacity to stretch and then return to normal when released. This process is controlled by two abundant proteins, collagen and elastin, which are found in the muscles, skin, and bones. While collagen gives structure to the skin, elastin allows it to stretch.

Skin which is stretched beyond the normal level is known as hyperelastic skin. It occurs when there is a rapid increase in collagen or the production of elastin becomes low, and hence the skin loses its capacity for elasticity.

Major Causes of Hyperelasticity

Hyperelasticity is often found in people with Ehlers-Danlos Syndrome (EDS). EDS is a collective group of genetic disorders that alter the connective tissues that play a vital role in structuring and supporting the organs, bones, skin, and blood vessels in the human body. It emerges due to a defect in certain genes that affect the protein collagen and, in turn, makes the connective tissue much weaker. This overall process of EDS, due to mutation in the genes, causes excessive stretchiness of skin.

The different types of EDS are hypermobility, arthrochalasia, kyphoscoliosis, dermatosparaxis, vascular, and classic. Of these, the most severe is vascular EDS, which affects the walls of the blood vessels and the intestines.

EDS follows an autosomal inheritance pattern, and so it affects people in different ways. However, all the above-mentioned types of the syndrome carry hyperelasticity along with it.

Connective Tissue and Hyperelasticity

Connective tissues are a group of tissues essential for the formation and support of the human body. Supporting and transporting other tissues and substances are its secondary duties. A defect in the connective tissue might lead to hyperelasticity of the skin. '

A few other disorders that affect the connective tissues and result in stretchy skin are:

1. Marfan syndrome: Marfan syndrome is be a genetic disorder that affects the connective tissues. The fibrillin-1 protein is the most important factor that causes the syndrome. The mutation in this gene increases the production of TGF-β (transforming growth factor beta) and creates a defect in the connective tissue, which also leads to hyperelastic skin.
2. Subcutaneous T-cell lymphoma: Lymphoma is a type of skin cancer that arises in the white blood cells of the immune system. It often occurs as a skin rashes that can spread all over the body. Cutaneous T-cell lymphoma develops very slowly inside the body. If found in the early stages, there are chances of treatment for recovery from this lymphoma. There are two types of lymphomas–Hodgkin and Non-Hodgkin lymphoma. Non-Hodgkin lymphoma affects only the skin, causing skin lymphoma. This paves the way for other skin-related disorders, of which hyperelasticity is one.
3. Osteogenesis imperfecta: Osteogenesis imperfecta is a set of genetic disorders characterized by easily breakable bones caused by a disorder in collagen. This type of breakage of bones occurs apparently without any reason. Sometimes, multiple fractures take place simultaneously. There are some rare cases where fractures occur in a baby even before birth. As this is a collagen-related disorder, it is accompanied by stretchy skin,
4. Pseudoxanthoma elasticum (PXE): This is a progressive disorder that is distinguished by the accumulation of calcium and other minerals in the elastic fiber. Elastic fiber makes up connective tissues that provide stiffness and flexibility to the entire body. When the accumulated minerals in the fiber damage the connective tissue, it leads to stretchy skin. PXE affected people develop yellow bumps called papules. These papules are found in the joint bends like the underarms, neck, and elbow.

Age and Elasticity

Damage to the elastic tissue (elastin) usually happens due to age. As people grow older, the production of elastin decreases and begins to break down, thereby losing its elastic property. This makes the skin stretch and hang loosely.  

Premature aging of the skin can also cause hyperelasticity. The factors that facilitate quick aging are as follows:

1. Exposure to sun: Daily exposure to too much sun can damage collagen and inhibit the body from producing new collagen. It increases wrinkles and the skin becomes stretchy. Also, ultraviolet exposure can break down elastin fibers, making the skin saggy.
2. Smoking: Increased production of enzymes called matrix metalloproteinases happens due to smoking and degrades collagen in the skin. It also inhibits collagen synthesis, making skin hyperelastic.
3. Dehydration: When the skin lacks adequate water , it starts to become thin and begins to sag. Less intake of water, adverse climatic conditions, over consumption of dehydrating drinks like alcohol, and certain diseases cause dehydration.
4. Loss of fat: Loss of the fat can result in loosening of the skin.