elderly skin problems

Common Skin Problems in Elderly People, and What to Do About Them

Skin issues in the elderly can come in different shapes and forms - here are some ways you can identify, prevent, and treat different skin disorders for your elderly loved ones.

by Elaine Francis, R.N.

Skin issues can come in different shapes and forms as we get older – here are some ways you can identify, prevent, and treat different skin disorders for your elderly loved ones.

Why does our skin change as we get older?

We can become more prone to various skin conditions as we age. As we grow older, we lose collagen – the protein that causes elasticity in our skin – leading to a sagging appearance. Our skin also becomes thinner and drier, making it more prone to cracking or tearing. Changes in the tissues that underlie our skin, including when we lose or gain weight, can change the appearance of skin. As we get older we’re also more likely to have problems with our circulation, and our ability to heal and fight infections can be reduced as well. Some underlying or pre-existing conditions – whether from existing diagnoses or new conditions – can affect skin health. There are also some medications – steroids, blood-thinners, and others – that can cause skin changes. Sometimes medications that are necessary to treat skin conditions, such as steroid creams for eczema, can cause skin thinning leading to problems later in life.

What are some common skin problems that older people experience?

Eczema

This common skin problem can become even more common as we age, and cause more problems as naturally drying older skin exacerbates dry skin conditions.

Pruritis

The medical name for itchy skin; pruritis or pruritic conditions are characterised by itching and discomfort. Keeping skin well moisturised can help, but a doctor may advise mild steroid creams or antihistamines for problematic itching.

Rosacea

The earliest stages of rosacea are redness of the face, which then leads to tiny broken veins and permanent redness, especially on the cheeks and nose. It is usually more visible in people with lighter skin, but can affect anyone.

Thinning skin

This can affect anyone as we age, but is a particular problem for people who have had to take steroids like prednisolone or use steroid creams for skin conditions. Thin ‘tissue paper’ skin is more prone to tearing, and bruises can show more under thinner skin.

Dry skin

Without necessarily having a clear cause like eczema, dry skin becomes common as we age as we produce less of the natural oils that keep our skin healthy – or which made our skin greasy in our youth! Using a non-fragranced moisturiser designed for delicate or sensitive skin can help keep skin supple and comfortable.

Pressure sores

Not strictly a skin condition, but a condition which causes broken skin and damaged tissues where the weight of the body presses on fragile tissues. Pressure damage – sometimes known as ‘bed sores’ are a particular problem for people who are unable to move around very much and change their positions to alleviate weight and pressure.

Cracked skin

Dry skin can be prone to cracking, and this can be a particular problem for people with conditions that cause swelling in the lower limbs like heart failure or lymphoedema. As the tissues underneath the skin swell, skin is stretched and can develop small breaks which give it the appearance of cracked china or areas of more significant split skin.

Ulcers

As we get older, we may find that we don’t heal as easily, and even a small knock or cut to our skin can develop into a problematic ulcer. Problems with circulation make us more likely to develop ulcers, and they’re particularly common in the lower legs, and in people with conditions that affect the circulation like diabetes or peripheral vascular disease.

Benign skin tumours

Every new or changing mole should be assessed by a doctor, but benign – non-cancerous – skin tumours are common in older people.

Apart from skin conditions that cause problems like pain or itching, people may notice other changes in their skin as they age – for example, areas of skin that become darker than your loved one’s usual skin colour are common, especially in people who have spent a lot of time in the sun. Sometimes known as ‘age spots’, ‘liver spots’ or seborrheic dermatosis, these are not usually a problem but any significant changes in the skin should be assessed by a doctor.

The most common changes in our skin that we associate with aging are wrinkles. These are a natural, normal part of aging and affect everybody to some degree. People who have had lots of sun exposure and people who smoke tend to have more wrinkles than others. Areas of the face that move most – around the mouth, eyes and forehead, tend to develop wrinkles sooner than less mobile areas of the face and body. Wrinkles reflect changes in the elasticity of the skin and the underlying tissues, and while they cannot be prevented, the appearance can be minimised by good skin care and moisturising.

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How to prevent skin problems

We cannot prevent the changes that underlie the common skin problems that we experience as we age, but there are steps we can take to manage them and to maintain healthy skin. Good skin care reduces the risk of serious problems and can help the skin maintain its integrity. A care can make a big difference to the integrity of skin and reduce the kind of cracking and weakness that can allow bacteria to enter the deeper layers of the skin and cause infections like cellulitis and abscesses.

Managing dry skin can help prevent serious problems as skin that’s in good condition provides an essential protective layer against infection and loss of fluid. Skin that’s well-moisturised with a simple, greasy product is less likely to crack and flake, and using simple moisturisers as soap substitute can help prevent the dryness and irritation that can be caused by conventional soaps. Avoiding heavily perfumed or drying products can help reduce the risk of irritation which can cause skin to be more sensitive and cause more problems.

Existing skin conditions need to be carefully managed as we get older, so using the creams and treatments recommended by our doctors is important. Changes in existing skin problems like eczema or psoriasis should be reassessed by a doctor and some treatments, like strong steroid creams, may need to be used with extra caution on thinning older skin.

Treatment for common skin problems

Some skin problems can be well managed with good care; with a careful routine for maintaining healthy skin and support to prevent wounds from gait and mobility problems.

More serious problems should have urgent treatment as cracked, broken skin can allow bacteria to enter the deeper tissues of the skin and poor skin condition can easily lead to infections. An infection in the deeper layers of the skin causes hot, red, painful areas of skin, and can even cause systemic infections, where people may experience flu-like symptoms, fever and can become seriously unwell with sepsis. Suspected infections should be assessed by a doctor as early treatment can prevent serious problems.

Any tumours of the skin – areas of unusual darkening, new moles or freckles which appear lumpy or with patchy, irregular edges need to be assessed urgently.

Can skin problems be a sign of an underlying condition?

Most skin conditions are not a sign of a serious underlying problem, but some can reflect other changes in our bodies. Skin that bruises more easily than usual, and bruises that take a lot longer to fade can indicate problems with blood clotting or other conditions, so it’s important to see a doctor. Some medications can also cause changes in skin health and make us more likely to bruise easily, or less able to heal well. Skin that doesn’t heal well might also be associated with vitamin or mineral deficiencies, so a doctor might recommend specialist assessment and blood tests if you have any new concerns.

Skin cancers can cause serious illness and require prompt treatment, so if you suspect that a skin condition could indicate cancer, it’s important to have a doctor’s input urgently. The quicker we treat cancer, the better the outcome.

How Homage can help your loved one with skin issues

Looking after skin is an important part of an older person’s care needs, and an older person who isn’t able to care for their skin properly may need more support. Problems with mobility, memory, or tiredness can make it harder to apply moisturiser and follow good skin care practices, especially if they’re finding it harder to reach their lower legs and feet.

Having supportive carers who can come and help your older loved ones with bathing and applying any creams and moisturisers can be an important step in promoting healthy skin and preventing serious problems for older people. Those who need to have prescription ointments and skincare products can also benefit from Homage’s medication delivery service.

Ongoing skin problems or new concerns should be assessed by a doctor, but skin changes are very common as we get older, and don’t necessarily mean that there’s anything serious to worry about. However, even the most benign skin conditions can be uncomfortable or difficult to manage, so it’s always okay to ask a doctor for advice.

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References
  1. Yalçın, B., Tamer, E., Toy, G. G., Öztaş, P., Hayran, M., & Allı, N. (2006). The prevalence of skin diseases in the elderly: analysis of 4099 geriatric patients. International journal of dermatology, 45(6), 672-676.
  2. Jafferany, M., Huynh, T. V., Silverman, M. A., & Zaidi, Z. (2012). Geriatric dermatoses: a clinical review of skin diseases in an aging population. International journal of dermatology, 51(5), 509-522.
  3. Thapa, D. P., Jha, A. K., Kharel, C., & Shrestha, S. (2012). Dermatological problems in geriatric patients: a hospital based study. Nepal Med Coll J, 14(3), 193-5.
  4. Trozak, D. J., Tennenhouse, D. J., & Russell, J. J. (2006). Seborrheic Keratosis (Old Age Spots, Liver Spots). Dermatology Skills for Primary Care: An Illustrated Guide, 235-240.
  5. Surber, C., Brandt, S., Cozzio, A., & Kottner, J. (2015). Principles of skin care in the elderly. G Ital Dermatol Venereol, 150(6), 699-716.
  6. Garcovich, S., Colloca, G., Sollena, P., Andrea, B., Balducci, L., Cho, W. C., … & Peris, K. (2017). Skin cancer epidemics in the elderly as an emerging issue in geriatric oncology. Aging and disease, 8(5), 643.
About the Writer
Elaine Francis, R.N.
Elaine Francis is a registered nurse with 17 years’ experience in healthcare. She turned to writing to follow her passion for realistic medical communication. She loves translating medical jargon into accessible language for the people who need to understand it most. When she’s not writing or working on a busy cardiology unit, she spends her time telling her children to hurry up.
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