It is crucial for elderly individuals to take care of the body’s biggest organ: the skin. As we age, our skin changes; it’s a natural process that we can’t stop. With the years it gets more fragile, making elderly skin more susceptible to injury and to accidental traumas.

A severe skin infection or chronic wound can be lethal for the elderly, that is why personal hygiene products and skin-friendly routines should be adapted to their needs.
At the same time, the caregivers’ role is essential in assisting elderly individuals in preventing skin disorders.

In order to avoid future issues, caregivers and family members should be aware of all signs and symptoms of skin diseases in the elderly. Keep reading to learn how to recognize and prevent any skin issue.

As we get older, our skin looks old and feels dry, irritated, saggy, and blotchy. The veins and bones become more visible and the skin feels less plump and smooth. This happens because the skin becomes thinner and loses water more easily making it more sensitive to the ultraviolet (UV) rays of the sun. Medications, medical conditions, stress, and obesity can also play a role.

In this article, you will learn more about the specific causes, symptoms, and cure or prevention methods for these 7 skin problems in the elderly:

• Dry and Itchy Skin
• Wrinkles
• Age Spots
• Senile Freckles and Skin Cancer
• Bedsores
• Xerosis
• Pruritus

Some of these old age skin problems are considered normal (intrinsic aging) which happens to all. Others may be caused by underlying health problems, environmental and lifestyle factors (extrinsic aging) such as UV rays, smoking, or drug abuse. Learn if your elderly patient’s skin problem is considered normal or not and how you can help them

Image 1: skin hydration and nourishment is essential.

Common Old Age Skin Problems

The process of skin cell renewal slows down as people age and bacteria can enter easily because their skin is thin and dry. In addition, the healing period of the skin when cut is longer and also bruises easily. Here we have summarized the most common skin problems that your old age patients might experience.

Dry and Itchy Skin

Cause

Drying of the skin is caused by loss of oil glands, lack of water, stress, and smoking. It could also be a sign of diabetes, kidney failure, or liver disease.

Symptoms

Itching and skin dryness are common problems among adults. The skin is rough and flaky and could lead to Xerosis (more information below) or asteatotic eczema if not addressed in the early stage.

Prevention/Cure

To help your elderly patient ease the itch and minimize the dryness, it’s helpful to hydrate the skin with a gentle and moisturizing cream that, ideally, contains shea butter and honey and has an auto-balancing pH.

An isothermic body cream can help to maintain the elderly skin highly hydrated and prevent further skin damage. Therefore, a proper selection of the products for bathing and skincare must be done.

Most of the worse or more serious skin diseases start with simple drying and itching so we’ve shared more tips in the latter part of this article on how to manage it.

Image 2: Example of dry skin.

Wrinkles

Cause

Wrinkles are the most visible signs of aging as the skin loses its flexibility and starts producing less collagen.

Prevention/Cure

Can skin elasticity be restored? Since it’s human nature, wrinkles can’t be cured but could be softened or slowed down with the help of anti-aging products that are rich with natural ingredients that enhance every person’s unique complexion. It helps reduce wrinkles and thickens the skin.

Choose a nourishing and moisturizing face cream with a soft and velvety touch. The most recommended cream should have a high amount of active ingredients, including Poria Cocos extract, and Kigelia Africana. These two active components work together to reduce the most evident signs of aging by increasing skin thickness, radiance, and microcirculation, as well as lowering wrinkle appearance.

Alternatively, Tretinoin is another helpful remedy that speeds up the process of creating new cells and repairing damaged ones. It also helps lighten skin pigmentations.

Aside from anti-aging products and tretinoin, reducing your patient’s exposure to the sun’s UV rays is also recommended.

Image 3: Example of wrinkles. These in concrete are called mouth wrinkles with a barcode effect.

Age Spots

Cause

During the late adult years, age spots appear on the face, hands, shoulders, and forearms. This is caused by spending a lot of time under the sun.

Symptoms

They are flat brown, gray, or black spots that usually cluster together in a certain area. They aren’t cancerous and can be lightened by using bleaching products.

Prevention/Cure

Age spots may be prevented by using sunscreen products that are effective in protecting your patient against UVA and UVB of the sun. If it’s irritating your elderly, you may approach a dermatologist for professional advice.

Another effective way to prevent age spots is to use an excellent face cleanser containing natural ingredients like cornflower and lotus flower for a natural, astringent and refreshing action, as well as shea butter for a soft as silky skin.

Image 4: Example of typical age spots located on the back of the hand.

More Serious Skin Problems in Elderly Patients

As previously stated, there are skin disorders associated with old age that are caused by underlying health issues, personal habits, and the environment. For these skin problems, more attention from caretakers is required, as well as pharmaceutical suggestions from doctors.

Senile Freckles and Skin Cancer

Cause

Like Age Spots, pigmentary changes such as Senile Freckles are a result of sun damage to the skin.

Symptoms

Senile freckles are brown spots that look like freckles but are larger. If they grow thicker or even larger, it might progress to skin cancer.

Prevention/Cure

Apply sunscreen on your patient’s exposed body parts whenever going out. Use products that are non-toxic because toxic ingredients can also cause skin cancer. Wearing a hat, long sleeves, and long pants can also help a lot in prevention.

Senile freckles can be removed by a specialist through freezing, electrosurgery, or applying chemicals. In 2020, there were 150,627 new cases of melanoma of the skin in Europe (source: Globocan). Check with a physician as soon as signs of senile freckles are visible on the person’s skin that you are taking care of to prevent progression to cancer.

Image 5: Freckles due to sun exposure localized on the hands.

Bedsores

Cause

Bedsores start as a reddened area on the skin that develops due to prolonged sitting or lying in bed. After more than 3 hours of pressure, the blood supply being distributed to the skin is cut off and the skin begins to suffer the first signs of damage.

Symptoms

There are 4 stages of bedsores:

• Stage 1 is pink or ashen that is slightly itchy and tender.
• Stage 2 is red and swollen with blisters or open wounds.
• Stage 3 is a crater-like wound that has already extended deeper into the skin.
• Stage 4 has thick black scabs and the wound is deep into the fat, muscle, or bone.

Infographics 1: Four Stages of Bedsores

Prevention/Cure

Because of the risk of infection, the sores should not grow beyond Stage 2 and up as much as feasible. Patients who are bedridden can progress to Stage 4 but this can be avoided by moving their bodies often (including during nighttime). In addition, we’ve compiled a list to help you with your everyday hygiene regimen:

1. Help them to avoid prolonged pressure on the ankles, heels, and buttocks because they have thin skin that can easily tear. The best way to do so is to change the position at regular intervals, every 1 or 2 hours.
2. Keep your patient’s skin clean and dry and check every day for redness, swelling, or soreness. Inform a doctor if there are any skin changes.
3. Avoid soaps, body washes, and talcum powder that dry out the skin. Ask a dermatologist, nursing staff, or pharmacist for safer options.
4. In the case of bedsores, a water-based (not oil-based) moisturizer that protects the skin and lets it breathe is needed daily.
5. Don’t rub or massage bony areas during bath time. Ask for help if you need it.
6. Always use protective mattresses, seat cushions, heel wedges, and limb protectors to protect your patient’s skin from tearing and building pressure sores.
7. Offer plenty of water (unless the doctor has told you not to).
8. Offer meals and snacks regularly and help your elderly patient to sit out of bed to eat if he/she can.
9. Maintain a regular toilet routine for your patient.
10. If the patient has a wound, plan to dress and care routines with the attending nurse or physician.

Image 6: Second degree pressure sore located in the hip area

Xerosis

Cause

Elderly patients experience Xerosis due to decreased sebaceous and sweat gland activity so the skin moisture is depleted. It can also be caused by renal disease, zinc, and essential fatty acids deficiency, thyroid disease, and neurological disorders.

Symptoms

This usually shows in the legs of old age patients but can be visible on their hands and trunk too. Cracks and fissures appear on the skin and if split deeper, can cause bleeding. If the patient scratches it, skin irritation worsens and may cause infection.

Prevention/Cure

Treating Xerosis is aimed at relieving symptoms but can be prevented during its early stage when dry and itchy skin occurs. Always find cleansers and moisturizers that have lactic acid as this is an effective antimicrobial and also helps eliminate dead skin cells. Also, soaps and cleansers that have natural ingredients minimize further skin damage.

Seek help from a dermatologist or physician immediately if the condition gets worse despite treatment, the skin is oozing, peeling, or has a ring-shaped rash.

Image 7: Damaged skin on an elderly person’s skin

Pruritus

Cause

This skin disease is another common dermatological problem in the elderly. It is said to be psychogenic affecting the scalp, arm, leg, or the whole body. Aside from being psychogenic, other causes may be liver or kidney disease, diabetes, and other chronic illnesses. It could also be caused by allergens or existing skin problems such as Xerosis, eczema, psoriasis, or others.

Symptoms

It is irritating to the point where the patient wants to scratch the afflicted region, which grows itchier as time goes on. Blisters, redness, scratch marks, and even bleeding may result.

Infographic 2: 8 tips to relieve itching in an elderly person

Prevention/Cure

To help prevent itching, you can apply these dermatologist-approved remedies:

• Apply an ice pack to the itchy skin for a cooling effect.
• Use a soothing and anti-inflammatory washlotion that has natural extracts like calendula. Before using this, you may place them in the refrigerator for a cooling effect.
• Help relieve the itch by preparing an oatmeal bath for your patient.
• Use warm water (not hot because it can dry the skin even more) for bathing or showering and limit the routine to 10 minutes only.
• Maintain a balanced humidity inside the room or house as extreme temperature changes may initiate itching.
• Purchase “unscented” or “fragrance-free” lotions, soaps, and hypoallergenic detergents to minimize irritation. Check the labels for ingredients to make sure there are no harmful chemicals added.
• Apply prescribed medications before the moisturizer.
• Reduce stress because it can worsen itching.

If the itching affects a large part of the body and isn’t manageable with self-care, do consult your elderly patient’s physician.

Image 8: Skin irritations of an elderly person that cause itching

More Tips in Managing Itchy and Dry Skin in Older Adults

Like mentioned earlier, dry and itchy skin could be the start of a more serious skin problem if not managed immediately. Below, we’ve carefully collected remedies you can do at home to help soothe your elderly patient and prevent their condition from progressing.

Personal Hygiene Tips

1. Use a gentle cleansing soap formulated for dry skin or body wash that contains moisturizer with VITAMIN E complexed with Lipoic Acid and Bisabolol to offer a targeted response to the needs of dry, chapped skin, subject to redness, and other alterations of the surface hydrolipidic film.
   It helps hydrate the skin and prevents further irritations. It is made perfectly for dry, thickened, and reddened skin.
2. Apply moisturizing lotion, ointment, or cream that is made to help regenerate skin cells every day. A moisturizing lotion is an excellent solution since it is specifically formulated for dry flaky skin. Apply it immediately after a bath or wash for best results. In case the patient’s skin stays dry and itchy even after regular application of moisturizers, consult a dermatologist. There might be other underlying causes or they’ll suggest other options such as exfoliating gently to slough off old skin cells.
3. Make bathing less frequent like every other day instead of daily because the skin loses its natural moisturizing factors every bath. Bathing daily will not allow the skin to rejuvenate — which becomes a slow process for older adults.
4. Bath or wash the patient’s face and hands with warm water. Don’t forget to apply lotion or moisturizing cream that is hypoallergenic after every hand, face, or body wash.
5. Use a soft washcloth (microfiber or organic cotton) for bathing and showering instead of loofahs or products that are abrasive. Remember, old age skin is more fragile at this stage.

Infographic 3: advice on personal hygiene to prevent skin problems

Lifestyle Tips

1. Help your patient wear loose and comfortable clothing (preferably cotton rather than polyester or other synthetic fabrics).
2. Change and wash your patient’s clothes and bed linen regularly to stay clean and prevent the growth and spreading of bacteria or insects/bugs that may worsen skin irritations and itchiness.
3. During winter or dry seasons, use humidifiers and vaporizers inside homes or the room to add moisture to the senior’s living environment. Humidifiers also have other health benefits such as preventing them from catching colds or flu viruses.
4. Keep your patient hydrated by increasing his/her water and other fluid intakes. Some elderly patients have difficulty remembering to drink and swallow so your assistance is important. Men should drink at least 2 liters while women should drink at least 1.6 liters of fluids a day. Offer a variety of drinks such as tea, fruit juices, and water depending on his/her preference.
5. Limit caffeine in his/her diet as it can contribute to the itching and drying of the skin.

Conclusion: Skin Care for Older Adults

Caregivers can help prevent or treat elderly skin disorders whether the cause is intrinsic aging (natural) or extrinsic aging (environment or lifestyle). First, by consulting the patient’s physician regarding their medications or medical history. Next is to consider their nutrition and physical and mental state. From there, you’ll know foods they are allergic to, what are their limitations in terms of activities like going outdoors, and what products to use for their personal hygiene.

Skin problems in the senior age group are manageable at its early stage. However, the best cure for these common old age skin problems is prevention. Regularly check your patients for suspicious spots or changes in their skin. Finally, it’s very important to make an appointment with their physician if symptoms persist because a serious disease or illness might be causing it.