Common Skin Problems In The Elderly
What are the common skin problems in the elderly?
Appearance and Texture Changes
The skin is constantly renewing itself. New cells are formed on the
lower layer of skin which slowly move upward. By the time they reach the
surface of the skin, these cells are dead and are removed daily. With
ageing, this process of cell renewal slows down. The "dead cell" layer
remains longer on the surface of the skin giving the .skin a dull look.
This skin feels rough and scaly.
The supporting structures and elasticity of the skin decreases with
age. The skin sags and wrinkles appear.
The skin of an aged person is thinner and easily disrupted. Blood
vessels, too, are easily disrupted, resulting in bruises called senile purpura. Senile purpura is commonly seen on
the forearms. Its presence does not indicate vitamin deficiency or a
bleeding disorder. The skin heals slowly following injury.
Xerosis /Asteatotic Eczema
The skin becomes dry and flakes easily as the oil contents of skin
decreases with age. Dry skin becomes itchy. Sensations of dryness and
tautness are common.
Dry skin has a rough and finely flaking or scaly surface. These are
seen in the upper back and the limbs, especially the shins. Sometimes
asteatotic eczema occurs in areas of dry
skin. These are seen as poorly demarcated, scaly round red patches.
Sometimes a distinctive appearance of red scaly fissures in an irregular
netlike pattern resembling cracked porcelain is seen.
Skin Infections / Infestations
Bacterial Infection : The fissures/cracks on dry skin predispose
bacteria entry into the skin to cause superficial infection.
Scabies an infectious, very itchy
skin infestation caused by a mite. The infestation spreads frequently
among elderly living in crowded homes. Sometimes crusting and scaling
can cover the whole body (Norwegian scabies).
Ringworm Infections : The elderly often have ringworm infections of
the nails and ski n, especially on the feet. Ringworm infection of the
nails will appear as discoloured and thickened nails. Ringworm infection
of the feet might show redness and blisters in addition to
The elderly can develop blistering disorders of different causes. A
common blistering disorder is herpes zoster
which is a reactivation of the chickenpox that an individual had
when young. This presents as a band of blisters on one side of the head
or body or along one limb. It can be associated with severe pain.
Blistering problems can also be due to an immune disturbance. A
common condition in this group of disorders is bullous pemphigoid, in which an individual
develops many large blisters, arising from red or normal skin. This
condition usually requires potent medications for suppression.
Non-Cancerous Skin Growths
The elderly can develop many benign skin growths of different types. These include
seborrheic keratoses (which are rough,
brownish-black spots), cherry angiomas (smooth reddish bumps) and
sebaceous hyperplasia (yellow bumps consisting of oil glands).
Benign skin growths do not need treatment but cancerous growth should
be removed early to prevent spread to other parts of the body. If in doubt
always consult a doctor. Your dermatologist can advise you whether your
skin growths are likely to be benign or cancerous.
Cancerous Skin Growths
elderly persons who had extensive sun exposure earlier in their life might
develop pre-cancerous skin growths called solar
keratoses and skin cancers like basal cell carcinomas and
squamous cell carcinomas. Basal cell carcinomas and squamous cell
carcinomas most commonly appear on the face. They start as small bumps and
gradually enlarge, until they ulcerate. They can be pink or black in
colour. See your doctor if you have any enlarging skin growth or a
<-There are several types of skin cancers. The commonest is called
basal cell carcinoma which appears as a
small shiny growth with a central ulcer or depression. This is a slow
Another type of cancer is squamous cell carcinoma
. They appear as red scaly patches or pinkish growths.
Sometimes they can be very large and raised.
Cancerous moles are less common but they tend to spread quickly if not
treated. They appear as moles with irregular borders, irregular colours
and lopsided shapes.
If you are not sure whether the growths are skin cancers, see your
doctor. All cancers must be removed.
Adverse Drug Reaction
elderly tend to be receiving multiple drugs for various medical problems,
they are more likely to develop adverse reactions to
drugs . The most common adverse reaction to drugs is seen in
the skin, where it can present as red, itchy rashes or blisters. It is
important that such rashes be recognised early so that the offending drug
can be discontinued, thereby preventing the damage caused by the drug from
becoming too serious. It is important to ,keep a record of the
medications, prescribed or not, that you take. Be sure to bring all
medications when you consult you-r doctor.
Some elderly persons have poor blood circulation in the legs, leading to rashes around the
ankles called Untreated, this might lead to skin ulcers.
What are the special skin care needs of the
The elderly require special skin care because their skin is thin and
dry. Care must be taken to prevent the skin from becoming too dry. Hot
baths should be avoided. Avoid frequent bath/shower. Avoid soap or at
most a mild soap should be used. If the skin is dry, moisturisers should
be applied on the skin after bath.
As the skin becomes dry, cracks appear. Bacteria enters the skin
easily to cause skin infection.
Those who are bedridden need to avoid prolonged pressure on the
ankles, heels and buttock. Too much pressure can tear the thin skin
leading to bed sores.