7 Common Skin Problems in the Elderly and How to Manage Them

According to the WHO, the global population of those over age 60 will cross two billion by 2050, and with it will come a considerable spike in associated dermatological issues.

Aging changes our skin both functionally and structurally. These changes include decreased healing, less DNA repair, and the thinning of the epidermis.

Skin diseases can affect the elderly both physically and psychologically, making their care and wellness even more critical. In this post, we explore some common skin problems the elderly face and how to manage them. (A must-read for caregivers at assisted living facilities or retirement homes.

How to Manage Common Skin Problems in the Elderly 

Some common skin problems diagnosed in the elderly are associated with diseases that affect other systems. Apart from physical discomfort, they can cause psychological trauma in the sufferer, along with their family members and caregivers. Keep your eye out for these.

1. Dermatitis

Seborrheic and stasis dermatitis are common in the elderly. The former is caused by Malassezia yeast which reduces immune functions. It is also known to be associated with depression, anxiety, and Parkinson’s.

To manage it, keep your skin moisturized, use medicated lotions and wet compresses, and wear cotton clothes.

Stasis dermatitis is a condition in which the valves in your leg veins don’t function correctly. The result can be edema, petechiae, and a brownish plaque with scale, mostly in the lower leg. See a doctor immediately, as medication is the best way to take care of this condition.

Contact dermatitis is extremely common in the elderly due to reduced immune functions and a thinning epidermal barrier. It may also result in a little inflammation. Since it is often caused by an allergy or reaction, the best way to prevent it is to avoid the root of the reaction. Anti-itch creams and cool and wet compresses help as well. It requires intensive care and constant monitoring, which is why assisted living is the best option.

2. Pruritus

Pruritus is a sensation of the skin that makes you want to scratch. This itch could be localized or generalized, with or without a rash.

By 70, almost all adults are affected by xerosis (the medical name for dry skin). This is the most common cause for generalized pruritus without rash in older people.

Some drugs and medications can also cause it. For better care and wellness of the elderly with pruritus, you must find out the underlying causes.

If it’s generalized pruritus without rash, half the time the reason is an underlying systemic disease like diabetes, hyperthyroidism, renal failure, and lymphoma. Finding the underlying cause, again, is the best way to treat it. However, you can manage the itch by keeping the skin moisturized; using sunscreen to prevent skin damage; and using mild soap, a lukewarm water bath, and cotton clothes.

3. Nummular Eczema

Coin-shaped pruritic lesions can develop into scales. This is the characteristic of nummular eczema. These lesions generally appear on the trunk, upper extremities, dorsum of hands, and lower legs.

To manage it, petroleum jelly and similar high or medium potency topical steroids and emollients are very effective. If there is a secondary infection, the treatment will need antibiotics like dicloxacillin or cephalexin, and something that covers staphylococcus. Assisted living is the best environment to take care of these conditions.

4. Purpura

Purpura are small hemorrhages in the serosal surfaces, skin, or mucous membranes and are often a result of thrombocytopenia, or decreased platelet count. It can also be the outcome of abnormalities in platelets, vascular defects, trauma, or reaction to a drug. Decreased immunity and reduction in blood vessels make the elderly especially prone to skin hemorrhages which require extensive care and wellness programs to treat.

To treat purpura, detecting the underlying cause is necessary. If the platelet count is very low, the patient will need infusions. In such cases, it is important that the person suffering from this skin disease use skin protection and live in a safe environment to prevent injuries.

5. Infections

Dermatophytosis, intertrigo, candidiasis, and viral and bacterial infections are the most common skin infections in the elderly. You can use allylamines or topical imidazoles for localized infections. For more widespread ones, pulse itraconazole, terbinafine, or griseofulvin are very effective.

For intertrigo, regular use of 2% ketoconazole shampoo for four weeks and then once every week will do the work. For prevention, use antifungal powder. For more severe cases, itraconazole is extremely effective.

Scabies can be transmitted by direct contact which is why it’s wise to let experienced caregivers at retirement homes take care of them. Wrists, feet, elbows and similar interdigital spaces are the most common sites of this infection. Oral ivermectin or permethrin can be used for its treatment.

6. Shingles

Shingles is a skin condition that also affects the nervous system. It causes a blistering rash that is painful and lasts anywhere from three to five weeks. Varicella-zoster, the virus that causes chickenpox, is also the root cause of this skin disease. The initial symptoms are often extreme sensitivity or pain on one side, followed by tingling, pain, inflammation, numbness, or blisters filled with fluids.

If a senior is suffering from shingles, pain medications and anti-viral drugs are used to speed up healing and minimize discomfort. Shingrix or Zostavax vaccinations can reduce the risk of shingles in seniors.

7. Melanoma 

Did you have severe sunburn at a young age? Do you have frequent UVR exposures? Freckles? Red or blond hair? Blue or green eyes? Too many moles? Then, you are prone to melanoma as you age. If you notice new moles, or changes to existing ones (think bleeding, itching, change in size), consult a doctor as these are symptoms of melanoma. Melanoma arising within nails, or on the soles of your feet or your palms is called acral melanoma.

If you have a bleeding red spot or a lesion that doesn’t heal and is extremely painful, it may be a squamous cell carcinoma. This can occur on sites that are often exposed to the sun, especially ears and lips. If it’s larger than 2cm, it will usually metastasize. Although it is the most common type of skin cancer, it’s also the least dangerous form.

Melanoma can only be treated by surgical excision.

Aging makes a person more susceptible to skin diseases like xerosis, melanoma, and pruritus. That’s why it’s important that a full dermatological examination is done regularly, whether at home or a retirement residence to look for undiagnosed skin problems. To keep skin from becoming damaged and infected, proper maintenance is required.