Common Elderly Skin Conditions

• Understand the varying types of skin conditions that the elderly population may experience and how to best assist them with care and treatment.
• Effective treatments for skin conditions should be discussed with the elderly patient and their caregiver in order for prompt interventions to be implemented.
• Nurses can provide education to both the patient and their family regarding common skin issues found among the elderly.

The skin is the body’s largest organ, and like any other part of the body, skin changes with age. Teenage years typically include oily skin and acne, and middle age is when those wrinkles of wisdom start appearing. 

As one approaches the elderly years, skin conditions may become more numerous and more noticeable as the skin continues to thin, lose fat, elasticity, and moisture.  As we age, skin cell turnover decreases dramatically, which slows wound healing. 

Aging also weakens the immune system and skin infections become more common.  Age spots may take up more space and large bruises may appear out of nowhere. 

Some skin problems such as bruises can be alarming but are usually harmless.  Other skin conditions require medical attention, and it is important that caregivers are aware of the most common skin conditions affecting the elderly population.

Types of Skin Conditions

Dryness & Itching

Dry skin in elderly adults is very common and it is said that more than half of older adults have it.  Some of the reasons may be due to a loss of sweat and oil glands, not drinking adequate amounts of water, and certain health conditions such as diabetes and kidney disease.

The skin may become cracked, painful, and itchy.  Scratching can cause skin irritation and can possibly open the way for infection-causing germs to enter.

Age Spots

The skin of older adults is often dotted with age spots due to years of sun exposure.  These flat, tan, or dark brown spots, which some call liver spots, typically show up on skin that has received the most sun, such as the face, arms, and back of the hands.  The spots are harmless but many dislike the look of them.

Skin Tags

Skin tags are soft, spongy, often flesh-colored growths of tissue that typically appear on the eyelids, neck, thighs, and skin folds such as the armpits, groin, and under the breasts.  They may hang from the skin on small stalks.

Skin tags are more common in women, people who are overweight, older adults, and people with diabetes.  They can become irritated if clothing rubs against them or if jewelry snags them.

Easy Bruising

Aging skin is thinner, and there is less fat to act as a cushion and protector.  Blood vessels are also more fragile and easily broken.  Bruises happen when blood leaks out of blood vessels, so more broken vessels mean more bruising.

Older adults who take blood thinners or even certain over the counter painkillers such as aspirin or ibuprofen may bruise more easily.  A minor bump or scrape can result in a large amount of bruising which can cause great concern for loved ones and caregivers.  The bruises are usually harmless, but anyone who often develops large bruises with no logical explanation should see a doctor to rule out any underlying health issues.

If a loved one or caregiver has any reason to suspect abuse as the cause of bruising, they should investigate further as soon as possible.

Skin Cancer

In older adults, the rates of melanoma spike and slower growing basal cell and squamous cell cancers also become more common.  In addition to more years of sun damage, older adults have a decreased ability to repair pre-cancerous cells.  Age is the strongest risk factor for non-melanoma skin cancers.

Shingles

Adults who had chickenpox as a child are vulnerable to shingles as adults.  Older adults are especially vulnerable.  Shingles begins with burning, itching, tingling, or extreme sensitivity in one area of the skin.  A painful rash then develops, often with a fever or a headache.  The rash eventually blisters and skin infections in conjunction with long-term nerve pain are possible complications.

Yeast Infections

A type of infection also known as candidiasis can occur in areas such as skin folds and on the buttocks area of immobile patients.  Yeast infections of the skin cause itchy, red, and painful areas that are usually associated with a foul odor.  Yeast infections are very common in the elderly population, especially after the use of broad-spectrum antibiotics.

Effective Treatments for Skin Conditions

Treatment for Dry and Itchy Skin:

• Ensure the patient takes short, cool baths or showers and uses a moisturizing soap
• Use a moisturizing ointment or cream daily
• Run a humidifier if the air is dry
• If the itching does not subside, inform the doctor as it could be a sign of liver, kidney, or thyroid issues.

Treatment for Age Spots:

• Apply sunscreen with at least 30 SPF to help prevent more age spots from developing.
• Encourage the patient to see a dermatologist to make certain the spots are age spots and not something else, especially if they change in appearance.
• If the age spots bother the patient, a skin care provider can treat them.

Treatment for Skin Tags:

• Skin tags are harmless; however, if they become bothersome and need to be removed the patient will need to see a dermatologist.
• Do not remove skin tags without the expertise of a professional.

Treatment of Bruises:

• Apply a cold compress for up to 20 minutes at a time
• If a leg or foot is bruised, keep it elevated while resting.

Skin Cancer Prevention:

• Limit the patient’s long-term exposure to the sun, especially during the time of day when the sun’s rays are the strongest.
• Apply sunscreen with SPF 30 or higher
• Perform a skin check once a month to look for new growths and changes in existing moles. Make an appointment with the dermatologist if anything suspicious is noticed.
• Have a skin cancer screening based on the schedule the dermatologist recommends, but at least once a year

Treatment of Shingles:

• Patients should be seen by a doctor as soon as symptoms appear. Early treatment with an oral antiviral medication may reduce the duration and severity of an outbreak.
• The patient should take an over-the-counter pain medication for pain control and use cold compresses, calamine lotion, and lukewarm baths for itching.
• To prevent shingles, offer the patient to be vaccinated.

Treatment of Yeast Infections:

• Clotrimazole or nystatin cream are topical fungal treatment creams used in yeast infections. If the creams are not effective then a stronger, oral medication may need to be used.
• It is important to eliminate a diet of bread and sugar during yeast infection treatment as these foods feed the infection and can make it worse.

Nurse’s Role in Education

The nurse has a very important role in raising awareness among the elderly population of the risk factors associated with skin disorders and the best interventions available to treat the conditions as soon as possible.

The nurse must also provide family and caregivers with the needed information on skin disorders and certain warning signs to be aware of in order for precise and active treatment to be started.  Knowledge and having a keen sense of awareness is imperative when dealing with skin disorders among the elderly population.

The Bottom Line

In conclusion, there are a variety of skin conditions that affect the elderly population.  Several of the conditions are harmless; however, it is important for caregivers to recognize changes in the patient’s skin as soon as possible in order for more serious concerns to be ruled out. Quick recognition of skin changes and prompt treatment will ensure the patient’s health and improve the patient’s quality of life.

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