Aging can be a great experience. Most people want to live as long as possible and remain in good health well into their later years. But, as we age, there are generalized changes to the physical condition of our skin.
Eczema in the elderly is a skin condition that results in dry, scaly patches of skin that can often be itchy and irritating.
As a caregiver, it’s important to follow a basic skin-care routine to keep your skin healthy and free from irritation. It’s also important to understand how to provide good skin care for the elderly in your care.
November is Eczema Awareness Month, and although many of the skin care tips below apply to everyone, keep reading for some special considerations when dealing with the elderly and eczema-prone skin.
As our skin ages we may experience the following:
- Fragile skin: Our skin tissue becomes loose and easily damaged
- Loss of subcutaneous fat: With associated loss of temperature control
- Dry skin: Reduced oil from sebaceous glands
- Epidermis damage: Outer layer of skin thins
- Dehydration: Older adults are prone to dehydration & poor nutrition affecting the condition of the skin
- Impaired circulation: Risk increases with age
- Glandular dysfunction: Sweat glands produce less sweat
- Reduced skin sensation: Impairs ability to feel touch, pressure, heat, etc.
The causes of eczema in the elderly may be affected by the skin changes mentioned above but often it is also aggravated by medications, co-existing illnesses, impaired mobility/stability, and cognitive impairment. Using creams, specifically steroid-based creams, can also thin the skin over time.
If using a steroid cream for a skin condition, it is important to check back in with the doctor every so often to ensure that it is still the best option.
Eczema in the elderly is a skin condition that results in dry, scaly patches of skin that can often be itchy and irritating. Luckily, once diagnosed, eczema is a skin condition that can be managed by a doctor.
Topical corticosteroids are often used to relieve itching and inflammation associated with elderly eczema. In addition to the normal considerations of caring for aging skin, skin suffering from eczema has its own set of precautions:
- Triggers: Eczema flare-ups can be caused by a number of triggers. Everyone’s skin reacts differently, but common triggers include: scented products, household cleaners, grass, chemicals, pet dander, dust mites, and even certain foods. If you or the elderly person in your care have eczema-prone skin, be aware of your triggers and avoid whenever possible.
- Moisture: Moisturizers should be a part of your regular skin-care routine. Consider using an unscented moisturizer that doesn’t contain additives or chemicals. For added protection, use moisturizers after washing skin to help seal in moisture.
- Home temperature: Extreme temperature fluctuations can be hard on skin. Depending on the season, an air-conditioner or humidifier can help regulate your home’s temperature and provide a comfortable environment.
- Avoid scratching: This one can be difficult, but there are ways to sooth the itch caused by eczema. Try applying cold compresses, or using moisturizing lotions, or baths containing colloidal oatmeal to calm the skin.
- Minimize sweat: Overheating or excessive sweating can be a cause of eczema flare-ups in some people. To combat this problem, ensure you or the elderly person in your care are wearing weather-appropriate clothing, staying out of direct sunlight, and drinking water to stay cool. It is also helpful to take a cool shower soon after a workout or excessive sweating, to help limit the amount of time sweat remains on the skin.
- Clothing: Consider wearing natural fabrics, such as cotton, as these are less irritating to your skin. Wash clothing in a mild and unscented detergent, avoid fabric softener, and always wash new clothing before wearing it to minimize skin irritation.
- Stress: Stress can exacerbate eczema. Try doing some deep breathing or progressive muscle relaxation exercises to calm your mind and body.
How skin damage can occur
Eczema is a skin condition that can affect a person of any age. But, when caring for the skin of someone who is elderly, it is especially important to visually inspect their skin regularly to catch any new skins irritations early to prevent further damage.
Aging skin can become damaged or injured from:
- Direct exposure to the sun
- Extreme heat and cold
- Wheelchair injury
- Bumping into things
- Transfers/repositioning: immobility can put skin at an increased risk of developing pressure ulcers.
- Jewelry of care providers (watches, rings, bracelets)
- Removal of dressings/tape and stockings
- Frequent bathing and poor lubrication
- During activities of daily living (ADL) e.g. toileting, bathing, dressing etc.
- Incontinence can be damaging to the skin if not managed well
Preventing skin injuries
To maintain and prevent injuries to your skin the following tips are suggested:
- Minimize bathing and avoid hot water
- Apply hypoallergenic moisturizer after the bath
- Avoid adhesive (sticky) products on fragile skin
- Promote adequate nutrition and hydration (see Canada’s food guide for seniors and Saint Elizabeth’s Healthy Eating for Healthy Seniors)
- Provide protection from trauma during routine care
- Keep finger and toenails short and filed to prevent self-inflicted skin tears
- Caregivers should avoid wearing jewelry or watches when providing care
- Protect your skin from the sun: wear hats, long sleeves and pants
- Protect your skin from extreme cold weather
As we age there are many changes to the physical appearance and function of our skin. Extra care is required to maintain healthy skin for ourselves and for the elderly people in our care.
What are your best tips for protecting your skin?