Ageing skin and common skin problems

Ageing skin can be very fragile. A small knock to the skin can cause a skin tear taking a long time to heal. You can keep ageing skin healthy and protect it from injury with a good skin care routine.

In this article:

• Bruising
• Excoriation
• Fungal infection
• Dry skin

Bruising

As we age our skin becomes thin and more prone to bruising. The blood vessels can be easily damaged and rupture. The loss of the protective fatty layer increases the risk of injury and an older person can bruise from a relatively minor bump.

Bruising can be minor or widespread. An older person may also be taking medications that thin the blood and interfere with the clotting mechanism of the body.

Bruising frequently occurs on the legs and arms. Mobility or lifting aids can often cause injury to the skin when transferring. Placing extra padding on wheelchair leg supports can help protect the limbs from damage. If a family member has frail skin, consider purchasing commercial leg and arm protectors.

Always inform your doctor if someone you care for has increased bruising, can't remember how the bruising occurred or bruising becomes painful. Some medications cause the skin to become thin and papery. In some cases bruising of the skin can be an indication of elder abuse.

Tips to protect skin from bruising

•  Wear long sleeve pants and tops
•  Protect the shins and arms with arm and leg protectors
•  Cushion wheelchair leg supports
•  Cushion forearm support frames with padding
•  Remove furniture with sharp corners
•  Remove clutter from walkways
•  Avoid prolonged exposure to the sun to protect against damaged skin

Excoriation

Excoriation and skin breakdown often occurs in the skin folds of older people. Moisture becomes trapped in areas such as the abdominal folds, under breasts, groins and toes. Excessive moisture causes the skin to become very red and sensitive.

Sometimes a person can have trouble drying particular areas of the body. They may be frequently incontinent, sit for long periods or wear inappropriate clothing. Someone with contracted limbs (stiff and immobile joints) is susceptible to excoriation in hard to dry areas.

Carers can also have difficulty drying under arms or behind the knees if the limbs cannot be moved freely. For someone after stroke excoriation can occur on the affected side or in contracted hands and fingers.

Incontinence increase the risk of skin breakdown. Excess moisture in the skin also increases the likelihood of infection. Excoriated skin can become itchy, sore and in some cases infected. Ask your community nurse, doctor or pharmacist to suggest a suitable barrier or topical skin cream. See your doctor if excoriation persists.

Tips to prevent excoriation

• Clean and dry skin folds well especially under arms, breasts, groins and toes
• Clean and dry skin thoroughly after an incontinence episode, apply a barrier ointment
• Change incontinence pads regularly
• Choose clothes made from natural fabrics to avoid sweating
• Ensure you wash your hands before and after coming into contact with skin, wear gloves
• For excoriation due to incontinence try Bodyworns, disposable absorbent underpants 

Fungal infection

Areas of the skin that are moist and prone to excoriation will often be at risk of developing infection caused by the yeast like fungus candida albicans. Areas commonly affected are the skin folds under the breasts, groin and area around the genitals. It appears as bright, reddened moist areas of skin with small papules that are itchy.

Factors associated with fungal infection:

• Antibiotic use
• Diabetes
• Steroids use
• Incontinence

Treatment of fungal infection

• Clean and dry area thoroughly
• Keep skin folds free of moisture
• Wear clothes that allow skin to breathe
• Ensure correct hygiene practices; don't share towels, wash hands
• Ask a community nurse, doctor or pharmacist to suggest a suitable anti-fungal
• Use a barrier cream to protect skin after infection has healed 

Dry Skin

Ageing skin has less sebaceous (oil secreting glands) and sweat glands, causing the skin to be depleted of moisture. Dry skin can be an uncomfortable and persistent problem for older people. The skin appears rough, scaly, cracked and dry.

Factors associated with dry skin:

•  Cold dry weather
•  Daily use of soaps
•  Frequent bathing
•  Nutritional deficiency
•  Underlying health conditions such as kidney disease
•  Medications
   

Tips to prevent dry skin

•  Avoid excessive bathing and harsh soap
• Try special no-rinse cleansers or Bag in the Bath products instead of soap
• Use warm water not too hot
• Increase fluid intake
• Apply moisturiser to damp skin directly after bathing
• Use emollients such as bath oils (take care with slippery baths)
• Pat skin dry 

Tip:

Inspect skin daily for bruising, tears, reddened areas, blisters or rashes. Notify the doctor of any changes in the appearance of moles or sunspots. 

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• How to prevent and care for skin tears