Ageing is a process of progressive decrease in the maximal functioning and reserve capacity of all the organs of the body, including the skin. This is often accelerated by environmental issues such as UV- radiation.
Since the skin is the largest organ of our body, ageing is seen here first. Major changes are dryness due to fewer oil glands and loss of water retention capacity, wrinkling of skin due to loss of fibroblasts and loss of volume and a variety of benign neoplasms. Aged skin is inelastic and recovers more slowly after injury. Changes in the skin also include depigmentation of hair, hair loss and abnormal nail plates.
Sun exposed skin is also subject to photoaging (premature aging of the skin caused by repeated exposure to ultraviolet radiation). This leads to excessive dryness, irregular pigmentation like lentigines, bronzing of skin, deep wrinkling, telangiectasias, purpura, benign skin tumours and actinic keratosis.
Common skin complaints in the elderly
Pruritus (itching) is the most common skin related complaint in the elderly. Mostly, it is due to xerosis (dry skin) which is exacerbated by hot water baths and harsh soaps. But in 10-50% cases, it could be due to diseases like diabetes mellitus, thyroid disease, renal (kidney) failure or hepatic (liver) disease. Sometimes, lymphomas or leukemias (cancers) could also cause pruritus. Adverse drug reactions or even infestations like scabies could also cause itching.
Fungal infections are common in the aged. Nail infections (onychomycosis) is seen in 40% of people above 60 years. Many of them also suffer from fungal infections between the toe web spaces and on their feet. Candida (a fungus) infections are especially common in the elderly.
Herpes Zoster is a viral infection seen in the elderly. Patients experience paraesthesias (altered sensations) and muscle weakness for long after the infection has subsided.
Leg ulcers are more common in the elderly because of impaired wound healing and reduced blood supply. Diabetes mellitus and atherosclerotic peripheral vascular disease aggravates this.
Adverse drug reactions increase with age, probably because the elderly consume more medications than the young. The aged also have impaired renal, cardiac and hepatic function.
Some other diseases like psoriasis, skin cancers and bullous pemphigoid are more common in the a
- Most of the ageing sign or changes in the body can be managed by taking simple measures. Use of unscented moisturizers within three minutes after bath helps in preventing problems due to xerosis (dryness) of the skin. Liquid paraffin or white petroleum jelly can be used liberally all over the body especially during the colder and rainy months. Hot water baths and use of harsh soaps should be avoide.
- Adequate sun protection should be taken at all times. Sun damage by UV- rays can increase chances of skin cancers. Any good sunscreen with SPF 30 should provide adequate protection. The sunscreen should be reapplied every 3 hours. The elderly should avoid going out between 9:00am and 4:30pm to avoid sun damage.
- Smoking should be stopped.
- Vitamin D supplements should be taken after consulting a medical practitioner.
- Lastly, the diet of the elderly should be rich in all the colorful fruits and vegetables which contain antioxidants.Ageing is irreversible, but it can be done with grace.