Three Skin Problems Primarily Afflicting the Elderly

Several skin conditions afflict the elderly more than younger adults. This is because the body changes with age. Some of these conditions are quite common; others are rare. Thin skin and asteatotic eczema are common conditions that tend to strike the elderly. Bullous pemphigoid is a rare skin disorder that also tends to afflict the elderly rather than younger individuals.

Thin skin

As you age, you will lose collagen, and this loss results in a thinning of the skin. Although this is a normal part of the aging process, damage from ultraviolet light accelerates the loss. Over the course of a lifetime, the hands and arms are exposed to high levels of ultraviolet light from the sun. Because of this, they are the main areas in which an elderly person's skin tends to become paper thin.

It's possible to minimize the damage by protecting your arms and hands. Use a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 15 whenever you'll be exposed to the sun's harmful rays. If you can tolerate long sleeves, wear them whenever possible, because they will help you in two ways. In addition to protecting your arms from the sun, long sleeves will shield your arms from anything that could tear your skin. Since dry skin tears easily, it's important to use a thick moisturizing lotion to keep it from drying out. Avoid topical corticosteroids if possible; they accelerate the thinning process. Fortunately, if corticosteroids are the cause of the thinning, your skin may return to normal after you discontinue use.

Asteatotic eczema

Asteatotic eczema is a common skin condition usually found on the legs of the elderly. In fact, most patients exhibiting this condition are men over 60. It is also known as eczema cracquelée and asteatotic dermatitis.

Asteatotic eczema causes the skin to become red, itchy skin, scaled, and cracked. It appears mostly on the legs but can also appear on the hands. Although it can be extremely itchy, it's important not to scratch; scratching would cause additional damage to the skin.

There are several known causes for asteatotic eczema. If soap isn't rinsed off completely, it may contribute to this condition by causing excessive drying of the skin. In the elderly, diuretics may be a factor. In rare cases, an underactive thyroid causes asteatotic eczema.

Asteatotic eczema is more common during the winter, when indoor humidity levels decrease. Ways to prevent this condition include running a humidifier, ensuring that the legs of your pants aren't too tight, and refraining from sitting in front of a heat source for extended periods of time.

If you have asteatotic eczema, it's important to treat it. Remedies include moisturizing the affected area with heavy lotions; if necessary, steroid creams will also help.

Bullous pemphigoid

Bullous pemphigoid is a rare blistering disease. Although it can strike patients of any age, this autoimmune disorder is more likely to appear in the elderly. Bullous pemphigoid develops when the body believes that the glue holding the skin together is a foreign substance.

Those suffering from bullous pemphigoid will notice blisters (bullae) that erupt suddenly, often for no apparent reason. The fluid in these blisters is clear or has a yellow tinge; in some cases, the blisters contain blood. As they grow, they may itch.

A blood test can indicate the possible presence of pemphigoid, but a biopsy under direct immunofluorescence is necessary for a definitive diagnosis. Benign pemphigus and old age pemphigoid are other terms for this skin disorder. Although rare, bullous pemphigoid is the most common of the autoimmune blistering diseases.

There is no cure for bullous pemphigoid. The most common treatment is prednisone, an oral steroid, taken in daily doses of 40 to 100 mg. Approximately half of those afflicted with this disease enter remission, which allows them to stop taking this drug. The other half must remain on a maintenance dose for the rest of their lives. Because of the serious side effects associated with prednisone--which include raising blood sugar, increasing cholesterol levels, and increasing the risk of infection--the dermatologist may initially prescribe an antibiotic and high doses of niacinamide; unfortunately, this treatment is not as successful as prednisone for most patients. The dermatologist will also prescribe topical corticosteroids.

Sources:

Paper Thin Skin Tears Easily
NetDoctor
Asteatotic Eczema
CIDPUSA
New Zealand Dermatological Society