The health of your skin goes beyond everyday bathing and moisturizing, especially as you age. As we get older, many changes happen to our skin that can be normal. But sometimes changes can also lead to an increase in skin damage, infections, and other problems. And if you struggle with mobility and continence, this can lead to even more skin concerns.
You may be surprised to learn that even just a few hours without the right attention can lead to serious injury to your skin and surrounding tissues. For example, every year in the US, 2.5 million people are diagnosed with pressure injuries (also called pressure ulcers).1 And this does not even include the other skin issues that older adults may face.
Common Skin Issues in Older Adults
With aging, our skin loses elasticity, can become thinner and more fragile, and is prone to injury. It also shows the effects of sun damage over the years and other problems. We’ll discuss some common skin issues you might notice as an older adult, and what you can do to care for your skin. It’s also important to know when to talk to your doctor about skin problems.
The following are common skin issues in older adults:
- Skin tears
- Bruising and discoloration
- Growths
- Itching
- Infection
- Skin breakdown and pressure ulcers
Let’s take a closer look at these concerns.
Skin Tears
Because of age-related thinning of the skin, and loss of the fat underneath the skin which leads to loose skin, sometimes skin can be “papery” or appear transparent in older adults. This fragile skin is more likely to tear easily. When thin skin is bumped against a hard surface, or a bandage is removed too quickly, for example, the skin can break open. In severe cases, a flap of skin can tear partially away.
If you have a skin tear:
- Be sure your hands are washed with soap and water before handling broken skin
- Apply pressure until any bleeding stops
- Gently rinse the area with water and let it dry
- If there is a flap of skin, move it carefully back over the tear (without forcing it)
- Cover with a non-stick dressing (a non-adhesive pad and gauze wrap works well)
- Watch for signs of infection. If there is drainage, redness, or increasing pain or swelling, see a doctor right away
- If the skin tear is very large or open, or you don’t feel comfortable caring for it, it is best to have it treated by a healthcare professional
Bruising and Discoloration
Fragile skin can bruise more easily, especially if you are taking blood thinners. And with age, sun exposure can lead to an increase in age spots (a normal area of darker coloring). It’s important to know when these bruises and spots are a sign of something more serious.
Problems you should see a doctor for include:
- A sudden increase in bruising
- Bruising under the skin that looks like tiny pinpricks all over
- Dark areas of skin that change shape, are raised, or rapidly darken
- Yellow discoloration of the skin
Skin Growths
Lumps, bumps, and changes in moles are all causes of concern. Skin cancer is more common as we age. It is seen in up to 12% of people over 65. 2
Changes to watch for include:
- New raised or discolored areas, especially if they appear suddenly or change rapidly
- Scaly, crusty spots
- New lumps or bumps, especially if discolored
- Changes in size or color of existing moles
- Any bumps or discolored patches that are oozing, bleeding, itchy, or painful
- Discoloration that starts to spread outside of the borders of a mole
- A mole that is more than one color
The bottom line? Don’t try to diagnose a lump, bump, or spot yourself. If it’s concerning you, or it’s new, talk to your doctor about it as soon as you can.
Itching
An unpleasant problem that can lead to skin injury, infection, and sometimes a loss of sleep, itching is important to address with your doctor. There can be many reasons someone experiences itching:
- Medication side effects
- Underlying medical problems, such as liver disease
- Dry skin (very common after age 70, and the most common cause of itching without rash)3
- Allergic reactions (especially if you notice a rash)
If moisturizing with lotion isn’t improving your symptoms, be sure to see your doctor to find out the cause of any itching.
Infection
Skin can become infected due to an injury or wound that is not healing properly, or without any known injury. Because infections can sometimes rapidly worsen or spread throughout your whole body (known as sepsis), this can be a serious problem if left untreated.
If you notice any of these symptoms, let your doctor know right away:
- Drainage from a wound or injury
- Redness, especially if it is worsening or spreading
- Swelling, especially if it increases
- Pain or burning (if you notice burning or irritation in skin folds such as under breasts or near the groin, this can sometimes be a yeast infection)
- Fever
Skin Breakdown and Pressure Ulcers
Also known as pressure injuries and bedsores, pressure ulcers are caused when the skin and the underlying tissue, such as fat and muscle, are damaged. This can happen for a few reasons. As we’ve discussed, older, more fragile skin can be damaged easily. So can overly dry skin, which is common with aging. Any skin that comes into contact with moisture for too long can become irritated or injured. And being in one position for too long can affect blood flow and damage tissues. This is especially true of skin and tissues over bony areas.
Symptoms of skin breakdown and pressure ulcers:
- Redness and blistering (often from stool or urine having contact with the skin)
- Discoloration that is red, purple, or blue
- Redness that doesn’t turn white when you press on it
- An area of skin that feels spongy or hard
- Skin that is warmer or cooler than the surrounding skin
- Pain and/or itching
- Drainage and/or open skin
Common locations of pressure ulcers:
- Tailbone and buttocks
- Hips
- Elbows, ankles, and heels
- Shoulder blades
- Spine
- Head (especially the back of the head)
Steps you can take to help prevent pressure ulcers:
- Change position frequently- pressure ulcers can develop in as little as 4-6 hours4
- For bed-bound patients, turning every 2 hours helps improve blood flow to the skin5
- Ask your doctor about a special mattress to relieve pressure if you’re mostly confined to bed
- Use cushions for wheelchairs and padding like pillows to lift heels off the bed and between knees
- Keep skin clean and free from drainage, urine, and stool
- Use a barrier cream like zinc oxide over skin that comes into contact with moisture
- Make sure you’re getting the right nutrition to support healthy skin- your doctor may suggest supplementation if necessary, like protein shakes
- Talk to your doctor about ways to keep dry skin moisturized
- Report any skin changes or redness to your healthcare provider right away
- Consider in-home caregiving help if mobility and hygiene are a challenge
The Best Advice for Skin Problems
When it comes to the health of your skin, watching for changes, keeping it clean and moisturized, avoiding one position for too long, and getting good nutrition all go a long way in preventing serious problems.
But, if you notice any problems or changes with your skin that are new or unfamiliar, whether they are causing you discomfort or not, the best advice is to talk to your healthcare provider. They can diagnose any issues and advise you on how to best treat your skin concerns.
When it comes to managing difficulties like incontinence, skin hygiene, and mobility, extra attention is needed to avoid skin breakdown and pressure ulcers. If tasks like repositioning in bed and maintaining good hygiene are becoming challenging to manage alone or with help from family, Caresify’s professional and expert in-home caregivers are available to provide extra support. This can help you avoid further complications like falls and skin breakdown. You can learn more on our homepage, or call 888-799-5007.
References
- https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/index.html
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5614327/
- https://www.gmjournal.co.uk/common-skin-problems-in-the-elderly
- https://www.aafp.org/afp/2015/1115/p888.html
- https://medlineplus.gov/ency/patientinstructions/000426.htm