Skin problems are very common among older adults. Some are considered a normal part of aging, while others may indicate more serious underlying health problems. Family caregivers should keep an eye out for signs and symptoms of the following five skin conditions that often occur in seniors to ensure their aging loved ones receive prompt medical care.

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Dry Skin in Seniors

Dry, flaky skin (xerosis) is the most common skin problem among the elderly. According to the Mayo Clinic, more than half of adults over age 40 have dry skin. The age-related reduction in oil and sweat gland function (which helps to keep the skin soft and hydrated) is the main cause of dry skin. Dry, scaly skin can be very itchy, which can trigger lots of scratching or picking, thereby increasing an elder’s risk of developing skin infections. Severely dry skin can also become cracked and very painful.

Treating Dry Skin

  • Use a gentle cleansing soap that contains a moisturizer or that is specially formulated for dry skin.
  • Moisturize with lotion, ointment or cream every day.
  • If your loved one is moisturizing but not noticing any improvements, have them gently exfoliate to slough off old skin cells.
  • Change your loved one’s bathing schedule to be less frequent. Bathing or showering every other day is gentler on the skin compared to every day.
  • Avoid using very hot water when bathing and washing one’s face and hands as this can dry out the skin.
  • Wear loose-fitting cotton clothing rather than polyester or other synthetic fabrics and tight-fitting items.
  • Use a soft washcloth for bathing and showering instead of loofahs or products that are abrasive.
  • Increase your loved one’s consumption of water and other fluids to keep their skin hydrated.
  • Limit caffeine intake, which can cause itching.
  • Use humidifiers and vaporizers to add moisture to the senior’s living environment, especially in dry climates and during winter.

Bruising in the Elderly

While it may take quite a bit of force to cause a bruise in younger individuals, even minor bumps and scrapes can cause extensive bruising in an elderly person. Our skin and blood vessels become more fragile as we age, and bruising may even occur without incurring an injury.

Treating Bruises

  • Apply a cold compress to the bruise. This reduces blood flow to the area, reduces the size of the bruise and decreases inflammation.
  • Avoid medications that contribute to bruising, such as over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin and naproxen.
  • Seniors who take prescription medications that reduce clotting, known as blood thinners, or who have clotting abnormalities should seek the advice of a physician or other health care provider immediately if serious bruising appears. This may indicate an adverse reaction or a need for their medications to be adjusted.
  • If a bruise takes up a large area of the leg or foot, the limb should be kept elevated as much as possible.
  • Keep an eye out for other signs of potential elder abuse.

Pressure Sores

A bed sore (also known as a pressure ulcer) is an open wound on the skin that occurs when a person is lying in the same position for an extended period of time. These wounds typically develop when a person is confined to bed or a chair. The tailbone, heels of the feet, ankles, back and elbows are common spots where pressure ulcers develop.

Treating Pressure Ulcers

  • Avoid spending long periods of time in the same position. If a senior cannot reposition themselves, then help reposition them at least every few hours. This will help distribute pressure over other areas of the body.
  • Specialized durable medical equipment like gel or foam mattress toppers and alternating air pressure mattresses can help prevent pressure sores from developing. These items are covered by Medicare Part B with a doctor’s prescription.
  • Keep high-risk areas of the body clean and dry. A solution of mild soap and water can be used to clean early stage wounds followed by a barrier cream.
  • Localized skin redness and warmth may indicate that a bed sore is about to appear. Contact your loved one’s physician to report the beginning signs of a pressure ulcer and develop a treatment plan.
  • Seniors often require the care of a specialized wound care nurse to assist in healing bed sores and coordinating ongoing prevention efforts. Do not hesitate to report any changes in a loved one’s skin integrity as bed sores can become deep and painful very quickly. If they are not addressed promptly, they can become infected.
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Shingles in the Elderly

Shingles is a condition that affects the skin and nervous system and causes a painful blistering rash that typically lasts between three and five weeks. It is caused by the same virus that causes chickenpox: varicella-zoster. The first sign of shingles is often extreme sensitivity or pain on one side of the body. Symptoms include burning, tingling, pain, numbness and fluid-filled blisters. If you suspect your loved one has shingles, call their doctor for treatment. Anti-viral drugs and pain medication are typically prescribed to help speed up healing and minimize discomfort.

Older individuals are at high risk for complications like skin infections and ongoing nerve pain even after the rash has healed called post-herpetic neuralgia. Vaccination with either Zostavax or Shingrix can help reduce a senior’s risk of developing shingles. Shingles shots are typically covered by Medicare Part D prescription drug plans.

Skin Cancer in Seniors

Skin cancer begins in the cells that make up the outer layer of the skin called the epidermis. It often develops due to sun exposure and sun damage but can also occur on areas of the skin that are not ordinarily exposed to sunlight. There are 3 types of skin cancer that typically impact older people:

  • Melanoma
  • Basal cell carcinoma
  • Squamous cell carcinoma

Regular self-exams and skin checks conducted by a dermatologist are crucial for catching skin cancer early on. Here are some warning signs to look for:

  • Changes in the appearance of a mole, including the size, shape and color
  • Moles with irregular edges or borders
  • More than one color in a mole
  • An asymmetrical mole (e.g. if the mole is divided in half, the 2 halves are different in size or shape)
  • Moles that itch, ooze or bleed
  • Ulcerations (holes that form in the skin when the top layer of cells breaks down and the underlying tissue shows through)
  • Sores that do not heal

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A “changing mole” or new skin growth requires evaluation by a dermatologist. If skin cancer is a concern, then the doctor will perform a biopsy and create a treatment plan if needed.

Senior Skin Conditions Can Point to Bigger Health Problems

The following medical conditions could spur changes in an elderly person’s skin. If irritation or other symptoms persist, make an appointment with their doctor.

  • Arteriosclerosis and other blood vessel diseases that cause circulatory problems
  • Diabetes
  • Heart disease
  • Liver disease
  • Malnutrition
  • Obesity
  • Adverse reactions to medication
  • Bleeding disorders

Sources: Mayo Clinic: Dry Skin Symptoms and Causes (https://www.mayoclinic.org/diseases-conditions/dry-skin/symptoms-causes/syc-20353885); Skin Care and Aging (https://www.nia.nih.gov/health/skin-care-and-aging); Shingles (https://www.nia.nih.gov/health/shingles); Shingles Shot Coverage (https://www.medicare.gov/coverage/shingles-shots); Skin Cancer: Basic Facts (https://www.healthinaging.org/a-z-topic/skin-cancer/basic-facts)