Category Archives: Aging, Mature Skin

Older Adult’s Skin

The U.S. Census Bureau’s data projects that the 65 and older age group is expected to double by 2030. In addition, the 85 and older age group is the fastest growing sector of the U.S. population.

Mature skin is visually and physiologically different from young skin. It  is beneficial to treat mature skin in a specialized manner because the incidence of skin problems tends to be higher in older adults than in other age groups.

Physiological changes in the skin due to natural aging increase the likelihood that older adults will experience vascular problems, benign growths and tumors, and contact dermatitis. When there is less blood circulation (ischemia) less oxygen is delivered to the skin cells. When skin cells renew  slowly or are not replaced in a normal manner the skin breaks down resulting in skin damage and discomfort.

The term ischemia means a decrease in the blood supply to a bodily organ, tissue, or part caused by constriction or obstruction of the blood vessels. Ischemia affects the skin of stroke patients, the skin of people with diabetes, the skin of people with rheumatoid arthritis and contributes to pressure ulcers (bed sores).

Structure and Function Skin Changes
Aging causes changes to each of the skins three layers. The epidermis, the skin’s top or outer layer, does not recover from injury as rapidly as young skin. The outermost layer of the epidermis loses lipids (fat-like substances), making the skin drier. The dermis, the skin’s middle layer, loses collagen and elastic tissue that keep the skin plump and protected against injury. The sweat glands in the mature skin are not as efficient at producing sweat, which increases the amount of time it takes to cool off the body on a hot day.

Skin Infections
An older adult’s skin takes two to three times as long to heal as the average adult’s skin. Older adults should monitor their skin for infections because simple cuts can turn into chronic wounds.

Skin in the lower extremities takes longer to heal (renew), people who have diabetes should perform regular foot checks to monitor for skin complications such as ulcers from developing.

Dry, Itchy Skin
Skin is naturally drier in older adults, so full body bathing isn’t typically needed as often. Those who bathe daily should avoid using very hot water or spend a long time in a hot shower or bath. Older adults should use mild soap, or a non-soap type cleanser, and use a therapeutic skin moisturizer immediately after bathing.

Medications Affect Both the Skin . . . and Treatment Options
At least 85 percent of all mature patients are taking some sort of medication. The administration of medications can induce dry skin or increase the intensity of dry skin.

Causes of Dry Skin

Dry skin is a very common condition. Dry skin is one of the most common skin abnormalities. Although certain individuals are more susceptible to dry skin, the condition can affect anyone, regardless of age, gender, or skin type.

Dry skin occurs when the skin’s outer layer (the stratum corneum) is depleted of water. The skin’s outer layer consists of dead, flattened cells that gradually move toward the skin’s surface and slough off. Called the stratum corneum, the outer layer has an important protective role. When this layer is well-moistened, it minimizes water loss through the skin and helps keep out irritants, allergens, and germs. However, when the stratum corneum dries out, it loses its protective function. This allows greater water loss, leaving the skin vulnerable to environmental factors.

Under normal conditions, the stratum corneum has a water content of 10% to 30%. This water gives the skin its soft, smooth, and flexible texture. The water comes from the atmosphere, the underlying layers of skin, and sweat. Oil produced by skin glands and fatty substances produced by skin cells act as natural moisturizers, allowing the stratum corneum to seal in water.

We continuously lose water from the skin’s surface by evaporation. Under normal conditions, the rate of loss is slow, and the water is adequately replaced. Characteristic signs and symptoms of dry skin occur when the water loss exceeds the water replacement, and the stratum corneum’s water content falls below 10%.

Although most cases of dry skin respond well to self-care, some cases require professional medical care. Mild-to-moderate cases of dry skin usually respond well to self-care measures and over-the-counter products. However, professional medical care is needed for severe dry skin, dry skin accompanied by other symptoms, and dry skin that persists despite self-care measures. These patterns of dry skin may signal the presence of other skin conditions, other medical conditions, or drug side effects. Persistent dry skin can lead to complications such as inflamed skin (dermatitis) and infection. A primary care provider can treat some cases of dry skin, but more complex cases of dry skin usually require treatment by a dermatologist.

Dry Skin Causes
Any factor that damages the stratum corneum can interfere with its barrier function and lead to dry skin. These factors include long, hot showers and cold, dry air, detergents and solvents, or chafing and scrubbing. When the stratum corneum is damaged, water moves more freely towards the surface of your skin where it evaporates, causing your skin’s water content to fall.

Abnormal loss of skin surface cells may also play a role in dry skin. Normally, cells lost from the skin’s surface are shed individually and unnoticeably. However, sometimes the cells stick together and resist shedding. As a result, the stratum corneum thickens. When the cells are lost, they are lost as large visible sheets called scales.

Some people inherit a tendency for dry skin. The moisture level of the skin is partly determined by genetics. Under identical conditions, different people will have normal, oily, or dry skin. Fair-skinned individuals seem to be more prone to dry skin than people with darker complexions.

The normal changes associated with aging often lead to dry skin. With increasing age, the skin’s ability to produce sweat, oil, and other fatty substances diminishes. The skin cells also divide more slowly, and the skin thins and takes longer to repair. As a result, the water content of skin is reduced in older adults. This age-related dry skin is usually more pronounced in women than in men.

Extremely dry skin is called xerosis (ze-ROW-sis).

 Extremely dry skin can be a warning sign of a skin problem called dermatitis (derm-muh-TIE-tis).

Dermatitis means inflammation of the skin. It can cause an itchy rash or patches of dry irritated skin. The earlier dermatitis is diagnosed and treated the better, because often without treatment, dermatitis gets worse.

Skin Aging and Dry Skin

Skin aging appears to be the result of both scheduled and continuous wear and tear processes that damage cellular DNA and proteins. Chronological skin aging and photoaging, have distinct clinical and histological features.

Chronological skin aging is a universal and inevitable process characterized primarily by physiologic alterations in skin function. In this case, keratinocytes are unable to properly terminally differentiate to form a functional stratum corneum, and the rate of formation of neutral lipids that contribute to the barrier function slows, causing dry, pale skin with fine wrinkles.

In contrast, photoaging results from the UVR of sunlight and the damage thus becomes apparent in sun-exposed skin. Characteristics of this aging type are dry and sallow skin displaying fine wrinkles as well as deep furrows, resulting from the disorganization of epidermal and dermal components associated with elastosis and heliodermatitis.

Understanding of the functions of the skin and the adapting principles of moisturizer use and application is important for the management of aging – mature skin.

J Dermatol. 2004 Aug;31(8):603-9.
Hashizume H.
Department of Dermatology, Hamamatsu University School of Medicine, Japan

Dry Skin Self Care Tips

People tend to think of dry skin as just a cosmetic problem. However, besides being uncomfortable, untreated dry skin can get so severely dry (xerotic) that it becomes inflamed and more susceptible to infections. Signs and symptoms of dry skin depend on age, health status, location, the amount of time spend outdoors and the cause of the problem.

When skin is dry, it is not because it lacks oil, but because it fails to retain internal hydration (water).

People with dry skin are likely to experience one or more of the following:
A feeling of skin tightness, especially after showering, bathing or swimming
Skin that appears shrunken or dehydrated
Skin that feels and looks rough rather than smooth
Itching (pruritus) that sometimes may be intense
Slight to severe flaking, scaling or peeling
Fine lines or cracks
Deep fissures that may bleed

Self Care For Dry Skin
Avoid long, hot showers or baths.
Use a moisturizing soap in the kitchen and bathroom.
Use gentle, fragrance-free, laundry detergent.
Use moisturizers, preferably creams or ointments rather than lotions because the thicker consistency is better at preventing skin dehydration. Apply the cream or ointment within 15 minutes of showering. Reapply moisturizer at night, and moisturize your hands  after you wash them.
Avoid perfume, cologne, or aftershave lotions that contain alcohol.

Moisturizing locks in the skin’s internal moisture to prevent dryness, cracking and tears. A therapeutic moisturizer will have emollient and occlusive properties. Emollients smooth skin by filling spaces between skin flakes with droplets of oil. Occlusives are substances the physically block transepidermal water loss in the skin layers. Kátha-Soma skin formula’s have emollient and occlusive properties. The Sólace skin formula is a therapeutic moisturizer for dry skin conditions that are often associated with aging. Visit Sólace Skin Cream.

Changes in Skin with Increased Age Lead to Dry Skin

The prevalence of dry skin is as high as 85% in the elderly population, with almost all being affected to some degree by the age of 70 years.

As skin ages, collagen and elastin fibers decrease along with total skin Kara-Soma skincarethickness. A direct result of the decreased thickness is a decrease in water and lipid (fat) content, sebum production, and sweating resulting in dryer skin. These degenerative changes result in a change of the skin structure and over time begin to affect the dermal vasculature.

A therapeutic moisturizer will rehydrate the skin barrier, increase water content, reduce transepidermal (internal) water loss and restore the lipid’s water barrier function. Moisturizing locks in the skin’s own water to prevent dryness, cracking and tearing. A therapeutic moisturizer will have emollient, occlusive and humectant properties. Emollients smooth skin by filling spaces between skin flakes with droplets of oil. Occlusives are substances that physically block transepidermal water loss within the skin layers. Humecants attract natural water from within the skin.

Tips When Using a Therapeutic Moisturizer
  A thick product such as a salve, or ointment type cream works best
Take a dollop of moisturizer from the jar, soften it by rubbing it between your hands, and apply it using the palm of your hand stroking in a downward direction.
  Do not rub the skin
  Leave a tacky film of moisturizer on your skin; it will be absorbed into the skins epidermis (top layer) in a few minutes.
Continue use of the therapeutic moisturizer even after the affected area heals to prevent recurrence.

Skin in the Elderly

The skin is one of the many organs that are affected by aging. The components of skin aging are both intrinsic, meaning structural and functional disturbances, as well as extrinsic, meaning the history of years of exposure to many environmental factors. Dermatologic autoimmune diseases such as psoriatic arthritis tend to increase with age.

Physiologic and pathologic changes in the skin result in clinically significant presentation as well. Polypharmacy (the administration of many drugs together) also increases the presence of cutaneous (pertaining to the skin) manifestation, including dry skin, in the older population. Prevalence of polypharmacy increases with age and this may not only induce a dry skin condition, but other drug reactions with cutaneous manifestations.

  1. The atropy of sweat glands (a physiologic change) results in decreased sweating (a pathologic change).
  2. The reduced movement of water from dermis to epidermis (a physiologic change) results in reduced epidermal hydration a (pathologic change).
  3. A reduction of stratum corneum lipids (a physiologic change) results in the decreased ability to retain water.

The term atrophy means waste away, typically due to the degeneration of cells.