FOCUS ON OLDER SKIN
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12
SKIN CARE TODAY
2017,Vol 3, No 1
S
kin ageing is an inevitable
fact of life that presents
nurses and patients
with a unique set of problems
when it comes to assessment,
treatment and maintenance.
Ageing skin is influenced
both by internal physiological
factors (intrinsic ageing), and
external factors (extrinsic
ageing). Intrinsic ageing affects
the structure and function
of the skin, which results in
dryness, atrophy (wasting),
laxity (looseness), wrinkling
and pigment changes. All
components of the skin are
affected by ageing, which will
eventually affect everyone
(Norman, 2003; Lawton, 2010).
SKIN STRUCTURE
Intrinsic factors
Epidermis
With age the epidermis becomes
thinner, there is flattening of the
dermo-epidermal junction and the
corneocytes (non-living cells that
form the outermost layer of the
epidermis) become less adherent
Care of elderly skin
allowed to dry out and split
(Kirkup, 2014).
Dry skin (xerosis) is a
common feature of ageing skin,
resulting from the reduced
production of sebum, alteration
in the lipid components of
the epidermis and disordered
activity of the stratum corneum
(Kirkup, 2014). The number of
melanocytes (melanin-forming
cells) and Langerhans cells
(antigen-presenting immune
cells) decrease, altering the
immune response, increasing
the risk of infections and skin
cancer, and decreasing the
skin’s ability to heal (Hill, 1994).
Dermis
The main changes in the
dermis occur in the supporting
fibres. The bulk of collagen
(the main structural protein found
in skin) decreases and, while the
Sandra Lawton, nurse consultant dermatology,
Rotherham NHS Foundation Trust and
Queen’s Nurse
IN BRIEF
It is estimated that 70% of elderly people have skin problems (All
Party Parliamentary Group on Skin [APPGS], 2000), and as people
age the skin undergoes several changes.
The continuous process of skin ageing affects the function and
appearance of the skin and increases the likelihood of skin
problems (Lawton 2008; 2014).
This article provides an overview of factors to consider when
caring for elderly people with skin problems.
KEY WORDS:
Skin
Older people’s skin
Emollients
Dry skin
Itching
Sandra Lawton
to one another, which reduces their
water-binding capacity and results in
dry skin (Hill, 1994). One common
exception to this age-related thinning
of the epidermis is an increased
thickening of the stratum corneum
(outermost layer of the skin, made
up of keratinised cells) on the soles
of the feet. Individuals affected may
find that their walking is impaired,
especially if these thicker layers are
i
Practice point
As dry skin is a common
presenting feature of ageing skin,
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include the use of emollients.
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