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The skin is the largest organ of the body, so it might seem odd that it’s something we rarely think about. The skin is responsible not only for protecting everything inside us, but it also gives us sensory perception, helps regulate body temperature, detects pressure, and so much more. As the skin gets older, those benefits start to break down. According to Nursing Times, as our skin changes, we start to lose the ability to detect changes in pressure or temperature. Aging skin gets thinner, drier, begins to sag as it loses firm structure, and becomes less resistant to trauma, tears, or infection.
You probably already know that the elderly are more prone to injury from falls[1] – that’s a good reason to have fall prevention interventions, like a medical alert device, grab bars, ramps, and the like. But did you know that the skin is more prone to bruises and tears if you do fall? And those openings in the skin can lead to an increased risk of infection.
Skincare is vitally important for senior health care. Understanding what happens to the skin as we age can help us know how to protect it as we get older. Here’s what you need to know to keep your skin as healthy as possible over the years.
Understanding the Skin
The skin, even as thin as it appears, actually has three layers[2]. The first two are the main layers everyone thinks about: the epidermis and the dermis. The epidermis is the outside. That’s the skin you actually see and touch. The cells in the epidermis produce substances like keratin, which keeps the skin strong and resistant to water, and melanin, which gives the skin color. There are also cells in the epidermis that provide immunity against bacteria.
The second layer, the dermis, is right underneath the epidermis. This is the thickest layer of skin and it provides strength and support. This is where the sensory receptors are, allowing you to feel pressure, temperature, pain, and other sensations. There are also small blood vessels in the dermis. The dermis also contains sebaceous glands (which provide oil and kill bacteria in pores), sweat glands, and hair follicles.
The final layer, the hypodermis, is very thin and mostly made of fat cells, which can help the body conserve heat. It also attaches the upper layers of skin to the fascia, which is the connective tissue that keeps everything in your body where it belongs.
How Our Skin Changes as We Age
As we get older, many things about our bodies change. Our eyesight begins to diminish. We become more likely to suffer accidents, as well as injuries as a result of falls. We can do many things to help mitigate these changes, such as aging in place home modifications, wearing the right eyeglasses or getting appropriate treatments, and investing in fall detection devices to get help immediately if we do suffer an injury.
So how, exactly, does our skin change? The following changes can happen. They might be gradual, or it might feel as though they happen all at once. And they can happen all over the body.
· Your skin becomes rougher and drier. Though it might have been rough and dry during the winter, now you’ll notice that it’s dry and rough year-round.
· The skin starts to become slack, sag, or otherwise hang loosely instead of feeling firm. The skin is losing its elasticity and gravity is pulling it down. You’ll notice more wrinkles everywhere.
· Your skin becomes easier to bruise. This results from thinning of the walls of the blood vessels in the dermis.
· You might notice lesions or other small tears in the skin. Some of these lesions might actually be benign tumors.
· The skin becomes thinner, almost transparent in some places, thanks to the thinning of the epidermis.
· The shape of your face might change. That’s because you’re losing fat from the skin, which makes your face look leaner and leads to looser skin. You might lose cartilage which leads to drooping of the nose, and bone loss around the mouth, which can cause puckering of the lips.
· Your skin might develop “age spots” or “liver spots” on the area that get sun exposure. This is why they usually appear on the hands and arms. Medline Plus cautions that you might notice more skin tags, warts, and other blemishes, as well as pinkish rough patches, which could develop into cancer.
· You might notice that if you get a cut or abrasion, it is more likely to become infected or take longer to heal. That’s because the skin is thinner, but also because there is a 60% decrease in blood flow as we age, as well as a loss of 50% of mast cells – those are the white blood cells that help boost your immunity[3].
But one of the most consistent and annoying issues you might face very early on is itching. WebMD reports that 85% of older individuals develop “winter itch” thanks to the overheated indoor air during the colder months, as well as the loss of oil glands as we age. Soaps and hot baths can make this winter itch worse, as can some medications.
Sunlight: The Big Skin Danger
Why do some people have very few skin problems well into their golden years, while others begin to have issues long before they hit retirement age? The reason is usually pretty simple: Sun exposure.
There are elastic fibers in the layers of skin. These are called elastin. The sun’s ultraviolet rays (UV light) can cause those elastin fibers to stretch and break down. You won’t notice this immediately, as it takes time for the damage to show up. That’s why sun damage might not show up in your 20s, 30s, or 40s – but it will catch up with you over time.
Though there is little you can do to reverse sun damage, there is plenty you can do to prevent it, and it’s never too early or too late to begin. Staying out of the sun, using sunscreen with an SPF of 30 or more, and wearing clothing over exposed skin, including wide hats, sunglasses, and long pants can help mitigate damage. So can a sunscreen with iron oxide, which blocks visible light and blue light[4].
How to Prevent Skin Dryness
Sunscreen and other ways to block the sun can help prevent premature aging on the skin, but what about that maddening dryness you might experience as you get older? Itching can be caused by sun damage, fewer natural oils in the skin, decreased cell renewal, and a loss of hormones, especially for women after they go through menopause. Here are ways to mitigate that itchiness, according to WebMD.
· Use sunscreen. Yes, we mentioned this earlier, but it pays to mention it again. It really is that important. Don’t forget to use a lip balm with sunscreen in it as well.
· Eat the right foods. Add a boost of vitamin A to your diet through low-fat milk and cheese, leafy greens, carrots, oranges, cantaloupe, and eggs. Find antioxidants in tangerines, sweet potatoes, cherries, citrus fruits, spinach, and grapes. Fatty acids, like omega-3s, can help replenish skin oils.
· Shower the right way. Long, hot showers might be tempting, but they can strip your skin of essential oils and leave it far too dry. Short, warm showers are a much better option. You should also use soap-free, non-scented cleansers. Use exfoliants sparingly, and look for those that have moisturizers included in the ingredients.
· Know when to apply moisturizer. Apply the cream two or three minutes after bathing. Pat the skin dry (don’t rub it) and apply the moisturizer. This ensures there is still enough moisture on your skin to help the moisturizer do a better job of keeping the skin supple.
Choose the Right Ingredients
Start by understanding the variety of ingredients in the most common skincare products. Check the labels to see what is in the product you’re using, as some that look like a fantastic option really aren’t. This quick primer will help you choose the right ingredients[5].
· Green tea extract. This ingredient is loaded with polyphenols, which fight free radicals. Free radicals can make your skin age faster.
· Alpha-lipoic acid. This natural chemical also attacks free radicals and helps erase fine lines and wrinkles.
· Retinol. This ingredient boosts the collagen your body creates, as well as improves skin tone and reduces fine lines, wrinkles, and mottled patches.
· Vitamin C. This can boost collagen in the skin, thus making wrinkles less visible. But vitamin C can be powerful in higher doses, so ask your dermatologist for the right cream for you.
· Caffeine. Doctors aren’t sure how well this can reverse the effects of aging, but studies show that it can help prevent the growth of skin cancer.
· Coenzyme Q-10. Sometimes listed as CoQ-10, this ingredient is naturally occurring in the body and goes after free radicals. It’s especially helpful for “crow’s feet” around the eyes.
· Alpha-hydroxy acids. Also known as AHAs, these include glycolic, citric, tartaric, and lactic acids. These show up in a variety of products, including peels and exfoliants. If you have dry skin, you’ll need to use a good moisturizer along with this ingredient.
· Salicylic acid. This is a great exfoliant for treating acne as well as smoothing the skin. Never use this if you are allergic to aspirin.
· Hyaluronic acid. Many consider this the “holy grail” of age-related skincare, as it plumps the skin and keeps it healthier. It’s found naturally in the body, in skin, connective tissue, and the fluid in your joints. Combine it with vitamin C products for a strong skincare boost.
How to Take Care of Aging Skin
When you’re in your 40s, you can expect to start seeing major changes in your skin, especially in the firmness of it. This is when the sun damage from years earlier starts to surface, and it can leave you with sagging skin or a mottled appearance.
This is when lifestyle adjustments come into play. Just as you might opt for medical alert technology to assist you if you encounter some sort of emergency, begin eating more fruits and vegetables to help maintain a healthy weight, or stop smoking to better your overall health, you’ll want to change up what’s in your bathroom cabinet for your skincare routine. Here’s what Real Simple recommends for at-home skincare.
Start with a gentle exfoliating cleanser for improving cell turnover and a mild cleanser for hydration. This is when hyaluronic acid comes into play, for use both day and night, as well as a powerful night cream.
Most women go through menopause in their 50s, and that can wreak havoc on the body in every way, including the skin. The hormone shift can mean lower levels of estrogen, which can lead to thinner, less elastic skin. Dryness can become quite serious, and acne can pop up, even if you haven’t had it since you were a teenager. Pigmentation problems, as well as signs of sun damage, become clearer.
At this point, you might want to drop the exfoliant altogether, as it can be too rough for thinner skin. Use a mild cleanser, perhaps one with salicylic acid, that can get into the pores and clean them well without abrasion.
Up to this point, most of the changes in your skin have been noticeable on your face, but now you’ll start seeing them elsewhere as well. This is when itchy skin takes center stage, as well as the “liver spots” and other imperfections that become more prominent. The best thing you can do for your skin – and yourself – is staying hydrated and dropping any bad habits that might be affecting your skin, like smoking.
When you reach your 60s and beyond, your skincare should become very simple. The big goal is hydration to prevent that awful itching that you can feel when your skin becomes too dry. Moisture retention becomes more difficult as we age, so it’s important to look for skin products that pack a serious punch of hydration, such as those with hyaluronic acid, and use them frequently. Keep a good lotion at your bedside table, next to your favorite chair, and at other places around the house to encourage you to remember to use it. Drink plenty of water, too.
A Note for Caregivers: How to Care for Elderly Skin
Taking care of the skin while caregiving for seniors, particularly if that person is bedridden, becomes more important than ever. Pressure on thinning skin can easily lead to lesions that have trouble healing or bedsores that can seem to appear out of nowhere, even with proper turning and similar care. Besides that, the itching that is associated with the dryness of elderly skin can make someone very uncomfortable, to a point of decreasing their quality of life. Older individuals might develop psoriasis, eczema, infections, and pruritus, all of which can be associated with dry skin and itching.
As a caregiver for the elderly, it’s important to take a good look at the skin on at least a daily basis. Ask about any areas of concern or spots that itch, hurt, or otherwise just feel “odd.” Keep in mind that things like pruritus can be connected to anemia, kidney disease, or diabetes, so it’s important to mention it to the doctor to have the proper tests run for things that might be developing within the body.
Look for emollients for the skin, which are often prescribed in the form of lotions, sprays, or creams. These help the body retain moisture and can work well for skin that is struggling to keep hydration. It might also be coupled with steroids, especially for those with eczema and similar skin conditions.
Be very careful when moving someone who is bedridden, as simply sliding across the sheets can cause abrasions. Any tape or dressings over a wound should be removed with the utmost care, as pulling them too hard or fast can result in serious skin trauma that can bruise easily and take a very long time to heal. Remember that those wounds can open up the body to infections, which can be tough to fight with an elderly immune system[6].
Just as you make sure your elderly loved one is safe with the best medical alert systems that can summon help at any time around the clock, you pay attention to the little things, too. Skincare for the elderly is a vitally important part of maintaining good health. The right time and attention – as well as the right skincare products – can contribute to keeping someone healthy and comfortable well into their golden years.