DRY SKIN AND CHRONIC ITCH

The more skin ages the drier it becomes, a change felt as roughness, as the feeling that the skin is covered with fine scales and as an itch which appears mainly in cold, dry  weather.  The skin becomes dry because aging skin holds less water than young skin.

Dry skin is the most common cause of itching in older people, but there are other reasons: sensitivity to dyes in clothing, to wool, to household cleaners and to cosmetics.  Various skin diseases such as scabies or internal diseases such as hyperthyroidism, diabetes, renal insufficiency or insufficiency of the liver can all cause generalized itching.  A small percentage of people over 70 suffer from generalized itching not linked to any specific cause.

TREATMENT:

In mild cases of dry skin, it is sufficient to apply a moisturizer on the entire body surface after bathing.  It is important to do this while the skin is still damp.  Using bath oil or an superfatted liquid soap will also prevent the loss of moisture from the skin and make it look younger and healthier.  In cold weather it is enough to soap only those areas which perspire (the armpits, the groin and between the toes); on the rest of the body a soap substitute, which does is less irritating and does not dry the skin, can be used.  Most heaters, especially air-conditioners which are also heating units, dry the air and the skin, and the use of a humidifier should be considered.  A bowl of water may also be placed near the heat source; this too will increase the humidity in the air.  If the skin still remains dry, a dermatologist should be consulted to rule out the possibility of a skin disease or of an internal disease which can sometimes cause dry, itching skin.

INFECTIONS AT THE CORNERS OF THE MOUTH

Redness and a white discharge at the corners of the mouth are a common occurrence in older people.  The main causes of this condition are a change in the structure of the mouth as a result of the loss of teeth and the sagging of the cheek muscles. 

A fungus infection called Candidiasis can grow in the moisture which accumulates in the wrinkles at the corners of the mouth.  It causes redness, a discharge and itching.  The infection is worsened by over-salivation, taking broad spectrum antibiotics, and B vitamin and iron deficiencies.

TREATMENT

The first stage is assuring dental treatment which will remove the fundamental cause of the infection, and giving vitamin and iron supplements if necessary.  Anti-fungal and anti-bacterial medications containing steroids should be applied to the skin.  Once the infection has disappeared, a fat-based ointment should continue to be applied to the corners of the mouth.

ACNE ROSACEA

Acne rosacea is a disease appearing in people over fifty years of age and characterized by redness, dilation of the blood vessels and lesions resembling adolescent acne.  It appears primarily on the cheeks, nose and forehead.  Some patients, especially men, develop enlarged sebaceous glands on the nose (rhinophyma) and dermatitis of the eyelids.  The exact cause of acne rosacea is unknown, but it is thought that at least some of the symptoms are caused by a parasite called Demodex folliculorum.  Hot beverages, spicy food, alcoholic beverages and exposure to the sun are all recognized as factors which can worsen the disease.

TREATMENT

The most effective treatment is the administration of antibiotics belonging to the tetracycline family.  Lotions or creams containing erythromycin or clindamycin can also be prescribed.  Dilated capillaries can be treated either with an electric cauterizing needle or a laser beam.

SUBCUTANEOUS HEMORRHAGES

In older people, small bruises on the arms and legs can cause the appearance of red marks which quickly become brown and purple.  These marks are subcutaneous hemorrhages which occur more easily in older people as a result of thinning of the skin.  An additional cause is the damage done to the connective tissue supporting the blood vessels of the skin by cumulative exposure to the sun during the person’s life.  In some cases these marks can be caused by problems in the patient’s blood-clotting mechanism or by the long-term use of drugs.

TREATMENT

Since the skin is thin and delicate, it should be protected by long sleeves and pants and by the regular use of fat-based creams and ointments.