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Maintaining Skin Integrity in Older Patients

Like with any other human body organ, the skin begins to decline with age. A loss of skin resilience and tensile strength coupled with delays experienced in wound healing are all consequences of human aging. Maintaining the skin integrity of older persons is critical to their well-being as they are more prone to chronic medical illness and their topical manifestations.

Skin Changes That Occur With Aging

Skin changes occur as a result of various physical and chemical injuries in every individual’s lifetime. While exposures will vary, the following are the most common effects of aging on the skin:

  • The skin develops a more coarse texture
  • Slackness results as a consequence of loss of intrinsic elastic components
  • Epidermal thinning resulting in a more transparent skin
  • Increased fragility and susceptibility to bruising/wounding
  • Development of skin tumors (benign or malignant)
  • Loss of subcutaneous fat/bone/cartilage resulting in a sunken skin appearance
  • Increased creases and wrinkles

Why Does Skin Integrity Weaken With Aging?

With the onset of aging, human skin gradually loses its strength and elasticity. This is due to various internal and external factors. Extrinsic factors contributing to skin decline include poor diet and excessive exercise, persistently high-stress levels, sunlight exposure (photoaging), alcohol consumption, smoking, and harmful lifestyle choices. Intrinsic determinants of skin deterioration with age include human genetic programming and body physiology. 

Poor Diet and Excessive Exercise

Inadequate intake of vitamins and nutrients in the right proportions from food consumed is one of the key triggers of skin aging over time. Consuming junk food and artificially-sweetened drinks instead of diets rich in vegetables and fruits is associated with lower levels of protective antioxidants leaving the skin susceptible to rapid wear and a poor healing response. Moreover, while mild to moderate exercises are beneficial to the body, repeated strenuous exercise releases free radicals that are damaging to skin health.

Sunlight Exposure (Photoaging)

The light from the sun consists of ultraviolet radiation of various wavelengths. Prolonged ultraviolet exposure is associated with an insidious skin-damaging process known as photoaging. Ultraviolet radiation consists of three types UVA, UVB, and UVC with UVA being the most dangerous sub-type. UVA can penetrate deep into the skin stimulating abnormal enzyme/protein formation and destroying collagen fibers. The overall effect of UV exposure is weak and thinner skin.

Smoking and Alcohol Use

Cigarette use is associated with the release of free radicals which deplete the body’s supply of vitamin C. Vitamin C plays a critical role in new collagen formation in skin tissues and a deficiency of this vitamin will impair wound healing and accelerate skin aging.

Genetic Programming and Physiological Responses

Human skin cells can repair themselves if exposed to physical, chemical, or radiation injury. However, as individuals age, the body gradually loses its ability to overcome these stressors. At a subcellular level, the aging of genetic material (DNA aging) affects the formation of collagen, which is a key component of healthy skin. With the loss of repair regulatory mechanisms over time, the skin gradually loses its tensile strength, elasticity, and wound healing properties.

Strategies for Maintaining Skin Integrity in Older Patients

Having recognized the factors responsible for the loss of skin integrity with age, activities that limit or eliminate their effects on skin will prove to be beneficial to wound healing and overall skin health, especially in older individuals. Some key strategies useful in maintaining healthy skin in older persons are outlined below.

Healthy Diet

Dietary choices including foods rich in antioxidants will help older individuals maintain healthier skin. Examples of some foods with beneficial antioxidants include carrots, spinach, olive oil, walnuts, oats, tomatoes, berries, dark chocolate, peanuts, and pomegranates. These food types contain vitamins, bioflavonoids, and polyphenols that help to rapidly heal wounds, firm, tighten, and tone skin.

Moderate Exercise

Mild to moderate physical exercises are useful in boosting blood circulation to the skin, boosting the nutrient supply required for its repair and maintenance. Very strenuous physical exertion should be avoided by older persons due to its negative effect on their body’s antioxidant stores.

Avoiding Excessive Sunlight

Limiting daily exposure to the sun’s rays is another strategy for promoting skin wellness in older patients. Older patients should wear protective clothing, use sunscreen as appropriate, and avoid tanning. 

Lifestyle Modifications

Smoking and excessive alcohol intake by older persons should be avoided as much as possible. Adherence to these healthier lifestyle choices will significantly improve wound healing and skin health by eliminating harmful free radicals and boosting antioxidant levels.

Managing Stress and Improved Sleep

Stress reduction through engagement in relaxing mental and physical activities is beneficial to long term skin health. A major factor contributing to higher stress levels among older individuals is poor sleep. Health care practitioners can offer quality advice on sleep hygiene and other methods of limiting the damaging effects of stress, with aim of maintaining the integrity of their skin.