Dry skin in the elderly: Complexities of a common problem

Dry skin, or xerosis, is a common skin condition in older adults, but it is not a normal part of aging. The geriatric patient may have several incurable, but treatable, chronic diseases that affect their skin. Xerosis in older adults is multifactorial: intrinsic changes in keratinization and lipid content, use of diuretics and similar medications, and overuse of heaters or air conditioners all contribute. Xerosis causes pruritus, which then leads to excoriations and risk of skin infections. Patients can minimize the effect of xerosis by increasing the ambient humidity, modifying their bathing technique and products, and using emollients to replace the lipid components of the skin. Care should be made to avoid skin sensitizers, such as lanolin, aloe vera, and parabens, that are commonly found in emollients. These may lead to a delayed hypersensitivity reaction. This contribution reviews the intrinsic and extrinsic aging processes of skin aging and advises practical changes in environment and emollient application that can be distributed to patients.