Dry skin or xerosis occurs due to a reduction in the skin’s natural protective oils, resulting in moisture escaping from the skin more easily, thus leaving it dry. This lack of moisture combined with a decrease in oil production from the sebaceous glands leaves skin dry, flaky and itchy. Normally, the body has a skin barrier that holds in moisture, but its effectiveness is dependent on the following layers functioning properly:
Where external or internal risk factors affect the skin barrier’s natural balance, it could lead to xerosis and the skin peeling away. These factors can be categorized as follows:
Every layer of the skin undergoes natural changes as we enter old age, and this means a reduction in new cell production capabilities for the stratum corneum layer. The skin replacement cycle usually takes around four weeks, but this time length may be doubled for members of the elderly population. Furthermore, this layer’s ability to hold onto skin moisture is also reduced, as this layer decreases in thickness by up to 50%, particularly in areas of the skin which have been regularly exposed to sunlight, such as the face, neck, back of the hands and outer arms. As for the dermis layer of skin, elastin and collagen fibers become thinner, meaning these fibers lose their elasticity, resulting in a slackening of the skin. In addition, sweat gland and sebaceous gland function is negatively affected by the ageing process, leading to some members of the elderly population suffering from extremely dry skin that is more prone to flaking and irritation.
Xerosis in the elderly is therefore quite common and often presents itself in the form of dry, flaky skin, or whole sections of skin peeling away or appear as scaly skin – similar to fish scale. This can affect the skin anywhere on the body, but is most pronounced on the arms and legs. The condition can occur in both women and men equally, showing that hormones are not the most important factor behind xerosis. Old age is the most likely cause for the reduction in subcutaneous fat production, meaning post-menopausal women are particularly at risk. That being said, frequent bathing in warm water and the use of high alkaline soap products can also damage the fat that provides protection for the skin barrier, making this another major cause of elderly xerosis. This is particularly the case during the cool season due to the lack of moisture in the air, causing the skin to lose its moisture, thereby leading to increased dryness and itchiness.
Treating xerosis requires the application of lotions that trap in moisture, reduce itchiness, improve the effectiveness of the skin barrier and decrease the amount of moisture lost through the skin. However, in cases of skin inflammation or bacterial infections as a result of scratching (causing pus-filled wounds), it is recommended that a doctor be consulted to provide advice on potential courses of treatment.