MANAGING ECZEMA IN THE ELDERLY

Aging is universal and unstoppable and as people age, their body's change resulting in a variety of health-related problems. One area where the change is most common and also visible is the skin. Eczema is a skin condition that affects people of all ages but is more common among the elderly.

What Is Eczema?

Eczema is a condition that causes dry scaly skin. The skin contains lipids, which are insoluble fatty compounds that surround the cells and enable water to be retained. This is what keeps the skin moist and soft. If the volume of lipids is reduced, the moisture that the skin needs is lost to evaporation and dry patches develop.

This causes irritation and itchiness. If nothing is done at this stage to control the problem, the skin soon becomes red and inflamed and develops cracks, all of which make it look unattractive. In some cases, fluid may start oozing from the skin.

There are different types of eczema. In the elderly the most common are:

• Asteatotic eczema: due to excessive dryness
• Stasis eczema: secondary to venous varicosities
• Sweat eczema
• Atopic eczema
• Eczema due to contact dermatitis: allergy to chemicals such as fertilizers, glue, hair dye, cosmetics
• Your doctor will be able to determine what type of eczema you may have and prescribe the right course of treatment.

The Causes

• There are numerous factors which, either on their own or in conjunction with others, can cause eczema. Among the most common are:
• A dry environment
• Dehydration
• Bathing in excessively hot water
• Excessive washing of the skin
• Using strong harsh soaps
• Improper diet
• Consuming drugs like statins that cause lipid levels to drop
• Medical conditions like hypothyroidism, asthma, renal failure and diabetes mellitus

Complications

• Besides the discomfort that eczema itself causes, it can also be the source of other medical problems. Among these are:
• Irritability and loss of sleep caused by the irritation and itchiness.
• Loss of sleep and other issues which affect the quality of life.
• Secondary infections arising from the condition, some of which may require hospitalization.
• If over 90% of the skin surface is affected by eczema, it is called erythroderma. This can cause nutrition loss due to the shedding of the skin scales and even cardiac and renal failure.
• Depression

Also Read:Fungal Infection – Types and Treatment

Prevention and Treatment

• Since eczema is caused by dryness of the skin, maintaining the right level of hydration is the best way to prevent it. The following steps can help to maintain the hydration levels of the skin:
• Do not bathe in excessively hot water. It may feel good to have a very hot bath, but the hot water dries out the skin by removing the natural oils that protect it. Lukewarm baths of a short duration are better for the skin.
• Do not keep indoor temperatures at high levels. The elderly often have trouble differentiating between a comfortable temperature and a hot one. Remaining in a hot environment can cause the skin to dry out. Additionally, areas of the skin where folds exist can collect perspiration which can also cause eczema.
• Applying a moisturizing cream or lotion all over the body at least once a day after a bath.
• Using a humidifier in the house to maintain humidity levels.
• Using gentle laundry detergent as some amount of this may remain on the clothes after washing and even traces of harsh soaps coming into contact with the skin can cause eczema.
• Avoiding the use of any makeup or skincare products which may cause adverse or allergic reactions. This will vary from person to person. If you suspect what is being used could be harming the skin, change to another product.
• Avoiding foods that cause eczema to flare up or result in allergic reactions. If allergic or skin conditions occur after eating any types of food, avoid them.
• If the skin problems are persistent or chronic, a dermatologist should be consulted without delay so that the appropriate courses of treatment can be started.

Article by Dr. Shwetha Rahul, M.D.DVL,
Consultant Dermatologist
Kauvery Hospital