The Physiological Effects of Ageing
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Nails become more brittle and develop beaded ridges due to a reduction in lipophilic sterols and fatty acids Helmdach et al, Box 3. Due to the cumulative effects of chronic sun exposure, the risk of skin cancers also increases with age. Cherry angiomas are cutaneous vascular proliferations commonly seen in older people, and typically appear as round-to-oval, bright red, dome-shaped papules and pinpoint macules, most commonly on the trunk or proximal extremities.
Initially described by Campbell de Morgan in , a cherry angioma is formed by numerous newly developed capillaries and prominent endothelial cells arranged in a lobular fashion in the papillary dermis Kim et al, Early lesions appear as flat, red macules that look like petechiae. As they develop, they become mm red papules. Cherry angiomas are usually asymptomatic but may bleed with trauma.
It is characterised by the recurrent formation of irregularly shaped, dark purple ecchymoses, about cm in diameter, often appearing on the forearms after a minor trauma Trozak et al, They do not undergo the colour changes of a normal bruise and take up to three weeks to resolve. Risk factors include chronic sunlight exposure and the use of oral or topical corticosteroids and anticoagulants. Senile purpura is caused by the thinning of dermal tissues and increase in the fragility of blood vessels.
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As a result, superficial vessels tear and rupture, even with negligible trauma. The subsequent leakage of blood into the surrounding dermis results in senile purpura. Although age-related skin problems are not usually life threatening, they can cause distress and decrease quality of life. Skin conditions that commonly affect older people are eczema, psoriasis, infections and pruritus Davies, , many of which are associated with dry skin and itching. Decreased sebaceous secretions, loss of oil glands and circulatory changes contribute to dry and scaly skin in the lower extremities, and skin becomes more susceptible to inflammation, infection and rashes.
Skin assessment and skin care are essential components of nursing care for older people. Skin assessment should be undertaken regularly and encompass detailed visual inspection and assessment of texture, moisture, turgor and temperature; personal skin hygiene should be encouraged Cowdell and Radley, Skin care should include the care of nails. Pruritus, a common complaint in older adults, may be caused by dryness, irritation or infection. It is also linked to diabetes, kidney disease and anaemia.
Emollients have a crucial role to play in skin health, especially for older people who have dry and itchy skin; these increase the amount of water held in the stratum corneum, either by drawing it from the dermis or by trapping it and preventing its evaporation. Many emollients — prescribed as ointments, creams, lotions or sprays — effectively alleviate skin dryness.
They are often used alongside other treatments, such as steroids, for conditions like psoriasis or eczema. Well-nourished and UV-protected skin exhibits remarkable resilience to intrinsic ageing Tobin, Skin tears, abrasions, lacerations and ulcers are often caused by friction, shearing force, pressure or moisture.
Simple manoeuvres, such as sliding patients across bed sheets or removing tape from skin, may result in significant skin trauma. As skin ages, it becomes thinner, more transparent and more easily bruised. Medications such as corticosteroids can make the skin even more fragile.
It is therefore particularly important to avoid applying tape other than soft silicone tape to hold dressings in place. Alternatives such as lightweight elasticated tubular bandages should be used to hold dressings in place on the arms and legs.
If hydrocolloid dressings are used, they should be removed with great care to avoid damaging the skin. In older people, the wound-healing ability of the skin diminishes and the immune system functions less vigorously. Often presentation of skin infection is initially non-specific, with acute disorientation, anorexia or weakness, and fever does not always occur Scheinfeld, These factors make it imperative that older patients are carefully monitored and receive early and correct treatment; for example, antibiotics or antiviral drugs should be started as soon as possible to reduce symptoms and shorten the duration of infection Laube, Baumann L Skin ageing and its treatment.
Journal of Pathology ; 2, Cerimele D et al Physiological changes in ageing skin. British Journal of Dermatology ; Suppl 35 : Cowdell F, Radley K Maintaining skin health in older people. Nursing Times ; 49, Davies A Management of dry skin conditions in older people. British Journal of Community Nursing ; 6, Farage MA et al Characteristics of the aging skin. Advances in Wound Care ; 2: 1, Flament F et al Effect of the sun on visible clinical signs of aging in Caucasian skin.
Clinical, Cosmetic and Investigational Dermatology ; 6: In: Burns T et al eds Rocks textbook of Dermatology , 7th edn. Oxford: Blackwell Science.
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Helmdach M et al Age and sex variation in lipid composition of human fingernail plates. Skin Pharmacology and Applied Skin Physiology ; 2, Kim J-H et al Cherry angiomas on the scalp. Case Reports in Dermatology ; 1: 1, Landau M Exogenous factors in skin aging. Current Problems in Dermatology ; Naidoo K, Birch-Machin MA Oxidative stress and ageing: the influence of environmental pollution, sunlight and diet on skin.
Nishimura EK et al Mechanisms of hair graying: incomplete melanocyte stem cell maintenance in the niche. Science ; , Patel T, Yosipovitch G The management of chronic pruritus in the elderly. Skin Therapy Letter ; 8, Pawlaczyk M et al Age-dependent biomechanical properties of the skin. Advances in Dermatology and Allergology ; 5, Maidenhead: Open University Press.
Rinnerthaler M et al Oxidative stress in aging human skin. Biomolecules ; 5: 2, Scheinfeld N Infections in the elderly. Dermatology Online Journal ; 3, 8. Tobin DJ Introduction to skin aging. Journal of Tissue Viability ; 1, Totowa, NJ: Humana Press. Vogel HG Age dependence of mechanical and biochemical properties of human skin. Part I: stress-strain experiments, skin thickness and biochemical analysis.
Bioengineering and the Skin ; 3: Skin Research and Technology ; 4, Wood JM et al Senile hair graying: H2O2-mediated oxidative stress affects human hair color by blunting methionine sulfoxide repair. New York: McGraw-Hill. Sign in or Register a new account to join the discussion. You are here: Older People Nurses. Anatomy and physiology of ageing the skin. Abstract The skin, the largest organ in the human body, performs important functions such as thermoregulation, storage and synthesis, sensation and protection.
Box 1. Source: Peter Lamb. Box 2. Box 3. Also in this series Anatomy and physiology of ageing 1: the cardiovascular system Anatomy and physiology of ageing 2: the respiratory system Anatomy and physiology of ageing 3: the digestive system Anatomy and physiology of ageing 4: the renal system Anatomy and physiology of ageing 5: the nervous system Anatomy and physiology of ageing 6: the eyes and ears Anatomy and physiology of ageing 7: the endocrine system Anatomy and physiology of ageing 8: the reproductive system Anatomy and physiology of ageing 9: the immune system Anatomy and physiology of ageing the musculoskeletal system.
Oxford: Blackwell Science Helmdach M et al Age and sex variation in lipid composition of human fingernail plates. Rigel DS et al Photoaging. Berlin: Springer Verlag. Related files. NT Contributor.
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As a result, your teeth and gums might become slightly more vulnerable to decay and infection. With age, your skin thins and becomes less elastic and more fragile, and fatty tissue just below the skin decreases. You might notice that you bruise more easily. Decreased production of natural oils might make your skin drier. Wrinkles, age spots and small growths called skin tags are more common. How your body burns calories metabolism slows down as you age. If you decrease activities as you age, but continue to eat the same as usual, you'll gain weight.
To maintain a healthy weight, stay active and eat healthy. With age, sexual needs and performance might change. Illness or medication might affect your ability to enjoy sex. For women, vaginal dryness can make sex uncomfortable. For men, impotence might become a concern. It might take longer to get an erection, and erections might not be as firm as they used to be.
You can't stop the aging process, but you can make choices that improve your ability to maintain an active life, to do the things you enjoy, and to spend time with loved ones. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.
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