Introduction
Intrinsic and extrinsic aging factors of the skin are inevitable, making the geriatric phase one of the most crucial to care for the skin. Unlike the young skin that heals with minimal scarring, old skin is fragile considering that it loses elastin which enables the skin to stretch and heal without wrinkles. Therefore, effective senior skin care is integral since the expected changes, including ruptured blood vessels and thinning of the skin, could have detrimental health consequences (Lynch et al., 2022). Some early intervention and management of skin conditions are necessary to promote healthy aging skin (McGovern & Kuhn, 2021). Physicians can use various assessment methods to examine skin conditions in older adults, including the integumentary assessment that can help identify malignant lesions. Therefore, expected skin changes, skin assessment methods, common conditions, and ways to identify malignant lesions in older adults are discussed.
Expected Skin Changes in Older Adults
The skin is made up of tissues and membranes that facilitate its renewal. The dermis, epidermis, and subcutaneous fat layers play vital roles in skin recovery. For instance, the dermis contains collagen bundles that give the skin flexibility and strength, which enhances the skin’s thickness and rigidity (McGovern & Kuhn, 2021). However, with aging, the blood vessels of the dermis become fragile and prone to injuries (McGovern & Kuhn, 2021). The loss of elasticity reduces the reproduction of collagen and the replenishment of cells resulting in the thinning of the skin (Papadopoulos, 2020). Another skin aging change is paleness brought by the reduced number of cells containing melanocytes which give the skin its natural color. This reduction in cells producing melanin makes the skin more translucent or clearer, highlighting age spots.
The inner layer of the skin acts as a thermoregulatory agent. The subcutaneous layer of the skin consists of fat cells that act as a shock absorber and help conserve the body from heat. As people age, the subcutaneous layer thins such that it provides less insulation and padding to the skin (McGovern & Kuhn, 2021). This factor increases the risk of skin injuries and the ability to regulate body temperature due to the less natural insulation. In such cases, older adults may experience issues such as hypothermia during winter (McGovern & Kuhn, 2021). Therefore, as individuals advance in age, they may experience risks of skin injuries and the inability to maintain a constant body temperature.
Skin Assessment in Older Adults
Loss of firmness, elastic rebound, and wrinkles are examples of age-related changes to the skin. This factor indicates that skin assessment in older adults should be focused on examining the intrinsic and extrinsic changes in the skin (McGovern & Kuhn, 2021). Physical skin assessment is conducted by assessing the skin’s color, vascularity, thickness, edema, and lesions (Lynch et al., 2022). The physical assessment focuses on inspection and palpation of the skin, which provides age-related changes on the skin.
Physical assessment is often used in younger skin, considering that old skin may have intrinsic issues, including broken blood vessels that are difficult to observe using the physical examination (Lynch et al., 2022). Therefore special strategies such as the integumentary assessment strategy are used considering that it provides a detailed description of the status of the skin (McGovern & Kuhn, 2021). The system gathers information about the skin through various detailed steps, including interview questions that ensure that the patient provides information about their skin extensively before an assessment.
There are various precautions to take when assessing aging skin, including maintaining skin integrity. One strategy to maintain skin integrity is exerting less pressure when handling aging skin. The reason is that aging skin is vulnerable to stressors such as pressure which can cause injuries (Lynch et al., 2022). Using approved equipment to assess skin conditions such as edema is necessary to confirm the diagnosis and provide appropriate intervention (Lynch et al., 2022). Contamination is also an integral factor when examining the skin, considering that bacteria such as coccyx can have detrimental health consequences. Therefore, the integumentary assessment strategy is important in properly examining aging skin.
Common Skin Conditions in Older Adults
Skin changes in old age increase the prevalence of diseases. The most common skin conditions in the geriatric age group include eczema, psoriasis, alopecia, and skin malignancy. According to Papadopoulos (2021), eczema is the most common skin condition among the geriatric population. Eczema is a skin condition that causes itchy rashes, dryness, and skin inflammation. This disease is prevalent in old age, considering that the subcutaneous layer of the skin dries, resulting in this irritation (McGovern & Kuhn, 2021). Another common skin condition is psoriasis which causes the skin cells to multiply at an abnormal rate resulting in skin buildup in specific places, which can be in the form of red patches or scales. This skin disorder causes bumps in the skin, with a major trigger being the weakening of the immune system in the geriatric stage.
Alopecia is another skin condition that results in significant loss of hair. Like psoriasis, alopecia also occurs when the immune system weakens, attacking the hair follicles, which results in shedding. Alopecia is common and affects the face and the head, causing balding. About 6.2% of people over 65 years in America suffer from alopecia (Papadopoulos, 2020). This data indicates that this disease is prevalent among the geriatric population and has detrimental effects on skin health. Malignancy is another skin disorder that results in the abnormal growth of skin cells (Papadopoulos, 2020). It exhibits various symptoms, including painful lesions of irregular sizes and spots on the skin. These conditions have significant consequences on the skin, considering that some have irreversible damage.
How to Identify Malignant Lesions
Malignant melanoma is skin cancer with symptoms varying from abnormal lesions to bleeding of the skin. Melanoma is clinically identified using a biopsy test or personalized surveillance approaches, such as self-monitoring. A biopsy is a skin test whereby a small sample of skin tissue is removed for laboratory tests (Mayo Clinic, 2022). This examination determines whether the lesion is cancerous or not so that proper interventions can be employed. Another strategy is the physical examination, whereby the physician focuses on asking about the individual’s health history and recommending various self-evaluation practices to look for signs of melanoma (Mayo Clinic, 2022). All these strategies are viable in determining the presence of cancerous lesions in the skin.
Conclusion
Aging makes the skin susceptible to conditions due to the reduced production of melanin and fat cells. The common symptoms of aging skin include wrinkles, thin skin, and colored spots. Examples of skin conditions in old age include eczema, psoriasis, alopecia, and skin malignancy. These conditions are contributed by weakening the immune system, which causes the skin to be prone to various infections. These conditions are diagnosed using different strategies, including physical, integumentary, and biopsy tests. Physical and integumentary assessments examine the skin by identifying various disorders, such as changes in color or rashes. On the other hand, biopsy tests are conducted to determine complex skin conditions such as malignant lesions.
References
Lynch, B., Pageon, H., Le Blay, H., Brizion, S., Bastien, P., Bornschlögl, T., & Domanov, Y. (2022). A mechanistic view of the aging human skin through ex vivo layer-by-layer analysis of mechanics and microstructure of facial and mammary dermis. Scientific reports, 12(1), 1-14. Web.
Mayo Clinic. (2022). Melanoma. (Website). Web.
McGovern, M., & Kuhn, J. K. (2021). Skin assessment of the elderly client. Journal of Gerontological Nursing, 18(4), 39-43. Web.
Papadopoulos, I. (2020). Comparative study of dermatological diseases of the elderly in relation to the rest population. Clinical, Cosmetic and Investigational Dermatology, 13, 173. Web.