Why Skin Aged
Marcie Mom: In the video, Doctor Claudia pointed out the growth of anti-aging skin products and treatments such as botox, dysport and hyaluronic acid injections. Topics covered in the video include (i) the difference between intrinsic and extrinsic aging and (ii) the biology of aging skin. Dr Claudia explained in the video that cells age due to oxidative stress and also pollution, lifestyle (smoking, stress) and ultra-violet rays (exposure to sun).
Characteristics of Aged Skin
Dr Claudia, I’ve been hearing of more and more elderly getting eczema, and scratching till they bleed. I saw in your video that ageing skin is drier, due to less renewed cells and a higher trans-epidermal moisture loss. Aged skin, as you pointed out, is characterized by epidermal thinning, wrinkles, flattened dermal-epidermal junction and collagen fragmentation. There is also less nutrient transfer and reduced sensation.
For eczema in elderly, is the thinner and weaker skin making the skin more vulnerable to allergens, thus triggering skin rashes?
Dr Claudia: The aging skin process can certainly make older skin more vulnerable to disease, but it’s important not to confuse dehydrated skin with eczema. Aged skin can be both dehydrated and dry, which can decrease the barrier function and allow more irritants and allergens to penetrate. In the elderly, another form of eczema known as asteatotic dermatitis commonly occurs on the shins, hands and trunk. This looks like a dry riverbed – dry, cracked and polygonally fissured skin. This can be due to aging, dehydrated skin and malnutrition. Overuse of soap and water can also trigger this. There may be other factors at play, so it’s important to get a proper medical diagnosis.
Prescription Medicine leading to Chronic Eczema
An interesting factor in elderly eczema has to do with the medication regimen older people often take. Prescription medications including diuretics and calcium channel blockers (CCB) can lead to chronic eczema. In fact, a recent French study concluded that “the long-term use of CCB is a risk factor for chronic eczematous eruptions of the elderly.” Those deficient in vitamin B6 may also have an increased risk of developing dermatitis. Since our skin needs essential fatty acids, those whose diets do not contain enough healthy fats may suffer from dry skin as well.
Menopause and Eczema
Marcie Mom: Can you also explain how menopause affects the skin of older women? Does this make the skin more susceptible to eczema?
Dr Claudia: Hormones sometimes play a role in developing eczema. In pregnancy, one of the most common skin conditions is eczema, where the hormonal changes shift the body’s immunity and predispose it towards allergic reactions and eczema. Of course, not all women suffer from this. For more read this post I wrote on the topic.
Hormones and Dry Skin
The female menopause results in a marked decrease in many hormones, and this decline can happen of a number or years. The decrease in hormones like estrogen and progesterone can lead to dry and dehydrated skin, and uneven pigmentation. Since the epidermal barrier required proper moisture and lipid content, this can cause more sensitivity and enhanced penetration of irritants and allergens. A decrease in thyroid hormones can also lead to dry skin. So reduced levels or female hormones can lead to dry, itchy, flaky skin – but not necessarily eczema skin.
For more info on hormones and skin, check out this article I wrote here.
Modern Diet Changes and Eczema
MarcieMom: Aging skin and menopause are part of natural body growth (age) yet I kept having friends tell me they never knew of eczema starting at elderly till it happened to their parents! Is there such a phenomenon in the US and could it have anything to do with our diet? As you pointed out in your video, too many free radicals (unstable molecules) create oxidative stress that lead to wrinkles, hyper-pigmentation and inflammation.
Dr Claudia: See my answer to Q1!
Marcie Mom: Thanks Doctor Claudia, your explanation will certainly help clarify some questions for those with elderly family members with eczema.