As the global population ages, skin disorders in geriatric individuals have become increasingly prevalent and a growing concern for healthcare providers. A published study from the Journal of the American Geriatrics Society (JAGS) reported that 75.7% of adults aged 70 and above experience at least one skin condition, while 39.1% of them have three or more concurrent skin conditions that necessitate treatment, either through self-care or under the supervision of a healthcare professional. Age-related changes in the skin, underlying health issues, and lifestyle factors contribute to this heightened vulnerability, making it essential to develop targeted approaches for prevention and management.
Functional medicine offers a comprehensive and holistic approach to addressing these issues, emphasizing prevention, early detection, and personalized treatment plans that consider each patient's unique needs and circumstances. By focusing on the root causes and employing integrative therapies, functional medicine aims to promote long-term skin health and overall wellness in the geriatric population.
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What are Skin Disorders?
Skin disorders encompass a wide range of conditions affecting the skin's appearance, texture, and function, impacting a person's overall well-being and self-esteem. They can be acute, chronic, or recurrent and may result from genetic predisposition, environmental factors, or underlying health issues. As we age, skin loses elasticity, becomes thinner, and heals slower, making it more susceptible to various skin disorders. Additionally, the cumulative effects of sun exposure, pollution, and lifestyle habits over time can further exacerbate the risk of developing these conditions, highlighting the importance of prevention and proper skin care throughout our lives.
Most Common Skin Disorders in Gerontology
Some skin disorders are more common in individuals as they age. Below are the tops skin disorders in the geriatric population:
Dermatitis in the Geriatric Population
Dermatitis is inflammation of the skin that often results from allergies, irritants, or underlying health conditions. In geriatric individuals, age-related changes in the skin can make it more susceptible to dermatitis, leading to discomfort and potential complications. Examples include seborrheic dermatitis, a common, non-contagious skin condition causing red, scaly patches and dandruff, and stasis dermatitis, a circulation-related condition that causes swelling, redness, and sometimes itching or pain in the lower legs due to poor blood flow and fluid buildup.
Itchy Skin (Pruritus) in the Geriatric Population
Pruritus is characterized by intense itching, which may be a symptom of other skin conditions or systemic diseases. In the geriatric population, dry and thinning skin can exacerbate pruritus, affecting the overall quality of life. Examples of common conditions that cause itching include fungal infections.
Bedsores (Pressure Ulcers) in the Geriatric Population
Pressure ulcers are skin sores that develop due to sustained pressure on a specific area, often in bedridden or wheelchair-bound individuals. Older adults with limited mobility are at a higher risk of developing pressure ulcers (bedsores), which can lead to serious complications if untreated.
Age Spots in the Geriatric Population
Age spots, which are also known as liver spots or solar lentigines, are flat, brown, gray, or black spots that develop on the skin due to long-term sun exposure and natural aging. In geriatric individuals, the accumulation of sun exposure over the years and the skin's reduced ability to repair itself can lead to the formation of age spots. These spots are generally harmless but can affect one's appearance and may sometimes be mistaken for more serious skin conditions, such as skin cancer.
Shingles (Herpes Zoster) in the Geriatric Population
Shingles is a very painful rash caused by the reactivation of the varicella-zoster virus (chickenpox virus) in older adults. Shingles risk increases with age, and the condition can cause significant pain and complications, including postherpetic neuralgia (long-lasting pain that can occur after a shingles outbreak).
Possible Causes of Skin Disorders in Geriatric Population
Age-Related Changes in Geriatric Skin
As people age, their skin becomes thinner, less elastic, and produces less oil while also experiencing slower healing. These age-related changes can make geriatric individuals more prone to various skin disorders and complications.
Sun Exposure in the Geriatric Population
Cumulative sun damage over the years can lead to skin cancer and other skin conditions in older adults. Geriatric individuals must be vigilant about sun protection to minimize further damage and related risks.
Medications and Geriatric Skin Health
Some medications can cause skin reactions, exacerbate existing conditions, or increase photosensitivity in geriatric individuals. Examples include some blood-thinning medications, antibiotics, and heart medications.
Underlying Health Conditions Affecting Geriatric Skin
Underlying health conditions, such as diabetes (which can cause poor circulation and reduced skin healing), kidney disease (leading to toxin buildup and dry, itchy skin), and autoimmune disorders (causing issues like skin eruptions and blistering), can contribute to skin problems in older adults by directly impacting skin health and function. Stress, another common factor, can exacerbate skin conditions, such as delaying wound healing and increasing the risk of infection through lowered immune system protection. The varicella-zoster virus (chickenpox) remains in the body for life. So exposure during childhood is the primary risk factor for developing the reactivation known as shingles.
Poor Nutrition and Geriatric Skin Health
Poor nutrition, characterized by inadequate intake of essential nutrients, can compromise skin health in geriatric individuals. Research shows that over time the body's ability to absorb nutrients decreases, leading to deficiencies in skin-protecting and promoting vitamins such as vitamins E, C, and zinc. Inadequate nutrition may also cause an imbalance in the gut's bacterial community, resulting in alterations to the skin. This imbalance, known as gut dysbiosis, can increase the gut's permeability, enabling bacterial substances to enter the bloodstream and stimulate immune cells. Consequently, this can cause widespread inflammation and oxidative stress, factors that can contribute to negative changes in the skin. Consuming foods that one is sensitive to can lead to a permeable gut (leaky gut).
Functional Medicine Labs to Test for Root Cause of Skin Disorders
Comprehensive Metabolic Panel (CMP) for Geriatric Skin Health
A CMP evaluates various markers, including kidney and liver function and glucose levels. This test can help identify underlying health conditions that may contribute to skin disorders in older adults, such as pruritus or pressure ulcers. Conditions like diabetes or kidney dysfunction can weaken the immune system and affect circulation, making older adults more susceptible to skin issues. Identifying and managing these conditions can help prevent or treat skin problems and improve overall skin health.
Nutrient Status Assessment for Geriatric Skin Health
Tests like the SpectraCell Micronutrient Test can assess nutrient status, identifying deficiencies that may impact skin health in geriatric individuals. Addressing these deficiencies through diet or supplementation can improve overall skin health. Optimal nutrient levels support skin repair and maintenance, therefore having the potential to improve all types of skin conditions, including dermatitis and pressure ulcers.
Food Sensitivity Testing for Geriatric Skin Health
The 96 IgA Food Sensitivity Panel is a food sensitivity test that can help detect food sensitivities that may be causing intestinal permeability (leaky gut) and contribute to dermatitis or other skin conditions in older adults. Certain foods can trigger immune responses that lead to inflammation and irritations. Identifying and eliminating trigger foods can alleviate symptoms, improve skin health, and reduce the risk of developing conditions like dermatitis.
Stress Hormone Testing for Geriatric Skin Health
Evaluating hormone levels through tests such as the Adrenal Stress Profile can help assess the impact of stress on skin health in geriatric individuals. Proper management of stress and hormone imbalances, such as cortisol, can contribute to healthier skin and overall well-being. Chronic stress and hormone imbalances can contribute to inflammation, reduced wound healing, and increased infection susceptibility - therefore having the potential to exacerbate any skin disorder and even be a cause of dermatitis and shingles.
Stool Testing for Geriatric Skin Health
Tests like the GI-MAP can evaluate gut health and detect imbalances in the gut microbiome that may affect skin health in geriatric individuals. Addressing these imbalances through dietary adjustments, probiotics, or other interventions can improve overall skin health and well-being. A healthy gut microbiome plays a role in immune function and inflammation regulation, which are crucial for maintaining general health, which includes healthy skin. By identifying and correcting imbalances in the gut microbiome, geriatric individuals can experience improved skin health and reduced risk of skin disorders such as dermatitis and related conditions.
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Conventional Treatment for Geriatric Skin Disorders
Conventional treatments for geriatric skin disorders may include topical medications, oral medications, or light therapy, depending on the specific condition and its severity. While these treatments can provide relief, they may not always address the root cause of the issue. Functional medicine practitioners aim to identify and treat the underlying causes to promote long-term skin health.
Complementary and Integrative Medicine For Skin Disorders
Integrative medicine practitioners use an individualized approach to treatment. Below are some of the most treatment methods to address dermatological conditions:
Gut Health Support for Geriatric Skin Health
A low-inflammatory Mediterranean diet is recommended for geriatric individuals to support skin health and manage various skin disorders. This diet emphasizes whole, unprocessed foods, such as fruits, vegetables, whole grains, lean proteins, and healthy fats, which provide essential nutrients and antioxidants for skin health and reduce inflammation. The anti-inflammatory nature of the Mediterranean diet may help alleviate symptoms associated with dermatitis and pruritus, while its nutrient-rich content can support skin repair mechanisms and overall health, potentially aiding in the healing process of pressure ulcers and other skin conditions. Furthermore, the diet's emphasis on immune-boosting foods can help lower the risk of shingles or minimize the severity of the condition.
Addressing Nutrient Deficiencies for Geriatric Skin Health
Supplementing with essential nutrients like vitamins A, C, and E, zinc, and omega-3 fatty acids can support skin health and healing in older adults. These nutrients help maintain skin structure, reduce inflammation, and support the immune system. By addressing nutrient deficiencies, the symptoms of dermatitis and pressure sores can be improved, while skin repair mechanisms can be enhanced, potentially improving skin healing for all conditions.
Omega-3 Fatty Acids for Geriatric Skin Health
Omega-3 fatty acids (frequently found in fish oil) have anti-inflammatory properties that can support skin health in older adults. Supplementing with omega-3s may alleviate symptoms related to inflammation-driven skin conditions. This is due to the fact that inflammation can exacerbate skin conditions like dermatitis and pruritus, so by reducing inflammation, omega-3 supplements can alleviate these symptoms. Additionally, omega-3s can aid in preventing or treating pressure ulcers by promoting wound healing.
Vitamin D for Geriatric Skin Health
Vitamin D, an essential nutrient, can support immune function and may help reduce inflammation associated with some skin disorders in geriatric individuals. By ensuring adequate vitamin D intake, general skin health and overall wellness can be improved. Specifically, adequate vitamin D levels can help reduce the risk of shingles or minimize the severity of the condition by keeping the immune system strong.
Probiotics for Geriatric Skin Health
Improving gut health in older adults through probiotics, prebiotics, and dietary changes can positively impact skin health by reducing inflammation and supporting immune function. A healthy gut can reduce inflammation and support the immune system, which in turn contributes to overall skin health and healing. Probiotics can help improve symptoms of dermatitis and support immune function, which may prevent or reduce the severity of shingles.
Topical Treatments for Geriatric Skin Health
Integrative medicine practitioners may recommend natural, evidence-based topical treatments, such as aloe vera, calendula, or tea tree oil, to alleviate symptoms and promote healing in geriatric skin conditions. Aloe vera, calendula, and tea tree oil have been shown to promote the healing of chronic wounds, such as pressure ulcers. For age spots its generally recommended to use a prescriptive treatment like bleaching creams (hydroquinone) retinoids (tretinoin) which can help gradually fade the spots over several months. The treatments might cause temporary itching, redness, burning or dryness.
Laser Treatments and Chemical Peels for Skin Health
Many skin disorders including age spots can be treated by a Dermatologist with lasers, chemical peels, cryotherapy, and microdermabrasion. Its important to consult with your dermatologist so they can individualize your treatment needs.
Acupuncture for Geriatric Skin Health
Acupuncture, a traditional Chinese medicine technique, may help alleviate itchiness and inflammation associated with some skin conditions in older adults. This alternative therapy can provide relief and support overall skin health. As acupuncture has been shown to be beneficial for pain conditions, this treatment might reduce pain associated with skin conditions such as shingles.
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Summary
Skin disorders are common among geriatric individuals, with various factors contributing to their development. Functional medicine offers a comprehensive approach to addressing these conditions by identifying and treating the root causes. Older adults can improve their skin health and overall well-being by optimizing nutrition, addressing nutrient deficiencies, supporting gut health, managing stress, and incorporating complementary therapies.