Itchy skin in the elderly

Studies show that almost 4 in 10 elderly have problems with itchy skin. What causes itchy skin in the elderly, what consequences can it have, and how can it be alleviated?

This article is based on an interview with Professor of Dermatology, Torkil Menné.

Itchy skin is a very common problem among the elderly. The prevalence among people aged 65 or over is around 37%.1 Itchy skin among the elderly can be caused by, among other things, older people producing less filaggrin and their skin barrier being, therefore, less robust. Thus, a weakened skin barrier leads to inflammation of the epidermis. Inflammation inhibits the formation of certain proteins and amino acids in the skin, which results in dry and itchy skin.

Many elderly people have very dry skin, severe itching and so-called “fish scale” skin, which is dry and scaly skin on the legs and arms (also called ichthyosis vulgaris). This is typically because the epidermis and skin barrier weaken with age, leading to inflammation of the epidermis. However, chronically dry and itchy skin in the elderly can also be due to medications (e.g. opioids, penicillin, etc.) as well as chronic diseases such as Diabetes Mellitus, Psoriasis and impaired kidney function.1

Nocturnal itching can affect quality of life
Itchy skin can be very troublesome, and nocturnal itching especially can impact severely on quality of life because you wake up several times during the night and your sleep is impaired. One reason why itchy skin is particularly bothersome at night is that it may be possible to distract yourself from the itching during the day because you have other things to think about. If you are a light sleeper, itchy skin can wake you and it may be hard to fall asleep again.

Itching and quality of life

Chronic itching, defined as itching that is present for more than six weeks, can be disabling and significantly reduce quality of life.1

Treatment
Dry, scaly and itchy skin, which occurs because the elderly produce less filaggrin and therefore have a less robust skin barrier, can be treated with creams that increase the skin’s natural water-binding capacity. Strengthening the skin barrier can also be effective in treating skin itching, especially nocturnal itching.

Would you like to learn more?
If you would like to learn more about skin itching in the elderly you can delve into the scientific article listed for reference below.

Reference
  1. Fourzali, K.M., Yosipovitch, G. Management of Itch in the Elderly: A Review. Dermatol Ther (Heidelb) 9, 639–653 (2019)

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