BEST PRACTICES

Caring for aging skin: What patients need to know

3 factors to look for when choosing the right skin cleanser for elderly patients.

Elderly man smiling.

The largest organ of the human body is the skin, spanning up to 2 meters. It works hard to protect the body from environmental factors, but the skin’s protective power declines throughout the years. For you and the bedside nurses, this adds to the challenge of treating older patients. It’s important to choose—and to guide patients toward using—the right skin health products to properly treat delicate skin.

What happens to skin as it ages

As people age, skin goes through changes due to both external influences and normal internal processes. Aging skin is also weakened by a decrease in sebaceous gland activity, and the depletion and dehydration of lipids, which Medline Clinical Nurse Educator Ronald Krinn, BSN, BA, RN, CWOCN, defines as “the mortar that holds cells together.” External factors such as medications, comorbidities, smoking and environment can further contribute to skin breakdown, Krinn notes. This breakdown results in skin that is often dry, translucent and thin. In terms of skin health, this translates to a more fragile dermis, making it prone to pressure ulcers and skin tears. In turn, these wounds leave your patients open to potential infection.

Ronald Krinn, Medline Clinical Nurse Educator, BSN, BA, RN, CWOCN profile picture.“Age-related changes in tenacity and strength naturally occur in the skin due to the loss of collagen and important proteins that occur in the evolution process of new skin cells.”
Ronald Krinn, Medline Clinical Nurse Educator, BSN, BA, RN, CWOCN

Why clean skin is healthier skin

To decrease the risk of infection on fragile, older skin, Gail Dereczyk BSN, RN, CWOCN, Medline Clinical Nurse Educator, stresses the importance of “keeping the skin clean and free of bacteria that are not part of the normal flora.” Choosing the right cleanser for the job is the first step in caring for aging skin. Unfortunately, many traditional, over-the-counter soaps and skin cleansing products fall short. The wrong cleanser can also compound dryness and itching, strip the skin’s acid mantle and disturb the pH of the epidermis, further impairing skin. The right cleansing product for older skin aims to counteract these issues, helping to maintain skin moisture.

Kim Kehoe, BSN RN CWOCN DAPWCA, Clinical Education Specialist profile picture.“Harsh soaps and surfactants in cleansers can cause damage to skin proteins and lipids, inflammation and swelling of the stratum corneum, and altered lipid rigidity.”
Kim Kehoe, BSN RN CWOCN DAPWCA, Clinical Education Specialist

Top 3 qualities of a skin cleanser for older skin

Look for these characteristics when considering a cleanser for older patients at your facility.

  1. pH balanced
    While optimal skin pH is slightly acidic, aging skin tends to be more alkaline. “Many traditional soaps include amphiphilic cleaning agents that are highly alkaline and contain harsh detergents that can quickly dry out the skin and strip the skin of its acid mantle,” says Kim Kehoe, BSN RN CWOCN DAPWCA, Clinical Education Specialist. A pH-balanced cleanser can help bring back some of that acidity.
  2. Gentle
    Harsh soaps can “strip the skin of its natural oils and defense mechanisms,” Krinn remarks. This leads to tightness, dryness, barrier damage, irritation, pH disruption, increased water loss or dehydration of the skin, and itching, Kehoe says. Fragrances can also cause allergic reactions or sensitivities, so it’s good to choose a hypoallergenic cleanser.3 Particularly for patients requiring frequent cleansings, a no-rinse foaming cleanser like Remedy Phytoplex provides gentle care and soothing, unscented moisture support.
  3. Nourishing
    “Cleanser technology has come a long way from merely cleansing for the removal of sebum, soil, dirt and bacteria to providing mildness, moisture and now nourishment to the skin in addition to cleansing,” Kehoe explains.

Cleansers are just the beginning

The right cleanser for aging skin should be part of a comprehensive skin are system that includes nourishing treatments to protect skin and maintain moisture balance.