Skin Problems

Seborrheic Dermatitis 

The cause of this long-lasting skin condition is not fully known, and there is no cure. It can cause:

• Dandruff on the scalp, hair, eyebrows, and beard or mustache
• Greasy patches of skin with flaky white or yellow scales on the scalp, face, chest, armpits, groin, or under the breasts
• Rashes that vary by skin color. They may be ring-shaped. On brown or black skin, rashes may be darker or lighter than the normal skin tone. On light skin, rashes are usually red.
• Itching (also called pruritus)

Rosacea

Rosacea is a common skin condition, especially in people with light skin. Symptoms include:

• Red skin
• Facial flushing (sudden redness)
• Red pus-filled sores
• Thickening skin
• A large red nose
• Eye irritation

Dry Skin (Xerosis)

Dry skin is common in older adults because the skin does not hold moisture as well as it used to. This can make skin conditions worse.

Neurodermatitis

Neurodermatitis is long-lasting itching with no known cause. This type is most common in people age 60 and older. Scratching can start a cycle where the skin changes and itches even more. A doctor must rule out other causes before making this diagnosis.

Intertrigo

This is skin irritation that happens when skin rubs against skin. The skin may look red, white and wrinkled, or raw with a bad smell. It often happens around the breasts, belly, and groin.

It is more likely in people who do not move around much, have a larger body size, have poor hygiene, or have a weak immune system.

Bullous Pemphigoid

This is the most common autoimmune blistering disease. It can lead to infections. It usually appears when a person is in their 80s.This condition can come and go.

• The most common symptom is itching, along with widespread clear blisters. The inside of the mouth and other mucous membranes are affected in about one-third of cases.
• This condition may be linked to brain or mental health conditions (like stroke or dementia) or the medicines used to treat them. 
• Other medicines, including some for pain, fluid retention, or infection, can also cause it.

Pruritus

Long-lasting itching (chronic pruritus) is common in older adults and can lower their quality of life. Dry skin is the most common cause, but there can be others.

A doctor needs to do a full evaluation to find the cause. For example, itching can sometimes be a sign of cancer.

Psoriasis

Psoriasis is long-lasting skin inflammation. It causes red, scaly skin patches. It can also affect the scalp, nails, skin folds, palms, and soles of the feet.

Stasis Dermatitis

Stasis dermatitis is a skin condition of the lower legs that causes inflammation, redness, swelling, and itching, mostly around the ankles.

Herpes Zoster

Herpes zoster, or shingles, happens when the chickenpox virus becomes active again in the body. It is most common in older adults. Shingles starts with pain, itching, tingling, tenderness, or sensitivity of the skin. This is followed by painful blisters.

Scabies

Scabies is a very itchy and contagious disease caused by a tiny mite. It often affects the hands, feet, genitals, breasts, and wrists. It can cause serious itching and infection.

Seborrheic Keratoses

Seborrheic keratoses are very common skin growths in adults age 40 and older. They may be tan, yellow, gray, black, or skin-colored, with a waxy or wart-like look. They can appear anywhere on the body except on mucous membranes, palms, and soles of feet.

Some of these growths can be dark. Without testing, it can be hard to tell them apart from melanoma (a type of skin cancer).

Vascular (blood vessel) Overgrowths

• Cherry angiomas are the most common blood vessel skin condition. They look like round or oval, bright red, dome-shaped spots up to a few millimeters wide. They are not harmful, but they can bleed if disturbed. They are only removed if they cause problems.
• Venous lakes is another common vascular skin condition in older adults. These are dark purple, soft, round or oval spots. They often appear on the ear or lip.

Actinic Keratoses

Actinic keratoses are pre-cancerous skin growths caused by long-term sun or ultraviolet (UV) exposure. They are rough and itchy, with white, yellow, or brown scaling.

They are more common in people with light skin and appear most often on sun-exposed areas like the face, neck, and arms. These growths often appear before a cancer called squamous cell carcinoma. 

Skin cancer is the most common type of cancer. The risk goes up with age, especially for people with light skin. But people with darker skin can also get it.

Although skin cancer often appears where the sun hits most, it can show up anywhere, including areas that rarely see sunlight or that are hard to see.

Older adults should check their skin once a month and use sun protection, including sunscreen and protective clothing.

Basal Cell Carcinoma

Basal cell carcinoma is the most common cancer in the United States. It may spread nearby but rarely spreads to other parts of the body. There are four types:

• Nodular: looks like a waxy, solid bump with small blood vessels.
• Morpheaform: looks like a scar.
• Superficial: looks like a red bump or flat growth with scales or raw patches, often with red veins around it.
• Pigmented: looks like a colored bump or flat growth. It can be mistaken for melanoma.

Squamous Cell Carcinoma

Squamous cell carcinoma is the second most common skin cancer. It often looks like a red, irregular bump or flat growth with scales. These cancers can spread into nearby tissue. They are more likely to spread to other parts of the body than basal cell cancers, especially when they appear on the lip or ear.

Melanoma

Melanomas are cancer cells that start in the skin cells that make pigment (color). They spread to other parts of the body more often than basal cell and squamous cell cancers. People with Parkinson's disease have a higher risk of melanoma.

There are 4 main types of melanoma:

• Lentigo maligna: an irregularly shaped or colored tan or brown flat growth that grows slowly.
• Superficial spreading: an irregularly shaped growth or bump with mixed colors that spreads outward before growing deeper.
• Nodular: a growth that grows fast and deep. It is often brown, black, or gray, but can be red or skin-colored.
• Acral lentiginous: a dark brown or black patch on the palms, soles, or nail beds. People with darker skin tones have a higher risk of this type.

Hair loss is common in older adults. Hair loss (alopecia) can be scarring or non-scarring.

Scarring Alopecia

In early stages, there may be redness, infection, itching, burning, or pain. This type of hair loss destroys hair follicles. Hair is unlikely to grow back.

• Frontal fibrosing alopecia attacks the hairline and eyebrows in women around menopause. Over time, eyebrows and the entire front hairline can be lost. The cause is not known. Treatment may include steroids or medicines that suppress the immune system.
• Traction alopecia happens when hairstyles pull hair tightly, like tight braids or ponytails. Hair is lost along the hairline where it is pulled. Hair regrowth is unlikely. It is important to stop tight hairstyles to prevent more loss.
• Erosive pustular dermatosis involves ongoing infected bumps on sun-damaged scalp. The cause is unknown and it is hard to treat.

Nonscarring Alopecia

Normal aging causes hair to go gray and become less thick. 

• Androgenetic alopecia (also called pattern baldness) affects men at the top and sides of the head. In women, it more often affects the top of the scalp.
• Telogen effluvium is another common type of non-scarring hair loss. It can happen quickly or after a stressor like surgery or illness. It is more common in older adults and can be linked to poor nutrition or chronic illness.

Older adults need to know about common and potentially life-threatening skin reactions to certain medicines. Stopping the medicine right away, getting emergency treatment, and possibly going to a hospital or specialist are critical steps for severe reactions.

Non-Life-Threatening Drug Eruptions (Rashes)

Local drug rashes are often caused by contact with a skin (topical) medicine. Various rashes can happen in response to:

• Antibiotic ointments and essential oils
• A topical or oral medicine, combined with sun exposure. Some medicines that can cause this include water pills (diuretics), some antibiotics, and methotrexate. Some chemical sunscreens and pain medicines can also cause sun-related rashes. People taking these medicines should use strong sun protection.

Medicine-related skin diseases include:

• Drug-induced subacute cutaneous lupus erythematosus is an autoimmune disease that causes rashes triggered by sun exposure. Rashes may be ring-shaped or scaly. Medicines like proton pump inhibitors and blood pressure drugs can cause this. It goes away when the medicine is stopped.
• Acneiform drug rashes look like acne. Lithium, steroids, and other drugs can cause them. If the person must keep taking the medicine, antibiotics can treat the rash. Otherwise, the person may need to stop the medicine.
• Urticarial and serum-sickness-like drug rashes involve hives and other symptoms that start within hours or up to a few weeks after taking a medicine. Stopping the medicine may be needed, or symptoms can be controlled with antihistamines or steroids.

Life-Threatening Drug Eruptions (Rashes)

Some drug rashes are life-threatening and need emergency care. These include:

• Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe blistering rashes that cause skin and other surfaces to peel away from the body. People with these symptoms need emergency care and transfer to a burn center.
• Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe medicine reaction with widespread rashes. Other symptoms include fever, facial swelling, and swollen lymph nodes. 
• Angioedema is deep swelling under the skin, similar to hives. Swelling can happen on the face, lips, tongue, throat, genitals, and gut. Swelling in the airway is life-threatening. .