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Xerosis
(Dry Skin)
Dry skin is a common cause of pruritus in the elderly. Symptoms are often worst in the winter, when central heating decreases humidity indoors and skin is exposed to cold and wind outdoors.
The skin is scaly, especially over the lower legs, forearms, and hands. The stratum corneum epidermidis may be compromised by fissures or excoriations, allowing environmental irritants to penetrate the skin and progressively worsen the condition, adding inflammation to dryness. This complication of xerosis is called erythema craquele or asteatotic eczema.
Treatment: Patients should be advised to keep the air in their home as humid as possible. They should bathe only once a day and avoid using strong soaps, rubbing alcohol, detergents, and other drying agents whenever possible. Patients should also avoid placing potentially irritating materials (such as wool) next to the skin.
Emollients should be applied frequently and liberally, especially after bathing when the skin is still moist. Many lubricating agents are available, ranging from cosmetically elegant lotions to greasy ointments. White petrolatum (petroleum jelly) is an inexpensive and effective lubricant. Creams containing urea or lactic acid help remove scale, keep the skin hydrated, and prevent symptoms. Patients should avoid scented moisturizers because the perfume may irritate dry skin.
A low-potency topical corticosteroid ointment, such as 1% or 2.5% hydrocortisone, is useful in treating inflamed dry skin (see TABLE 101-3). It should be applied to affected areas after a bath or shower and at bedtime. Prolonged use should be discouraged because of systemic absorption.
Xerosis
(Dry Skin)
Dry skin is a common cause of pruritus in the elderly. Symptoms are often worst in the winter, when central heating decreases humidity indoors and skin is exposed to cold and wind outdoors.
The skin is scaly, especially over the lower legs, forearms, and hands. The stratum corneum epidermidis may be compromised by fissures or excoriations, allowing environmental irritants to penetrate the skin and progressively worsen the condition, adding inflammation to dryness. This complication of xerosis is called erythema craquele or asteatotic eczema.
Treatment: Patients should be advised to keep the air in their home as humid as possible. They should bathe only once a day and avoid using strong soaps, rubbing alcohol, detergents, and other drying agents whenever possible. Patients should also avoid placing potentially irritating materials (such as wool) next to the skin.
Emollients should be applied frequently and liberally, especially after bathing when the skin is still moist. Many lubricating agents are available, ranging from cosmetically elegant lotions to greasy ointments. White petrolatum (petroleum jelly) is an inexpensive and effective lubricant. Creams containing urea or lactic acid help remove scale, keep the skin hydrated, and prevent symptoms. Patients should avoid scented moisturizers because the perfume may irritate dry skin.
A low-potency topical corticosteroid ointment, such as 1% or 2.5% hydrocortisone, is useful in treating inflamed dry skin (see TABLE 101-3). It should be applied to affected areas after a bath or shower and at bedtime. Prolonged use should be discouraged because of systemic absorption.

Tags: Xerosis

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