Download older person skin care pathway

OLDER PERSON SKIN CARE PATHWAY
Aim: The aim of this pathway is to provide guidance on the appropriate management of the skin in older people. Adequate skin care is a major strategy for maintaining the skin barrier,
skin integrity and skin health. For some people the use of routine leave on emollients (creams or ointments) will be adequate however this pathway provides guidance on skin that is at
risk of further drying and dehydration. Untreated dry skin may become irritated and result in rashes, eczema, cellulitis and secondary bacterial infection.
Ageing skin
Skin becomes thinner and more
translucent. An increase in pigmented
spots in sun exposed areas is common.
Dry
Skin that is leathery in appearance is a
sign of reduced elasticity. Skin bruises
more easily
A decrease in the sweat gland activity
reduces the amount of oil present in the
skin which leads to dryness
2. Apply a leave on emollient such as o
Zeroderm ointment or Zerobase
cream. If this is not effective consider
Hydromol ointment, Cetraben cream
or Doublebase gel . Apply 3-4 x a day
3. If the skin is very dehydrated then
apply a Urea based leave on emollient
- Balneum cream. Apply ONCE a day
I
Ageing skin
Dehydrated,
very dry.
1.Use a soap substitute / wash, bath
or shower emollient such as
Zerolatum bath additive, Zeroderm
Ointment or Aqueous cream (Hospital
only)
Very dry dehyrated skin
Skin that is not hydrated can develop
fissures and crack s and become very
painful.
Itchy skin
Dry skin is a common cause of itching in
older people
1.Use a soap substitute / wash, bath or
shower emollient such as Zerolatum,
Zeroderm Ointment or Aqueous cream
(Hospital only)
2. Apply a Urea based leave on
emollient - Balneum cream ONCE a
day. Avoid using on broken / cracked
skin as it can cause stinging
3.Apply a leave on emollient such as
Zeroderm cream or ointment,
Hydromol or Doublebase gel 3-4 times
daily
4.Use Balneum Plus cream TWICE
daily for itchy skin
Good Practice
 Use Ointments rather than
bland creams for dry skin as
they keep the skin moist for
longer
 Avoid over use of harsh soaps
or chemicals as this removes
the oil from the skin
 Zeroderm and Hydromol can
be used as soap substitutes as
well as emollients so you may
not require a bath additive as
well.
 Aqueous cream is to be used
as a soap substitute only.
 Refer to the Emollient formulary
fact sheet regarding suitable
quantities/expiry dates
 Apply emollients in the direction
of the hair line to avoid
increased risk of infection
 Warm water Is less drying than
hot water
References:
Wounds UK (2012) Best Practice Statement: Care of the Older Persons Skin (2nd Edition) Wounds UK London
Kotter J, Lichterfeld A, Blume-Peytav iU (2013) Maintaining skin integrity in the aged: a systematic review. British Journal
of Dermatology (169)
Moncrief G et al (2013) Use of emollients in dry skin conditions: consensus statement. Clinical and Experimental
Dermatology Vol 38 No 3. Wiley Blackwell
KCCG (2014) Medicines optimisation formulary factsheet prescribing emollients.
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