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Skin health is essential for well being in older people. Personal hygiene is fundamental to skin health, but a lack of evidence exists about effective practices. An evidence base, disseminated through nursing education and patient health promotion, must be developed.
Skin health is essential to the well being of older people but evidence indicates a significant number of people experience troublesome cutaneous symptoms. Skin breakdown can have a detrimental impact on quality of life and may be costly (Gardiner et al., 2008). As skin ages, it undergoes intrinsic and extrinsic changes that make it more vulnerable to damage. Personal hygiene practices are an important part of preserving or improving skin health, specifically the integrity of the skin barrier. Many older people manage their own personal hygiene while others need varying degrees of support from health and social care staff. In this article, skin aging and common skin problems observed in older people are outlined. Current evidence on personal hygiene practices is examined and significant gaps in current knowledge identified. The need for the evidence to be strengthened and used as a basis for nursing education and patient health promotion is demonstrated
Skin Aging
As skin ages, it undergoes numerous progressive and degenerative changes both intrinsic and extrinsic (Farage, Miller, Beradesca, & Maibach, 2009; Ronda & Falce, 2002). Intrinsic skin aging is the programmed, true biological changes (Lawton, 2007) (see Table 1).
Extrinsic aging is concerned with additional factors such as damage from exposure to the environment (Lawton, 2007), in particular the sun (ultraviolet exposure). Other factors that may affect skin health in older people include reduced peripheral sensation, reduced mobility, incontinence, depression and dementia, polypharmacy, diabetes and vascular changes, and poor nutrition (Finch, 2003). The cumulative effect of the aging process is that the skin becomes a less effective barrier, risk of infection increases, and wound healing is delayed (Lawton, 2007). These chang - es make skin significantly more vulnerable to damage (Baranoski & Ayello, 2012) and consequent problems of breakdown.
Prevalence of Common Skin Disorders in Older People
Anecdotal evidence based on clinical observation indicates skin problems are extremely common in older people (Levell, 2008; Wheeler, 2009). However, few epidemiologic studies have provided accurate data about prevalence. Of those, each has different methodologies...