Dry Skin Care in Older Adults

The aging process is relentless when it comes to our skin, especially during the double threat of winter: dry, heated indoor air and dry, cold outdoor air.

Our autumn has been such a damp and cool season and our heating system has been working overtime to keep us warm. At first, I thought I had developed a new health problem when my skin became so itchy and it wasn’t even winter yet. Dear hubby reminded me that the house had been drier earlier this year due to the heating system being turned on so much sooner.

Although I was relieved that my itchy dry skin was just “winter skin” and not a new health issue, I set out on a quest to find out how to relieve dry itchy winter skin and what to do to keep our aging skin hydrated year round.

How to Help Dry Skin in Older Adults?

The answers I found point to the importance of hydrating our bodies from both our inner and outer environments, including:

  • Showering or bathing in warm, not hot, water.
  • Using gentle cleansers without harsh ingredients or fragrances.
  • Applying moisturizer immediately after showering or bathing.
  • Applying topical antioxidant-enriched serums that may nourish our skin from the outside.
  • Applying sun screen and wearing materials that help block the sun’s rays.
  • Setting up humidifiers, plants, even an open container of water next to a radiator to help humidify our air.
  • Drinking water and eating water-filled fruits and vegetables, which help hydrate us from the inside.
  • Eating foods that contain essential fatty acids like salmon, avocados and nuts that may help moisturize the skin and keep our water inside our bodies.
  • Adding dietary prebiotics and probiotics to support our inner and outer microbiomes.
  • Limiting or eliminating sugar-laden and processed foods, which may accelerate our skin’s aging process.
  • At the end of the day, getting a good night’s sleep, which is vitally important for repairing the skin.

Is dry skin due to aging or from a medical condition?

It is important to have dry skin evaluated by your own doctor before changing your skin-care routine. Skin conditions like eczema can cause itchy dry skin and should be ruled out or diagnosed and treated before self treating dry skin associated with aging. Dry skin and other skin conditions may progress to more serious problems for older adults, including skin tears and infections, and should always be evaluated by your own medical professionals before treating dry skin symptoms on your own.

Diabetes and other illnesses such as kidney disease, thyroid problems, heat stroke and fungal infections, as well as certain medications including diuretics, may all cause or contribute to dry, itchy skin. It is important to talk to your doctor about your dry skin issues to rule out these or other health-related causes that may need medical treatment before you self treat your own dry skin.

What causes the skin to become drier as we age?

There are medical conditions that can cause dry skin as we age, but simply aging itself causes our skin to become drier. This is because of the many changes the skin goes through as we age. The skin is our body’s largest organ and is made up of three layers:

Epidermis

The epidermis is the outermost layer of our skin. One of the jobs of the epidermis is to create keratin, a protein that provides structure and protection, creating a sort of first line of defense and waterproofing against our external environment. As we age, the keratin is slower to renew and our first line defense barrier weakens.

Dermis

The second layer, the dermis, gives skin strength and support, through it’s mesh-like structure of collagen and elastin. The dermis contains many blood vessels in its dermal papillae, which bring nutrients to the epidermis. The dermis also contains sebaceous glands, which produce oils including sebum, that lubricate the skin. These oils also contribute to waterproofing to help keep the skin from drying out. As we age, the dermal papillae tend to flatten out, leaving us with fewer blood vessels to shuttle nutrients to and remove toxins from our skin.

Hypodermis (Subcutaneous)

The third, and thickest, layer of our skin is the hypodermis, also known as the subcutaneous layer. The hypodermis contains fat cells, which provide protection, insulation, and temperature regulation, among other important functions like storing nutrients and energy. As we age, this layer loses a lot of the fat, which contributes to wrinkling, thinning, and drying of the skin.

Skin Microbiome

Sitting atop these three layers, and also to some degree throughout these layers, is the skin’s microbiome, the collection of bacteria and fungi and other microbes that live on and within our skin.

Similar to the gut microbiome, the skin’s microbiome …

“… aids in wound healing, limits exposure to allergens and UV radiation, minimizes oxidative damage, and keeps the skin plump and moist.”
Dr. Kara Fitzgerald, ND “Your Skin Microbiome: Why It’s Essential for a Healthy Glow” Mindbodygreen

How to keep skin hydrated?

Using this simplified overview of the miracle that is our skin, what can we understand about our aging skin and what might we do to keep our skin hydrated as we age? The body tends to draw moisture from wherever it can when it is dehydrated, and this is another reason our skin may seem drier. But there are steps we can take to hydrate both our skin and our environments.

How Can We Protect Our Skin from the Sun?

Older people need a little extra care when it comes to protection from the sun’s damaging rays. It’s important to build a barrier against sun damage, say the experts, and use sun screen to protect ourselves from the damage caused by the sun, in addition to taking further steps as we age.

  • Sun screen: WebMD recommends a water-resistant, broad spectrum UVA/UVB protective sun screen with an SPF of 30 or above – including applying to areas of balding on the head. Reapply every one to two hours that you are in the sun.
  • Special clothing: Complete the barrier with special clothing made to block the sun’s rays.
  • Sunglasses: Wear sunglasses that block both UVA and UVB rays
  • Wear a hat: Top yourself off with a broad-brimmed hat.
  • Stay out of sun: Stay in the shade when possible and limit sun exposure during the sun’s strongest hours between 10 a.m. and 4 p.m.

Does pollution contribute to dry skin?

While sun damage is real and we should all heed our doctor’s warning about sun screen and staying out of the sun, air pollution also ages and dries the skin, according to an article in SELF. Even though government regulations have decreased the amount of pollutants in the air, we are still being assaulted by tons of emitted pollutants every year. These pollutants might find their way not just onto our skin, but may also, according to the article, cross through the layers of our skin:

“These particles’ tiny size—sometimes as many as 20 times smaller than pores—allows them to infiltrate deeper layers of the epidermis, causing not only inflammation and dehydration but also a cellular-level reaction that leads to lost elasticity and firmness.”
Elizabeth Einstein “How Pollution Is Affecting Your Skin-And How to Fix It” SELF

The doctors interviewed for the article suggest washing your face thoroughly but gently with a mild cleanser every morning and night. The doctors suggest removing as much of the pollutants as possible, without aggravating your skin.

Can Serums Help Moisturize the Skin?

To combat the damaging free radicals that pollutants create, the doctors say the same antioxidants that we hear so much about in our food nowadays are the same antioxidants that can be found in serums for our skin. These antioxidant serums may help neutralize the damage from the free radicals. In a BMC Dermatology study, researchers suggest that special topical skin creams containing Vitamin C may increase the density of the dermal papillae that tend to flatten out as we get older, as well as increase the amount of blood vessels within the dermal papillae. Another serum is hyaluronic acid serum. Hyaluronic acid draws water to itself, which helps keep moisture in the skin. I’m looking forward to trying out these serums, preferably a serum that combines Vitamin C and other antioxidants with hyaluronic acid.

Also finding its way into topical applications are ceramides. Ceramides are fats found in the epidermis’ stratum corneum, which is the outermost layer of the epidermis. Studies are beginning to show that ceramides may be beneficial in hydrating the skin, as well.

Indoor air pollution

It’s not just industrial air pollution and the sun’s rays that contribute to dry skin. In our own homes, fireplace fires and second-hand smoke also can contribute to drying skin.  As mentioned earlier, the comfort of heated indoor air comes with a price where our skin is concerned.

Humidifying our indoor air can help keep our homes and workplaces from drying out our skin. There are some low-cost ways to add humidity at home. House plants will add moisture to the air as long as you keep watering them, hanging clothes to dry on a drying rack instead of throwing them in the dryer, and leaving open containers of water near radiators to evaporate water into the air can help.

I haven’t found those methods to provide enough moisture, so I bought a portable cool-mist humidifier. I’m debating whether I like it better than a vaporizer for sleeping, when we can lose even more moisture (more on sleeping in the next section).

More expensive are whole-house humidifiers, which can be desirable if you have the means. Whatever method works for you, just be sure to check frequently that you are not over humidifying, which can cause mold to grow.

For more, visit How to Humidify Your Home by TrueValue Projects.

Does sleep affect our dry skin?

Apparently beauty sleep is really a thing. During sleep, our skin repairs and rebalances itself. Our skin is also vulnerable to a process that increases at night called transepidermal water loss (TEWL) in which water moves from the dermis through the epidermis and evaporates. That’s why it is important to sleep in a correctly humidified room, and to get enough sleep.

How to Keep Moisture in our Dry Skin?

You would think that water would be hydrating to our skin, and while we should drink plenty of water to help stay hydrated (more on that below), prolonged contact with water can actually dry our skin out more. The stratum corneum, the outermost layer of the epidermis, contains natural moisturizing factor (NMF) that includes substances like moisturizing ingredients, including amino acids, hyaluronic acid, ceramides, and fatty acids. NMF substances absorb moisture from our environment and helps keep our skin hydrated.

“Because NMF components are water-soluble, they are easily leached from the cells with water contact—which is why repeated contact with water actually makes the skin drier.”
Brannon, Heather. “Want Healthy, Attractive Skin? This Is Mostly Responsible for It.” Verywellhealth.

So this means I’ll wear gloves when washing dishes and take shorter, warm (not hot) showers and baths. I’ll be bathing and showering with gentle, fragrance-free, moisturizing soaps, cleansers, or body washes. Harvard Health suggests Dove, Olay, and Basis, or soap-free cleansers like Cetaphil, Oilatum-AD, and Aquanil.  It’s advised to gently pat your skin with a soft cotton towel to dry off and apply fragrance-free moisturizer right after drying.

When I was growing up there weren’t that many different ways to clean the skin. I remember Ivory Soap for face washing and Lifebuoy Soap for the rest of the body. We used Noxzema for the acne years and Ponds Cleansing Cream when we began wearing makeup. Thankfully, we’ve come a long way in skin care routines.

Many sources recommend glycerin soap for dry skin, although with a few caveats, such as make sure to get one that does not contain harsh ingredients or fragrances. It also reportedly does not produce much lather and may seems to disappear from the soap dish rather quickly if left in a moist environment. I haven’t tried glycerin soap, but I have used Castile soap, which is soap that has not had the glycerin removed in the soap-making process. I tend to switch between Olay and Dove nowadays, followed by Lubriderm lotion.

Lubriderm has always been an effective moisturizer for me, but this year I’ve moved to Lubriderm Advanced Therapy Lotion for extra-dry skin and it has helped a lot. I keep a bottle at each sink to help me get into the habit of reapplying every time I wash my hands. I use it at night, too, and under cotton socks and gloves when my dry heels and hands need a little extra help. (Just make sure you don’t try to walk around after applying lotion to your feet!)

Rita Pichardo-Geisinger, MD, suggests a number of moisturizers in the article Careful Attention to Aging Skin, including Cetaphil Restoraderm, CeraVe and Vaseline Clinical Therapy.

Can Diet Affect Dry Skin?

After reading about all the ways our skin can be damaged, I realize how extraordinarily resilient our skin truly is. So how else can we help our skin to retain moisture? Can a good diet can help in our quest to hydrate our dry skin? A search for the most skin-moisturizing foods we can eat reveals what health experts have been telling us about our overall health: Drink plenty of water (in lieu of soda, coffee and alcohol, which aren’t as helpful in hydrating us as water) and include whole, unprocessed, vitamin-rich foods that are lower in sugar and contain plenty of healthy fats, antioxidants, and water in our diets, including:

Fish, including wild salmon, sardines, herring, and mackerel, which are high in Omega-3 oils; Eggs; Avocados; Nuts and Seeds; Extra Virgin Olive Oil and Flax Seed Oil; Carrots; Cucumbers; Dark Leafy Greens; Sweet Potatoes; Celery; Peppers; Citrus and Berries.

According to a study in the American Journal of Clinical Nutrition, “Women with senile dry skin (dryness as a result of aging) had significantly lower intakes of linoleic acid and vitamin C than did women without senile dry skin. The author noted that their findings were “from habitual intakes of vitamin C from food sources” not from supplementation. Linoleic acid, an essential fatty acid, is available in many food sources.  The study also found that lower protein in older adults diets was shown to “increase skin fragility.”

Of course, that doesn’t mean we shouldn’t take supplements, just that the overall diet is important when it comes to keeping our skin hydrated and healthy. Some recommend bone broths  to help replenish collagen, but that is not something I have tried.

Further research discusses the role of personalized nutrition in our health and specifically our skin health. Evolving rapidly are two relatively new fields: Nutrigenomics and Dermagenetics.  Nutrigenomics is the science that studies nutrition’s effect on our DNA and gene expression. The related field of Dermagenetics tests for genetic mutations related to skin health and then suggests nutraceuticals or skin creams containing cosmeceuticals that may help those conditions. Nutraceuticals are food or food products that can provide health benefits. Cosmeceuticals are cosmetics with health-benefiting ingredients (like adding vitamin C  to a skin cream).

Remember to always check new foods, supplements, or topical creams or lotions with your personal medical professional, as some foods may interact adversely with certain medications and any dietary changes have the potential to affect us older adults.

And what about feeding our skin microbiome?

It turns out recommendations to feed our skin microbiome are similar to the recommendations for feeding our gut microbiome, according to How to Get More Bacteria on Your Face—’Cause That’s Actually Something You Want. High fiber foods contain prebiotics, which the good bacteria eat. Examples include asparagus, garlic, and oats. Probiotic foods like yogurt contain the “good” bacteria to help colonize our skin.

Can certain foods cause dry skin?

There are plenty of foods to avoid because they are the not good for your skin, according to Prevention, and they include any foods that cause our blood sugar to rise and fall rapidly. Rice cakes and even “healthy” cereal are on the list.

“A poor diet can cause inflammation, which triggers oxidative stress and in turn damages collagen and DNA, making you look older.”
Jessica Migala, 10 Worst Foods For Your Skin

Can exercise help dry skin?

Studies show that moderate exercise (cleared first by your doctor!) may help to increase blood flow and reduce stress, two factors necessary to maintaining healthy skin. And at least one study shows it’s not too late to get the benefits of exercise for your skin, according to an article in the New York Times Well section.  The researchers compared skin samples of sedentary 65 year olds before and after they embarked on an endurance training program for three months. They found that the inner and outer layers of the 65 year olds’ skin compared similarly to younger participants in the study who were 20 to 40 year olds.

While many of us won’t be able to embark on endurance training, it might be worth it to ask our doctors about increasing our movement a bit if we can. Just remember to be sure to clear any new exercise or additional movement with your doctor first and start slow!

Photo Credit: Pixabay | silviarita

References and Further Reading

Components of Skin – Health Video: MedlinePlus Medical Encyclopedia.” Edited by Laura J Martin, MedlinePlus, U.S. National Library of Medicine.

Young, Allison. “10 Foods You Should Eat More Of This Winter To Prevent Dry, Dull Skin.” Prevention.

DeVault, Norma. “Food Sources of Linoleic Acid.” Healthfully.

Ramos, Lara. “12 Foods That Hydrate Your Skin From The Inside Out.” Yon-Ka Skin Care Blog.

Skin Care and Aging.” National Institute on Aging, U.S. Department of Health and Human Services.

Benshosan, April, and Sharon Feiereisen. “22 Superfoods You Need To Combat Dry Winter Skin.” Eat This Not That.

Baumann, Leslie S., et al. “The Role of the Skin Microbiome in Skin Care.” Dermatology News, Mdedge.

Best Hyaluronic Acid Serums.” The Dermatology Review.

Ajmera, Ripa. “Benefits of Glycerin Soap.” Livestrong.com.

 

2 thoughts on “Dry Skin Care in Older Adults”

  1. This is a great read.. Ty! Being a diabetic I’m constantly having to moisturize my skin. I have found Gold Bonds Diabetic Lotion works best for me. This article though opened my eyes to sooo much much that contributes to dry skin and additional things I can to to help with with it. Thank you again for posting.Im sure it will help all who reads. 🙂

  2. Thank you Sandy! I know, right? I was amazed to find out how much contributes to dry skin as we get older. Thanks for the tip about Gold Bonds Diabetic Lotion. I will have to pick some up and try it. Thanks for commenting!

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