Psoriasis in Older People

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Changes in the skin

Skin aging is a natural part of growing old. Certain factors can contribute to the speed of skin aging – too much sunlight, smoking and alcohol are 3 major causes of accelerated skin aging.
The actual mechanism of skin aging is not fully understood. However there appears to be a number of factors which combine together to produce an effect that differs from person to person.
What is similar, however is the effect. As we age our skin undergoes changes that reduces its ability to protect itself. Firstly, the collagen in the outer layer reduces by around 1% per year causing the skin to thin. Since collagen gives skin it’s tensile strength, loss of it leads to wrinkling. Decreased elasticity is also a feature as elastin fibres significantly decrease in size and number.
Decreased blood supply with age causes the dermis to gradually lose its blood supply which adds to the difficulty of healing damaged skin and a slowing of cell replacement causes the turnover of cells in the epidermis to reduce by up to 50% which also slows the healing process.
Decreased melanocytes, the pigment producing cells causes the skin to lighten and produce age spots.
A reduction in the number of Langerhan’s cells, which serve as macrophage and immune moderators of the epidermis increases the risk of skin infections.

Aged skin also suffers from increased dryness as the eccrine glands decrease in number and decrease sweat gland production. It is the sebum produced by the sweat glands which helps the skin to keep a moisturised and the atrophy of subcutaneous fat on hands, face, shins, waist in men and thighs in women leads to sagging and folds, which can then become infected.

All these are bad enough without the problems associated with psoriasis.

What this means for you

It is very important that you care for your skin. Examine it carefully on a regular basis to make sure there are no areas where possible infection could occur. Moisturise regularly and maintain a healthy diet to keep your skin as healthy as possible.

If you damage your skin there is a chance that it may develop a psoriatic lesion. Keep a special watch on all bumps and scrapes.

You may find that your doctor changes the strength of some of your medications. For example they may reduce the strength of topical steroid creams as your skin would react badly to the more potent versions that you had when you were younger. Your psoriasis may take longer to go into remission than when you were younger but this is part of the balancing act between good treatment and reducing possible side effects.

Drug Interactions

Some medications used for other conditions may interact with your psoriasis treatment or even provoke an outbreak of psoriasis so it is vitally important that your doctor is made aware of all medicines that you are using, including those you may have bought from a pharmacy or supermarket medicines counter.

For example lithium, used to treat bipolar disorders, gold, used in some arthritis medications and heart drugs called Beta Blockers have all been shown to make the symptoms of psoriasis worse.

You are not alone

As the general population ages and other conditions become less of a threat to life there will be an increase in the number of elderly patients requiring psoriasis management. Doctors are aware of this trend and are already being educated to help manage psoriasis in the elderly in a way that pays particular attention to quality of life issues. If you have any concerns regarding how your psoriasis will affect you as you get older you should talk to your doctor, healthcare provider or nursing staff.