|
|
|
|
| HEALTH & FITNESS |
|
|
|
Why skin care is important in
the elderly Pain in the arms: The cause may be in the neck Health Notes
|
|
Why skin care is important in the elderly Primary care physicians and dermatologists are now seeing more elderly patients presenting age-related dermatological conditions. As people age, their chances of developing skin-related disorders increase due to multiple underlying medical conditions — diabetes mellitus, atherosclerosis and decreased immunity. Common skin disorders found in elderly individuals are xerosis, pruritus, eczematous dermatitis, purpura, chronic venous insufficiency, psychocutaneous disorders, etc. Care-givers and medical personnel can help decrease or prevent the development of many skin disorders in the elderly by addressing several factors like the patient’s nutritional status, medical history, current medications, allergies, physical limitations, mental state and personal hygiene, and for specific underlying etiologies, several pharmacological treatment choices are suggested. As people age, their chances of developing skin-related disorders increase. Two types of skin ageing exist — intrinsic ageing, which includes those changes that are due to normal maturity and occur in all individuals, and extrinsic ageing, produced by extrinsic factors such as ultraviolet light exposure, smoking and environmental pollutants. Decreased mobility, drug-induced disorders and an increased incidence of chronic diseases are among the reasons for elderly individuals being at a heightened risk of having skin diseases. Atherosclerosis, diabetes mellitus and congestive heart failure are some disease processes that can be detrimental to skin. These diseases are known to impede vascular efficiency and decrease immune responses, thereby reducing the body’s ability to heal. The inevitable changes in the skin in the aged: Epidermal changes: Melanocytes ( normal skin colour giving cells) Approximately 15 per cent decline per decade. Density doubles on sun-exposed skin. Langerhans cells: Decreased density leads to decreased responsiveness to temperature, pressure and touch. Dermal changes: Decreased collagen — 1 per cent annual decline. The dermis becomes relatively acellular, avascular and less dense, and the loss of functional elastic tissue results in wrinkles. The nerves, microcirculation, and sweat glands undergo a gradual decline, predisposing to decreased thermoregulation and sensitivity to burning. Nails undergo a slow decline in growth, with the thinning of the nail plate, longitudinal ridging, and splitting. The subcutaneous fat layer atrophies on the cheeks and distal extremities, but hypertrophies on the waist of men and thighs of women. Skin changes in age-related loss of elasticity and thinning of the skin. Clinical results: Xerosis, laxity, wrinkling, uneven pigmentation, easy tearing and traumatic purpura. Photo-aging — clinical results: Actinic keratoses, fine and coarse wrinkling, telangiectasia, blotchiness and pigmentary changes, elastotic skin with giant comedones.
Xerosis
Xerosis is characterised by pruritic, dry, cracked and fissured skin with scaling. Xerosis occurs most often on the legs of elderly patients but may be present on the hands and trunk also. The appearance of xerotic skin is like a pattern of cracked porcelain. These cracks or fissures are present because of epidermal water loss. If the skin splits and cracks deeply enough to disrupt dermal capillaries, bleeding fissures may occur. Pruritus occurs leading to secondary lesions. Scratching and rubbing activities produce excoriations. Subsequently, environmental allergens and pathogens can easily penetrate the skin, increasing the risk of allergic and irritant contact dermatitis as well as infection. Eczematous changes can occur with a delayed hypersensitivity response, even in advanced age. Secondary infection is an inherent risk with any break in the skin barrier. This cycle needs to be broken to disable the process and prevent complications. Xerosis preys upon the elderly. This is primarily due to the fact that these individuals have decreased sebaceous and sweat gland activity; this reduced activity predisposes the aged skin to moisture depletion. Psychogenic Pruritis: Patients complaining of the sensation of parasites crawling on them without evidence of the presence of parasites may have delusions of parasitosis. This condition is more attributable to a psyche-related disorder than to a dermatological problem.
Purpura
Purpura is characterised by small haemorrhages in the skin. Elderly persons are especially susceptible to haemorrhage into the skin. Aging causes a gradual reduction in the number of blood vessels and elastic fibres as well as losses in dermal collagen and fat, causing a thinning of the skin and reduced protection from external trauma. Important measures include skin protectors and having an environment that prevents injuries. The writer is Chief Consultant Dermatologist, National Skin Hospital, Mansa Devi Complex, Panchkula. E-mail:
drvikas.nscindia@gmail.com |
|
Pain in the arms: The cause may be in the neck Innumerable people suffer from neck, arm and shoulder pain. Many reasons are given like injury to muscles, tendons and nerves. Neck pain could be linked to the shoulder, forearm and hand. Compression of the spinal cord due to disc herniation in the lower back causes sciatica whereas pain radiates to the leg and foot. Similarly, cervical disc herniation could lead to pain/numbness in the arm/hand. Discs are located between the vertebras of the spine, and their main function is shock absorption and facilitating spinal movements. Each disc has a thick outer band that surrounds a gel-like substance. Cervical disc herniation is also referred to as prolapsed disc, protruded disc, ruptured disc, slipped disc and so on. Disc bulge could be as a result of the aging process vis-à-vis disc degeneration, and not an abnormal finding. This simply denotes the loss of the normal fluid content of the disc, the end result being the loss of normal disc height. Numbness is often experienced in the arm and hands during morning hours. That is generally not worrisome as it happens due to the nerve supplying the affected area being pressed. This is only a transient feeling. Numbness in the hands/feet also occurs among the diabetic. Aging also could lead to numbness due to decreased blood supply. Disc herniation occurs due to many reasons: A clinical examination reveals sensory abnormality and muscle weakness along the affected spinal nerve route. In such cases, the diagnostic tool available is MRI. Symptoms Treatment Acute cases respond to short-term immobilisation (cervical collar). However, prolonged continuous usage of the collar is not advisable as it could result in the weakening of the neck muscles. The collar should be removed for an hour (every three hours). Exercises Shoulder shrugs: While standing erect, arms held loosely at sides, breathe deeply and lift the shoulders as high and far back as possible. Now breathe out and lower the shoulder to the starting position. Repeat 10 times thrice a day. Strengthening exercises Place both hands behind the back of the head, tilt the head backward against the resistance of the hands. Place one hand above the ear, resisting the motion of bringing the ear to the shoulder on the same side. The dilemma encountered by cervical disc patients is to choose between conservative treatment and surgical intervention. Surgery is recommended only when an individual does not respond to conservative treatment for six to eight weeks. Reassurance by the treating doctor and an optimistic outlook of the patient go a long way in relieving pain. The writer is a former doctor/physiotherapist, Indian cricket team. E-mail: |
|
Diabetes drug could help fight Alzheimer’s
London: People with Alzheimer’s have been offered new hope with experts claiming that a diabetes drug could be used to treat the devastating effects of the disease.Scientists at the University of Ulster found the drug could help protect damaged brain cells and may even promote the growth of new ones, the Daily Express reported. Type 2 diabetes is a known risk factor for Alzheimer’s and it is thought that impaired insulin signalling in the brain could damage nerve cells and contribute to the disease. — ANI Taking ibuprofen or paracetamol regularly may make you deaf
London: Women who regularly take ibuprofen and paracetamol are at a higher risk of losing their hearing, researchers say. The study of more than 62,000 women found that taking the drugs just twice a week increases the risk of hearing loss by up to 13 per cent. Using ibuprofen six times a week makes women up to 24 per cent more likely to develop some degree of hearing problem as compared with those who do not use the medication.Those using paracetamol up to five times a week increase the risk of hearing loss by 21 per cent. The same effect was not seen for women who regularly take aspirin. — ANI
Quitting alcohol ‘may help reclaim bone loss’
Washington: As little as eight weeks of abstinence from alcohol can initiate correction of an imbalance between bone formation and resorption due to its toxic effects, a new study has claimed. Physical activity can also serve as a protective factor against reduced Bone Mineral Density (BMD). Osteoporosis, or reduced bone mineral density (BMD), is defined by an absolute decrease in total bone mass, caused mostly by an imbalance between osteoclastic bone resorption and osteoblastic bone formation. — ANI
Beware of egg yolks
London: Don't go to work on an egg. Or at least not more than twice a week, particularly if you're at risk from heart disease. According to new Canadian research, the more egg yolks people eat, the worse the effect on blood vessels. Results of the study show that the build-up of carotid plaque, a waxy substance that clogs blood vessels and which is linked to reduced blood flow and higher risk of cardiovascular disease, is greater the more egg yolks people eat. "Our results suggest a strong association between egg consumption and carotid plaque burden," the researchers say. "The effect size of egg yolks appears to be approximately two-thirds that of smoking. We believe our study makes it imperative to reassess the role of egg yolks, and dietary cholesterol in general, as a risk factor for heart disease." The study, reported in the journal Atherosclerosis, assessed the affects of eating eggs by nearly 1,200 people, with an average age of 61. Results show that the carotid plaque area grew with age after 40, but increased exponentially with the number of years of smoking and egg yolk eating. — The Independent
|
The famous saying “Old Is gold” doesn’t apply to human skin as elderly people are recognised by their wrinkled and dull skin. The country’s population is getting older, with a greater percentage of people being in the over-65 age group. This trend is expected to continue well into the 21st century. Additionally, with the population of those aged 80 and above also rapidly rising, an increased emphasis on geriatric medicine is inevitable. Geriatric dermatology is a speciality that is getting particular attention. 
Sudden jerk while lifting heavy weight.