Home' Australian Pharmacist : Australian Pharmacist August 2016 Contents Australian Pharmacist August 2016 I © Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
COUNSELLING IN PRACTICE
KEY LEARNING POINTS
As people age, their skin becomes drier and more fragile. Xerosis (dry skin) is
common in elderly people, and often leads to pruritus (itching).
Skin dryness in elderly people can be exacerbated by cold dry air, central heating/
air conditioning, direct skin exposure to fan heaters, excessive immersion in water,
and use of alkaline soaps and detergents.
Xerosis can be treated/prevented by application of a moisturiser (emollient) at least
twice daily. Moisturisers act as either occlusives (prevent evaporation of moisture
from the skin by forming an oily film, e.g. petrolatum) or humectants (draw water
from deeper skin layers to the stratum corneum, e.g. glycerol, urea). An effective
moisturiser should contain a humectant and an occlusive, to enhance both
epidermal hydration and barrier function.
Xerosis can also be improved by certain lifestyle modifications, e.g. reducing the
duration of baths/showers, showering/bathing in lukewarm (not hot) water, using
non-irritant, soap-free cleansers instead of soap, and using a humidifier to increase
the humidity of the air inside the home.
1. Cohen KR, Salbu RL. Pruritus in the elderly: clinical approaches to
the improvement of quality of life. P & T 2012;37(4):227–39.
2. Haroun MT. Dry skin in the elderly. Geriatr Aging
2003;6(6):41–4 . At: http://orbis.cssam.com/files/content/2003/
3. Chinniah N, Gupta M. Pruritus in the elderly – a guide
to assessment and management. Aust Fam Phys
2014;43(10):710–13. At: www.racgp.org.au/afp/2014/october/
4. Oakley A. Ageing skin. In: DermNet NZ. 2015. At: www.
5. Wounds UK. Best practice statement: Care of the older person’s
skin. London: Wounds UK; 2012. 2nd edn. At: www.wounds-uk.
6. Best Practice Advocacy Centre New Zealand. ‘Seventh age itch’:
preventing and managing dry skin in older people. Best Pract J
NZ 2014;63:6–15. At: www.bpac.org.nz/BPJ/2014/September/
7. Puizina-Ivic N. Skin aging. Acta Dermatoven APA
2008;17(2):47–54. At: http://s3-eu-west-1 .amazonaws.com/
8. Rossi S, ed. Australian medicines handbook. Adelaide: Australian
Medicines Handbook; 2016.
9. Wey SJ, Chen DY. Common cutaneous disorders in the elderly.
J Clin Geront Geriatr 2010;1:36–41 . At: www.e -jcgg.com/article/
10. Norman RA. Common skin conditions in geriatric dermatology.
Ann Longterm Care 2008;16(6). At: www.annalsoflongtermcare.
11. Oakley A. Eczema craquelé. In: DermNet NZ. 2014. At: www.
12. Duffill M, Oakley A. Emollients and moisturisers. In: DermNet NZ.
2016. At: www.dermnetnz.org/treatments/emollients.html
13. Kraft JN, Lynde CW. Moisturizers: what they are and a practical
approach to product selection. Skin Therapy Letter 2005;10(5):1–
8. 2015. At: www.skintherapyletter.com/2005/10.5/1.html
14. Brayfield A, ed. Martindale: the complete drug reference.
London: Pharmaceutical Press. At: www.medicinescomplete.
15. Lawton S. Safe and effective application of topical treatments to
the skin. Nursing Standard 2013;27(42):50–6 . At: http://journals.
16. Sansom LN, ed. Australian pharmaceutical formulary and
handbook. 23rd edn. Canberra: Pharmaceutical Society of
17. Ciconte A. Xerosis. In: Australasian College of Dermatologists.
2016. At: www.dermcoll.edu.au/atoz/xerosis/
18. Vierkötter A, Schikowski T, Ranft U, et al. Airborne particle
exposure and extrinsic skin aging. J Invest Dermatol 2010
1. As skin ages, it undergoes a number
of changes, including:
a) An increase in the turnover rate of
b) A decrease in the lipid, water and
natural moisturising factor content of
the stratum corneum.
c) An increase in the activity of sebaceous
and sweat glands.
d) Increased turnover of collagen and
elastin in connective tissue.
2. Apart from xerosis, what is the MOST
common skin problem in elderly
a) Atopic eczema.
3. Factors that INCREASE the risk of
xerosis in elderly people include:
a) Use of alkaline soaps and detergents.
b) Inadequate showering/bathing.
c) Excessive humidity.
d) Warm air temperatures.
4. Which of the following ingredients
used in moisturisers is a humectant?
b) Cetyl alcohol.
d) Ammonium lactate.
5. Which of the following
recommendations for relieving/
preventing dry skin in an elderly
person is the MOST appropriate?
a) Apply glycerin to the dry skin areas at
least twice daily.
b) Apply aqueous cream to the dry skin
areas at least twice daily.
c) After bathing, dry the skin vigorously
to make sure it is completely dry before
d) Use a soap substitute instead of soap to
wash yourself in the bath/shower.
the direction of hair growth) should be
demonstrated. Her preferences should
be considered when recommending
a suitable moisturiser, but she should
be advised to use one that contains
no irritants (e.g. perfume, colouring
agents, alcohol, sodium lauryl sulfate).
She can be provided with information
about lifestyle strategies that may help
to relieve her xerosis (e.g. bathing for no
longer than 10 minutes, avoiding soap,
using a humidifier). She can also be
given a PSA Eczema and dermatitis Self
Care Fact Card, which contains useful
information about skin care. Eileen’s
pruritus is most likely due to xerosis,
and regular application of a moisturiser
should alleviate it. If the pruritus persists
despite moisturising treatment, she
may need to apply a low-potency
corticosteroid cream to the itchy areas
for a short period of time.
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