Chapter 28: Integumentary Function & Skin Care in Aging

Integumentary Function & Skin Care in Aging details the critical physiological functions of the skin, such as preventing dehydration, providing thermal regulation, and acting as a sensory hub for environmental perceptions. A significant portion of the text is devoted to the structural and functional transformations that accompany the normal aging process, including a substantial decline in the epidermal replacement rate, a reduction in dermal thickness by roughly twenty percent, and the redistribution of subcutaneous fat. These changes collectively increase an older adult's vulnerability to skin tears, bruising, and compromised thermoregulation. The chapter categorizes various skin conditions, from benign growths like cherry angiomas and seborrheic keratoses to chronic inflammatory dermatoses such as psoriasis and intertrigo. It also addresses infectious challenges, particularly candidiasis and the reactivation of the varicella-zoster virus, which leads to the painful condition known as herpes zoster, or shingles. Crucially, the material provides a detailed overview of skin malignancies—basal cell carcinoma, squamous cell carcinoma, and melanoma—emphasizing early detection through specific assessment criteria like the ABCDE method. Furthermore, it distinguishes between the different types of lower extremity ulcers, including those caused by arterial insufficiency, venous hypertension, and diabetic neuropathy. A major clinical focus is placed on the prevention and management of pressure ulcers, utilizing evidence-based tools like the Braden and Norton scales to identify risks such as immobility, poor nutrition, and moisture. By outlining standardized staging criteria and diverse wound care strategies, the chapter equips healthcare professionals with the knowledge necessary to maintain skin integrity and enhance the quality of life for the geriatric population.