Chronic itch, especially in the elderly, is fre- quently a symptom of xerosis (dry skin), which can be caused by atrophy of the skin barrier and diminished hydration. Other common causes in the older population also include dermatoses, such as eczema, psoriasis, lichen planus, urticaria, and bullous pemphigoid.
It’s common in older adults because as we age our skin gets thinner and doesn’t hold as much moisture. This often makes the skin irritated and itchy. It can also result from using harsh cleansers or soaps, bathing too often, or bathing in hard water or well water.
Senile pruritus can be defined as a chronic itch in a person aged 65 years or older, with no aetiology determined by an appropriate examination and check-up (6), although a clear and consensual definition is lacking. It is a diagnosis of exclusion.
Pruritus in elderly can be defined as idiopathic chronic pruritus in a person over 65 years old. Pruritus may present with or without skin lesions. In previous reports, the prevalence of pruritus in elderly patients was 11–78% [1,2,3].
To help soothe itchy skin, dermatologists recommend the following tips:
Have them wear gloves or place band aids on their finger tips. Keep their skin well moisturized and hydrated by ensuring a adequate water intake. Applying tissue oils not only facilitates healing, it also makes it difficult to pick or scratch because it makes the skin slippery. Keep their nails short.
Regular use of emollients is the mainstay of treatment in pruritus, aiming to ensure optimal skin hydration and preventing the itch-scratch cycle. Emollients enhance the skin barrier function, preventing transepidermal water loss and entry of irritants.
According to a 2017 article, healthcare professionals commonly associate itching with chronic liver disease, especially cholestatic liver diseases, such as PBC and primary sclerosing cholangitis (PSC). The itching typically occurs on the soles of the feet and the palms of the hands.
See your doctor or a skin disease specialist (dermatologist) if the itching: Lasts more than two weeks and doesn’t improve with self-care measures. Is severe and distracts you from your daily routines or prevents you from sleeping. Comes on suddenly and can’t be easily explained.
It can come and go or it may be continuous. It may affect your whole body or be limited to a specific area – usually your back or arms. Itching tends to affects both sides of the body at the same time and may feel internal, like a crawling feeling just below the skin.
Over-the-counter medicines for itching
For mild itching, apply calamine lotion; for more intense sensations, use hydrocortisone cream. Oral antihistamines can also reduce itchiness.
Urinary tract infections, or UTIs, are the most common bacterial infection in older adults, reports the AAFP. The use of catheters or the presence of diabetes can increase the risk of UTIs in elderly people.
Water is great for your health in many ways, including itch relief. Drinking more water keeps your skin hydrated from the inside out and flushes out toxins that can cause irritation. Remember, caffeine and alcohol are dehydrating and can worsen itching.
Hydrocortisone: The 1 percent strength of this steroid cream, which eases itch by reducing inflammation, is in a slew of OTC itch products, such as Aveeno 1% Hydrocortisone Anti-Itch Cream, Cortizone 10 Maximum Strength Ointment, and generics.
Traditionally, antihistamines are used to treat itch. Examples include diphenhydramine (Benadryl), hydroxyzine (Atarax), and chlorpheniramine (Chlor-Trimeton and others).