As the skin ages, it undergoes a number of changes:

  • The blood supply to the dermis weakens, the elastic fibres and the amount of collagen are reduced, resulting in wrinkling.
  • The reduction in blood supply also means there is less oxygen and nutrients delivered to the skin. The capacity of the skin to repair reduces with age.
  • There is a reduction in sebum secretion and sweating, causing dry, coarse, itchy and scaly skin. Once the skin becomes dry, it is more vulnerable to splitting and cracking, exposing it to increased water loss through transepidermal evaporation and to bacterial invasion, further adding to the likelihood of breakdown from infection (All Wales Tissue Viability Nurses Forum, 2011).
  • The epidermis generally becomes thinner with advancing age as cells reproduce more slowly and become larger and more irregular (Ewart, 2016).
  • As the epidermis thins and sensory receptors diminish in capacity, the incidence of injuries and infections increases.
  • As the hypodermis becomes thinner, the elderly are more prone to pressure damage, bruising and small haemorrhage.
  • There is slower healing in the older person as epidermal turnover time is increased.
  • Vascularity decreases in subcutaneous tissue. As the vascularity of the sacrum decreases, less external pressure is needed to stop the blood flow than in younger people.
  • Overheating and increased sensitivity to temperature changes caused by loss of efficiency of the sweat glands and diminished dermal blood supply may affect a person's ability to lose heat (Tortora & Derrickson, 2013).