Eczema is a skin disease that typically affects infants and young children. However, it is not uncommon for older individuals to suffer from it as well. Are the risks of eczema complications increased in these older individuals?
Eczema in the Elderly: Increased Risks?
- Eczema, in brief
- What is the prevalence of eczema in the elderly population?
- Is eczema more dangerous in older individuals?
Eczema, in brief.
Theeczema is a skin disease characterized by a skin inflammation. Most of the time, it manifests on the face, excluding the lips and eyes. However, it can also occur on other areas of the body, particularly on the knees and elbows. Eczema is characterized by several symptoms : red and swollen patches on which blisters form, extreme skin dryness, and itching. These manifestations can make it difficult to live with and impact both psychological and physical health.
We can distinguish several forms of eczema. One of the most common is atopic eczema, due to a specific genetic predisposition. Individuals with atopic eczema have a skin barrier that no longer fulfills its role, accompanied by a significant permeability of the stratum corneum. This causes fairly significant water loss and increases the ease with which microorganisms and allergens can penetrate the skin. One can also suffer from eczema without having any genetic predispositions. This is then referred to as contact eczema, in reaction to a specific allergen in the environment.
What is the prevalence of eczema in the elderly population?
Eczema can affect individuals at any age, although its prevalence is generally higher in children than in adults. Regarding the elderly, the rate of eczema is relatively low, less than 10% for those over 60 years old, but not zero. This may seem somewhat counterintuitive at first glance if one considers that the skin barrier weakens with age due to the gradual decrease of certain moisturizing compounds such as sebum and natural moisturizing factors (NMFs). These contribute to the maintenance of the hydrolipidic film on the skin's surface and protect it from dehydration and external aggressions.
As a result, the skin of older individuals tends to be drier, less elastic, and thinner. This fragility makes it more vulnerable to irritations and itching. However, older individuals are less affected by eczema, which can be explained in several ways. Firstly, it has been observed that certain types of eczema, such as atopic dermatitis, tend to improve or even disappear with age, although the mechanisms at work are not fully understood. Additionally, environmental factors that trigger eczema are often less present in the lives of older individuals. Occupational allergens, for example, can be considered. These elements help to partially explain the low prevalence of eczema in older individuals.
Is eczema more dangerous in older individuals?
Let's remember that eczema is not contagious and it is not considered a dangerous disease, despite the discomfort it causes. However, in some cases, eczema can become generalized, meaning that the lesions spread or it becomes infected. Rapid medical intervention is then necessary. While the rates of eczema worsening are not higher in older people, the consequences are often more severe.
Indeed, we observe a variation in the inflammatory response with age, which results in an increase in chronic inflammation, referred to as "inflammaging". This term is a neologism born from the contraction of the words "inflammation" and "aging". Over time, the immune system weakens, leading to a constant production of pro-inflammatory cytokines, molecules that trigger several inflammatory processes. Inflammaging can be the cause of an exacerbation of eczema symptoms.
Furthermore, it is not uncommon for older individuals affected by eczema to developvaricose eczema. This form of eczema, located in the lower limbs, is the result of venous stasis, or a lack of efficiency in the return of venous blood to the heart. This venous stasis is promoted by several behaviors, notably sedentariness. As people age, they often become less and less active.
Key Takeaway : Elderly individuals are fragile and require specialized care. Even though they are generally less affected by eczema, it is crucial to remain vigilant and, if you have any doubts or questions, to consult a physician.
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BORRADORI L. & al. Dermatologie et infections sexuellement transmissibles. Elsevier Masson (2017).