Learning Concept
Introduce yourself and confirm with your audience that they all know each other
Explain todays topic – Skin and the Aging Process
Learning Concept
Fundamental review of the skin as an organ of the body.
Teaching Points
The skin is the largest organ of the body. The average person may not think of the skin as an organ the way that they do their heart, lungs or gall bladder
The skin covers about 18 square feet and can weigh up to 12 pounds – these numbers signify just how “large” this organ is
The skin receives a 1/3 of our circulating blood volume, emphasizing the importance of circulation and blood flow
The normal temperature of the skin is 92 degrees
The skin as an organ of the body has the unique property of being able to impact its health topically, not just systemically, by what is put on it, or in some cases, NOT put on it
Did you know?
Frequent dressing changes, when not necessary, can impact healing by constantly exposing the wound to lower temperatures than the normal temperature of the skin at about 92 degrees.
Learning Concept
The functions of the skin.
Teaching Points
Briefly review each function as listed on the slide. Each will be discussed in more detail in upcoming slides
The skin plays a key role in protection, protecting the body against microbes, toxins, mechanical injury and the caustic environment we all live in
The skin also provides for sensation via nerve receptors
Water retention by maintaining needed fluids and nutrients within the skin
Thermoregulation via circulation and sweating
Synthesis of Vitamin D in the presence of sunlight
Expression of emotion
Did you know?
The skin is the only place in the body where Vitamin D is synthesized and occurs in the presence of sunlight.
Learning Concept
Understand age-related changes in the skin.
Teaching Points
Cellular Senescence – some cells no longer have the ability to reproduce and initiate cell division
Reduced Vitamin D Production – decline in vitamin D production and vitamin D receptors
Reduced Sensory Function – 30% reduction in nerve receptors in the skin and reduction of neurotransmitters leads to less awareness of pain, pressure, and exposure to heat and cold
Delayed Wound Healing - affected by compromised fibroblasts, tissue oxygenation, nutritional status. The inflammatory phase of wound healing is changed by the body’s ability to recognize and destroy pathogens and malignant cells.
Did you know?
Some of the changes of aging skin can be potentiated by other co-morbidities associated with elderly patients.
Learning Concept
Understand age-related changes in the skin, related to altered fibroblast function.
Teaching Points
Fibroblasts are fundamental for dermal structure and wound healing
Reduced in number in the aging skin
The decrease results in dermal atrophy, deterioration of dermal elastin, thinning of dermal collagen, decreased dermal strength and elasticity
There is also a reduction in the capacity of the fibroblasts to proliferate
Did you know?
A common analogy to explain the skin cells and lipids is comparing them to a brick wall, or “brick and mortar.”
Learning Concept
Understand age related changes in the skin related to decreased inflammatory response.
Teaching Points
Normal inflammatory response in wound healing is 1-5 days
Aging delays that process
The abnormal inflammatory response increases the risk for infection
The reduced number of macrophages also contributes to potential for microbial invasion
Did you know?
Atrophy of the cutaneous vasculature and capillaries in the dermis leads to reduced perfusion.
Learning Concept
Understand age related changes in the skin related to alterations in melanocytes.
Teaching Points
Pigmentation changes occur in the aging skin
This is caused by a change in the distribution and number of melanocytes
40% reduction per decade
Presents as “age spots” and graying of the hair
Did you know?
Melanocytes produce melanin that give color to skin and hair. The lighter skinned individuals produce less melanin than darker skinned individuals.
Learning Concept
Understand age-related changes in the skin related to decreased function of the sebaceous glands.
Teaching Points
pH is a measurement of acidity or alkalinity
Healthy skin is acidic – the “normal” range of our skins pH is 4.5- 5.5
pH is maintained by sweat and sebaceous glands
The slight acidic level of “normal” skin protects against microbes
pH of the skin increases with age
The increase in the pH makes the skin becomes more neutral or alkaline
This is caused by the reduced activity of sweat and sebaceous glands
Integrity of skin barrier is reduced
Did you know?
The naturally slightly acidic level of our skin is called the “acid mantle.”
Learning Concept
Understanding the age related changes in the skin related to the thinning of the skin and adipose tissue.
Teaching Points
Epidermis and dermis thin and are more susceptible to damage
Rete ridges flatten and make the skin more prone to skin tears
Adipose thins and there is reduced perfusion. Less perfusion makes the skin more prone to damage and slower repair.
Did you know?
The dermal layer sustains the most structural and atrophic changes.
Learning Concept
Factors to consider in maintaining skin health in the elderly.
Teaching Points
MARSI is a common injury among elderly. Adhesives that are used and then removed can cause damage due to the thinning of the layers and the flattening of the epidermal-dermal junction. Consider the adhesives that are applied.
Consider the types of cleansing that occurs. Use products that maintain an acidic pH, and do not require rinsing, when possible
Use soft disposable wipes for bathing, and avoid excessive rubbing or scrubbing of the skin.
Use of antimicrobial cleansing agents disrupts the normal flora of the skin, and should be used with caution.
Routine use of emollients to maintain skin barrier and restore moisturization levels.
Provide for adequate systemic hydration.