A survey of skin problems and skin care regimens in the elderly

In an attempt to provide clinically relevant data regarding both dermatologic disease and skin care needs in the elderly, 68 noninstitutionalized volunteers, aged 50 to 91 years (average age, 74 years), were enrolled in a study consisting of a 33-item questionnaire and a total cutaneous examination. Two thirds of the entire group and 83% of the 23 octogenarians reported medical concerns regarding their skin, with pruritus as the most frequent complaint. On examination, all subjects had at least one cutaneous abnormality, and symptomatic and/or medically significant disorders were present in 64.7%. In decreasing order of prevalence, disorders for which dermatologic therapy was judged desirable included actinic keratoses, tinea pedis, contact dermatitis, seborrheic dermatitis, stasis dermatitis, and skin cancer. Overall, there was rather poor correlation between the subjects' complaints and perceptions and objective physical findings. Further, despite a high prevalence and long average duration of dermatologic concerns, very few subjects had consulted a physician for these problems, and no complaints other than "rashes" and pruritus had ever been discussed with any health care professional. Review of skin care regimens revealed substantial limitations with regard to bathing, shampooing, and nail care, particularly for subjects aged 80 years or older. Despite a small sample size and possibility of selection bias among the subjects, these data strongly suggest that skin problems are common among the elderly and that at present their dermatologic needs are largely unmet.