Pharmacotherapy for Skin Disorders in Older People

Abstract

Human skin is a visible indicator of age. Structural and physiological changes that occur intrinsically with ageing skin combined with the effects of cumulative extrinsic damage can result in a marked susceptibility to cutaneous disorders in older patients. The progressive degeneration of ageing skin results in atrophy of the vasculature, deterioration of supporting dermis and erosion of normal immune function. Changes from the intrinsic and extrinsic effects of ageing skin have a wide clinical expression, e.g. xerosis, eczema, seborrheic dermatitis and contact dermatitis. Although rarely fatal, these cutaneous disorders can cause morbidity and reduce quality of life. Primary skin malignancies resulting from cumulative solar damage also carry considerable mortality. There have been exciting advances in the diagnosis and treatment of skin diseases in older people. However, comorbidities, polypharmacy and altered pharmacokinetics seen in older people pose significant challenges to effective treatment. Managing skin disorders in older people is often less than optimal because their special needs and limitations are not adequately addressed. This review provides an overview of treatments available for managing skin conditions commonly encountered in older people.