How to Care For Fragile Skin

Fragile Skin

As a person ages, skin becomes naturally thinner, fragile and can tear easily. Persons with decreased ability to move around, especially those who are bed and wheel chair bound are at increased risk for injury, as are those with sensory deficits. Certain medications, such as the long term use of corticosteroids, can cause skin thinning and delayed wound healing. Dehydration and poor nutrition decrease skin turgor and resilience and add to the risk of skin tears and breakdown.

Skin Care Tips

Care of aging skin helps prevent skin tears, skin breakdown, infection and unnecessary suffering.

Check for irritation.

• Assess regularly for areas of redness, discoloration or bruising.
• Pay special attention to areas of edema.
• Look for dry, cracked skin and blisters, scrapes or tears.
• Listen to complaints of itching, tenderness, burning or aching on skin surfaces or underlying tissue.

Keep skin clean.

• Use non-soap products free of dyes and perfumes.
• Use warm water when bathing – elderly skin is more sensitive to temperature extremes.
• Pat skin dry with soft towel or bath blanket.
• Avoid rubbing with rough towels.
• Apply additive free lotion after bathing to maximize absorption and twice daily on other days to extremities, to keep skin moist.
• Always clean skin carefully after toileting with mild soap and water, or use disposable wipes.
• Keep clothes and bedding clean and dry. Use disposable absorbent diapers and bed pads if needed.

Keep nails short.

• Remind the elderly, health care workers and caregivers to keep their nails trimmed and filed to prevent accidental injury.
• Avoid wearing jewelry that can snag frail skin.

Re-position frequently.

• Encourage re-positioning every 1-2 hours to increase circulation to pressure areas. Don’t massage over bony prominences to avoid damage to underlying tissue.
• Remind the person to shift their weight every 15 to 20 minutes when sitting or lying down.
• Pay attention to the person’s posture and position to reduce shear. Elevate the head of the bed to maximum of 30 degrees.
• Special mattresses and bed pads may be needed to protect the person from developing pressure wounds.
• Dress the person in soft, long sleeved shirts and non-binding calf high socks to protect the skin from tears.
• If patient needs assistance, use draw sheet when turning or lifting to reduce friction. Make sure bottom sheets are wrinkle free.
• Use pillows, gel pads and padding to protect bony areas and reduce pressure.
• Pad chair arms and bed rails to prevent bumps and bruises. Foot and elbow pads and forearm protectors also help reduce injury.

Remove tape carefully.

• Avoid ripping tape or adherent dressings from fragile skin to prevent pain and injury.
• Secure dressings or gauze with paper tape or other non-adherent wrap, such as stockinette or netting to prevent further injury to surrounding tissues.

Remember:

• Do offer fluids often to prevent dehydration.
• Do encourage good nutrition.
• Don’t use donuts; they create pressure and decrease circulation.

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