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Risques eczéma personnes âgées.

Eczema in the elderly: increased risks?

Eczema is a skin condition that typically affects infants and young children. However, it is not uncommon for older individuals to suffer from it. Are the risks of eczema complications increased in these latter individuals?

Summary
Published February 8, 2024, by Pauline, Head of Scientific Communication — 5 min read
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Eczema, in a nutshell.

Eczema is a skin condition characterised by skin inflammation . Most of the time, it manifests on the face, excluding the lips and eyes. However, it can also occur on other parts of the body, particularly on the knees and elbows. Eczema is characterised 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 identify several forms of eczema. One of the most common is atopic eczema, which is due to a specific genetic predisposition. Individuals with atopic eczema have a skin barrier that no longer fulfils its function, accompanied by a significant permeability of the stratum corneum. This results in substantial water loss and increases the ease with which microorganisms and allergens can penetrate the skin. It is also possible to suffer from eczema without having any genetic predispositions. This is referred to as contact eczema, which is a 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 non-existent. This may seem somewhat counter-intuitive at first glance if one considers that the skin barrier weakens with age due to the gradual decrease of certain moisturising compounds such as sebum and natural moisturising 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 susceptible to irritations and itching. However, older people 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 factors partly explain the low prevalence of eczema in older people.

Is eczema more dangerous in older people?

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 widespread, 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.

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 venous return of blood to the heart. This venous stasis is encouraged by several behaviours, notably sedentariness. As people age, they often become less and less active.

Key Takeaway : Elderly individuals are fragile and require tailored 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 doctor.

Sources

  • BORRADORI L. & al. Prurit du sujet âgé. Revue Médicale Suisse (2004).

  • GOLDENBERG G. & al. Eczema. The Mount Sinai Journal of Medicine (2011).

  • BORRADORI L. & al. Dermatologie et infections sexuellement transmissibles. Elsevier Masson (2017).

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