This week on MedHeads I spoke with Zoe Lance about skin integrity.
Skin is the largest organ od the body and serves many functions including its physical barrier function, the prevention of infection, the regulation of body temperature and sensation. As skin ages skin loses its collagen content. Chronic sun exposure can also contribute to skin aging. The net effect of this is skin thinning, reduced elasticity and reduced wound healing. The moisture content of skin is also important.
The optimal water content in skin is about ten per cent. Both too much moisture (causing skin maceration) and too little moisture (causing dry skin) in the skin can reduce skin function. Air is dryer in the winter when air is colder and less able to store water vapour, and also dryer in houses with central heating so skin tends to lose moisture in these conditions.
Dry skin needs to be moisturised at least once a day, if not three times per day. Dry skin is also more sensitive to the irritant effects of soap. Managing skin integrity also involves making sure that skin folds are not damp, because this can cause skin to become macerated and then ultimately infected. Nails need to be kept short and web spaces need to be dried after washing to prevent the risk of fungal infection.
Skin needs to be inspected regularly, not only for overall integrity, but also for blemishes and lesions that need to be checked out by a doctor. Pressure areas such as the elbows, knees, the lower back and the buttocks need special attention. The first sign of a pressure sore is a red rash developing over these pressure areas. Moisturising the skin and offloading the affected area can prevent an ulcer.
Skin in the pelvic region is particularly vulnerable to the effects of incontinence. Urine is generally acidic so exposure to skin to urine can cause chemical irritation which in turn can lead to loss of barrier function, infection, and ulceration. Incontinence needs to be managed appropriately and pelvic skin needs to be protected with thick barrier creams.
Finally, just like us, our skin needs to be fed and watered adequately. Attention to nutrition and hydration is important for our general health as well as our skin health.
Author: Ferghal Armstrong FRACGP, FAChAM, FASLM
Ferghal is a general practitioner, Adiction Medicine specialist and fellow of the Australasian Society of Lifestyle Medicine