Itchiness in the elderly

Many elderly patients who complain of itch may not have any primary skin condition.

• due to the increase in permeability of skin, elderly people are more likely to have dry skin leading to itching (1)
• between 10 and 50% of pruritic patients have systemic disease (see investigations)
• prurigo is a relatively common cause
• differential diagnosis includes scabies, lice, mites, fibreglass, eczema, winter itch, aquagenic pruritus

If the above have been considered, think of asteototic eczema.

Routine application of emollients together with other preventive measures such as maintaining good nutrition and keeping the ambient environment cool will prevent poor skin health (1).

Reference:

• (1) Dermatology UK (2007) Best practice in emollient therapy: a statement for healthcare professionals