How to manage skin tears and wounds as you age

It’s no secret that with life comes change, and as we age, our bodies are not immune to these changes, and as the years go on, our skin is just one of the many visible signs of ageing. The skin you’re in becomes thin and fragile, prone to tearing and long-suffering wounds.

Time’s fragile effect on our skin will happen regardless of how well it’s been looked after. However, there are many factors that can further weaken skin, such as:

• sun damage
• menopause
• smoking cigarettes
• nutrition and poor diet.

Starts at 60 have taken a deep dive into the causes behind these painful skin issues, looking into how best they can be treated and avoided.

What causes skin tears and wounds?

Speaking with Starts at 60, GP and founder of Candor Medical, Dr Lisa Beckett says skin tears are a common injury for seniors.

“They occur when the skin is stretched or pulled too far, causing it to tear. As we age our skin becomes thin and fragile. Because of this, even minor injuries, like bumping into a doorframe, can lead to a skin tear,” Dr Beckett said.

According to Beckett, skin tears result in numerous ways, however, there are three main skin injuries that lead to tearing:

• Shearing injuries: “This occurs when the skin is pulled in opposite directions, such as when a person is transferred from a bed to a wheelchair.”
• Stripping injuries: “This occurs when the skin is pulled off of the underlying tissue, such as when tape is removed from the skin.”
• Crushing injuries: “This occurs when the skin is compressed between two hard surfaces, such as when a person falls onto a hard surface.”

How to avoid skin tears and wounds

If left untreated, skin tears can cause major complications leading to infection and painful wounds that are slow to heal. The good news is, skin tears are largely preventable.

Dr Beckett says the first step in wound and skin tearing prevention, is to conduct a risk assessment.

“Ideally, we want to prevent getting a skin tear in the first place. Recognising the risk factors for a skin tear can help manage this risk,” she said.

A risk assessment should include factors such as:

• a skin inspection for dry and fragile skin
• advanced age
• previous history of skin tears
• poor nutrition and hydration
• risk of falls or injury and level of dependency
• limb and joint stiffness
• cognitive and sensory impairments
• medicines that affect the skin
• prosthetics that may rub on skin
• causes that may lead to prolonged contact with moisture (incontinence aids).

Once the risk factors are identified, Dr Beckett suggests chatting with your doctor to discuss any lifestyle changes that may be necessary, and to consider an assessment conducted by an Occupational Therapist.

“Have a talk to your doctor about your health. Discuss your medications, especially if they make you feel unwell or unsteady,” Dr Beckett said.

“Make sure your medical conditions are well optimised. Things like having to get up during the night to go to the toilet, feeling dizzy or poor eyesight can all increase your risk of falls.

“If you feel unsteady on your feet or you’re worried about falls – ask for a falls risk assessment.

“Consider getting an occupational therapist to come to your home and help with modifications like rails if needed. Remove rugs or loose carpet from the floor, wear well-fitting shoes, not slippers, and make sure you have good lighting.”

Dr Beckett advised that if you do suffer from fragile skin, you should avoid sticky dressings, sharp nails and jewellery and moisturise twice daily to keep your skin well hydrated.

“Eat a healthy balanced diet and stay hydrated, your skin is a continuation of your gut. If you’re lacking nutrients or you’re dehydrated it will compromise your skin health,” she added.

How to treat skin tears and wounds

On the unfortunate occasion that a skin tear occurs, Dr Beckett offered first aid treatments to use while waiting for professional medical help.

The first step is to “stop any bleeding by using firm pressure with a cloth or bandage” before attempting to clean the wound.

While it’s best to wait for your doctor, if you can, gently clean the wound with “water and disinfectant”, especially “if the wound is dirty” from an incident like taking a tumble in the garden.

“In some skin tears, the outer layer remains attached like a flap, and in others, it can be completely removed. If there is a skin flap we aim to keep it as close to the skin’s normal position as possible to help protect the wound while it heals,” Dr Beckett said.

With that in mind, and once the wound has been gently dried, Dr Beckett says to “apply non-stick dressings and a bandage”.

“I find it is a good idea to draw an arrow on the dressing in the direction that it should be removed to avoid lifting any skin tears when changing it,” she added.

“In most cases we’d suggest a review with your doctor or wound clinic to make sure the wound is clean and to help give the best chance of healing.”

Whilst ageing skin can’t be stopped, it’s important to continue to stay moisturised, hydrated, and maintain a balanced, healthy diet to aid our skin in its ageing process.

“Most importantly, wearing sunscreen and avoiding sun damage is essential,” Dr Beckett stressed.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.