Pruritus senileis is very common
Although there are only pruritic symptoms without primary skin damage, the disease process is recurrent and often itchy, which seriously affects the quality of life of the elderly in their later years.
What are the clinical features?
Generalized pruritus, which can develop everywhere in the body, with paroxysmal itching, often shifting from one place to another, with varying degrees of itching, and intensifying at night, seriously affecting the quality of sleep of the elderly.
How does the skin behave?
The skin is mainly dry, thin, and flaky, with scratches and scabs from prolonged scratching, eczema-like changes, lichenoid changes, and hyperpigmentation, and in severe cases, secondary skin infections.
Many elderly people with itchy skin mistakenly believe that it is caused by their unhygienic daily life and often wash the itchy parts with boiling hot water, resulting in a vicious cycle of itching and scratching.
What are the factors that cause the disease?
Physiological factors
Degenerative skin changes
As we age, the skin, the largest organ of the body, ages, mainly due to the aging of keratinocytes and fibroblasts.
Altered skin immune function
T-lymphocyte phenotype and function are significantly altered in older patients, with changes in cell quantity and quality as well as in the composition of cell subsets.
Changes in endocrine factors
In humans, hormone levels gradually decline in old age, while serum testosterone is lower than normal and serum estradiol and progesterone levels are higher than normal in elderly with pruritus.
Pathological factors
Pathology
Pruritus can be a symptom of many internal diseases, the most important ones being liver disease, renal failure, hyper- or hypothyroidism, iron deficiency anemia, and tumors of various tissue sources, with diabetes being even more of an important etiology.
Other
Allergies, neuro-psychiatric factors, etc. can also cause pruritus.
What are the treatment options?
General treatment and care
Pruritus caused by pathological factors requires symptomatic treatment according to the cause. Many elderly people actually do not have obvious pathological factors and should first focus on life care to avoid aggravating the disease. For example, avoid overly hot bathing water, avoid frequent use of alkaline soap, appropriate psychological adjustment, etc.
Systemic treatment
Antihistamines
Procaine hydrochloride intravenous closure
Sex hormones
Opioid receptor antagonists and 5-hydroxytryptamine receptor antagonists
Topical treatment
Emollients + physical therapy, e.g. olive oil, UV radiation
Traditional Chinese medicine
Medications
Chinese herbal topical lotion, Chinese herbal tincture topical rub, cream topical application, etc. Mostly use Chinese herbal medicines with the effects of dispelling wind and dampness, detoxifying and killing insects, nourishing and invigorating blood, cooling blood and moistening dryness.
Non-drug
Acupuncture therapy, ear point therapy, cupping, gua sha, etc.