Geriatric hands usually refers to the aging and flaking of the skin on the hands, while ichthyosis is a keratotic disease in which the patient will develop the phenomenon of geriatric hands due to abnormalities in the skin barrier and varying degrees of flaking of the skin throughout the body. The two are due to common pathophysiological changes caused by different reasons, and thus will present with similar clinical phenomena. The skin is the outermost physical barrier of the body, protecting it from dehydration, ultraviolet radiation, and the invasion of infectious agents on a daily basis. However, the skin is also one of the first organs to exhibit aging. Normal aging of the skin leads to atrophy, reduced elasticity, impaired metabolic and repair responses, combined with reduced sebaceous gland secretion and abnormalities in structural proteins or enzymes involved in skin barrier homeostasis, resulting in flaking of the skin in the elderly. While most ichthyosis is caused by genetic factors, it can also be caused by malignant tumors, autoimmune diseases, infectious diseases, and nutritional deficiencies. Patients are prone to skin flaking because of genetic mutations that abnormalize structural proteins or enzymes involved in skin barrier homeostasis. In both diseases, the structural proteins or enzymes involved in skin barrier homeostasis are abnormal, so patients with ichthyosis may develop a clinical phenomenon similar to that of elderly hands. When skin flaking symptoms occur, care should be taken not to bathe as frequently as possible to avoid damaging the skin surface barrier and reducing sebum secretion, thus aggravating the above symptoms. In addition, patients can add some fresh fruits and vegetables in appropriate amount to replenish skin moisture and relieve the flaking symptoms.