Atopic Dermatitis and Aging Skin
My skin, my eczema, is changing in subtle ways as I age, and not just the added wrinkles! I know the thinning of the skin, on my hands especially, has been hurried along by the use of cortisone creams. But my skin seems dryer, itchier, and I think it takes less exposure to an allergen to cause an outbreak. More flares more often.
Was it aging or some condition?
I began my research, hoping to discover if this is a result of aging itself or another less obvious condition for which there could be some relief. I discovered terms like senile atopic dermatitis, eczema heterogeneity, (different causes), asteatotic eczema, which, it turns out, is the same as eczema craquele, named for its look of cracked porcelain. This looks like what I have developed on my shins, which is the most common place it manifests itself and does happen more often in the elderly.
Atopic dermatitis in the elderly
I discovered that until recently, most studies and guidelines did not include people over 60 as a separate group. But now, atopic dermatitis in the elderly does represent a newly defined subgroup. Elderly patients with allergic atopic dermatitis are showing higher rates of positivity for specific IgE antibodies against house dust mites, followed by pollens and foods. Another difference in the elderly is a lower incidence of lichenified eczema at the elbow and knee folds. It also is slightly more common in men.1
Changes to skin as we age
As we age, our skin barrier function decreases, allowing for more reactions from those pollens and dust mites. Plus aging skin doesn’t recover as well as when we’re young. Other changes that are found in the elderly, even those without a history of atopic dermatitis seem to be eczema-like itching and xerosis (dry skin). No wonder my skin is showing it’s age! Seniors often become hypersensitive to fragrance mixes. No surprise there. Just walking past the open door of a scented candle or soap shop sets off a reaction.
Dupixent in 65+ patients
A recent study on the efficacy and safety of dupilumab (Dupixent) was conducted in a group of patients aged ≥ 65 years and affected by severe AD. It showed a significant improvement over the 16 weeks of treatment with a good safety profile. So at least we now have that as an option if needed.
What did I learn?
What did I learn from all this? I think aging is most likely the main reason my skin is slowly changing, or should I say showing its age? Why it seems dryer, itchier. But with my new knowledge of the changes brought about by aging with AD, the dust mites, the pollen, I need to find a way to avoid some of those triggers. If that’s even possible.
So I’ll continue doing my best, taking care of my skin. The constant moisturizing, trying to avoid triggers, even trying to avoid stress. But I’ll also keep trying new products in the perhaps vain attempt to acquire more healthy skin. I plan to become a super-ager, and I really don’t want to take all this itchiness, the flaking, cracking and peeling into my next century. Perhaps I’ll revisit this topic closer to my hundredth birthday.
Have you completed the Atopic Dermatitis In America survey? Answer poll for survey link.