It is not unusual for a patient to see me with 3 or 4 bandages on his or her arms from insignificant bumps that lead to large tears of their skin. Thinning of the skin is a serious problem for some elderly patients. But what can you do about it?
As we age, the thick collagen layer of the skin (the layer that leather is made from) atrophies or thins out. This is due to normal aging processes where breakdown of collagen and elastin (the proteins that makes skin spring back when stretched) is not balanced with production of new collagen and elastin.
This loss of collagen is accelerated by ultraviolet light damage. Ultraviolet light, which is a form of radiation from the sun, leads to a gradual but relentless destruction of the collagen and elastin in the skin. Thin, tissue paper-like skin occurs mostly on the arms and hands — two areas that have very high levels of exposure to ultraviolet light over a lifetime. Here in the US, the left arm is usually worse than the right; this is from a lifetime of exposure from the driver’s side window when driving.
The only thing that can be done for thin skin is to minimize damage before it is too late. This is especially important on the forearms and hands. The best way to do this is to wear long sleeves. Long sleeve shirts provide excellent protection from ultraviolet light damage (even plain cotton is an excellent sun barrier, probably better than any sunscreen). When long sleeves are not practical, then applying a broad spectrum sunscreen (that blocks both UVA as well as UVB light) is a good alternative. Sunscreens need to be reapplied every 4 hours to give good protection.
Once thinning of the skin has developed, there is little that can be done to reverse it. Again, wearing long sleeves is helpful because the clothing protects the skin from tears from minor bumps or scrapes.
Dry skin is also more susceptible to damage. Applying a thick moisturizing cream twice a day can help keep your skin protected. Minimizing washing with soap can also help preserve the natural oils on your skin, protecting it from further damage.
Eating a diet high in lean protein and getting adequate calories can also be helpful in maintaining your skin’s strength and in helping it repair quickly when a tear develops.
Lastly, avoid using topical steroids for longer than necessary — topical steroids hasten thinning of the skin and can make the problem worse. Fortunately, thinning of the skin from steroids is reversible and will improve after the steroids are stopped.