Therapeutic challenges in the mature patient

[Practical problems with the use of topicals in geriatric dermatology]

Changes related to aging affect all layers of the skin and are influenced by both intrinsic conditions and extrinsic factors. The extent of the senescent changes can vary enormeously in seniors, so that an individual assessment is useful and often necessary. Of particular clinical importance are changes in the epidermis, which entail a complex reduction of the barrier function and a reduction in the compensatory capacity with regard to exogenous noxae. This results in increased susceptibility, especially toward infection and cancer. Against this background, a prophylactic strategy for the substitution of the physicochemical and thus also the microbiological barrier in the context of basic care is very important. In order to be able to implement these consistently, recommendations for preparations explicitly designed for aging skin as well as practical instructions for use are highly meaningful. The latter should take into account limitations regarding mobility as well as possible cognitive deficits of seniors. For this purpose, creams and suitable preparations in terms of viscosity and composition should be recommended. In order to facilitate implementation, written or pictorial recommendations for application as well as digital assistance systems can be used. Due to demographic developments in Germany and Europe, the clinical relevance of geriatric dermatology will significantly increase in the future.