Can you develop eczema later in life?
Eczema can develop later in life due to lifestyle habits such as poor sleep and stress, family genes and ethnicity, and circulatory conditions like varicose veins. Ageing also causes the skin to become thinner and drier and more prone to inflammation, and eczema can then develop as the skin becomes over-sensitised.
1. Age, family genes and ethnicity
Adult eczema affects between 5-10% of people in the UK. (1) It is more common in urban areas and among people of black and Asian ethnicities. The incidence, or first diagnosis, of eczema or itchy, dry skin becomes more likely for everyone after their 59th birthday. (2)
There may also be some underlying genetic reasons why some people are more susceptible to eczema. 50% of sufferers are thought to be lacking a protein in the skin called filaggrin, which weakens skin's barrier function. Many of those who develop eczema later in life may have had eczema in childhood but have not been troubled by it in their early adulthood. Alternatively, you may find existing eczema worsening as you get older or for other reasons.
2. Skin becomes thinner as it ages
As we age, the skin thins and collagen production wanes. Skin becomes more fragile and transparent. This is not ideal, as eczema is thought to be a problem with the skin's barrier function. (3) When thinned and weakened, it reduces the skin's ability to keep irritants and allergens out. Eczema develops as the skin becomes over-sensitised, usually to harmless things, like wool, dust or soaps. The immune cells in the skin react to would-be threats by firing off natural chemical reactions that cause inflammation, redness and itching.
Eczema around the eyes is common in older adults. The skin there is particularly thin and fragile and often irritated by medicated eye drops, skincare products, makeup and even tears. Avoiding known irritants will help reduce flare-ups of redness and inflammation. Try not using anything but water on, or around, the eyes to see if that will help. Talk to your pharmacist or GP if you think that any prescribed medicated creams or drops are causing skin problems.
3. Skin becomes drier as it ages
One type of eczema that is very common in older people is Asteatotic or xerotic (dry skin) eczema.(4) The skin becomes itchy and abnormally dry. It can look scaly or cracked like crazy paving. My granny used to have this on her lower legs but it can pop up on the torso or arms as well. It happens because older skin isn't as efficient at producing moistening compounds that keep the skin's external barrier strong. Women may be further disadvantaged as hormonal shifts (i.e., menopause) can also affect skin moisture.
Young plump skin is generally dewy with moisture, and this is because new skin cells are really good at firing out natural moisturising factor, hyaluronic acid and sebum.
Natural moisturising factor (it's moisturising and protective!) is a complex mix of proteins, salts, sugars, and other stuff like urea. Its production is somewhat dependant on the protein filaggrin. A lack of filaggrin is strongly associated with eczema and atopic dermatitis.
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Asteatotic eczema is caused by a loss of water from the outer layer of the skin. It can get worse in cold, dry weather.
Other things that can dry your skin out are over-washing; washing or soaking in water that is too hot; and using toiletries that strip moisture from the skin. It's better to use gentle, hypoallergenic soaps (sparingly) or soap alternatives. Bathing in warm water, rather than steaming hot, will stop your natural oils from being washed away. Use a rich moisturiser afterward that will protect the skin from drying out, especially when the weather is harsh or heating is on.
4. Age can impact blood vessels and circulation
The skin is made of layers of different cells that rely on a constant supply of oxygen and nutrients delivered by the blood (via the arteries, veins and tiny capillaries). Older people are more likely to have conditions like varicose veins which restrict blood flow to the skin. Cardiovascular disease has been associated, in studies, with atopic dermatitis/eczema. (5) Stasis dermatitis or varicose eczema affects up to 20% of those over 70, usually affecting the lower legs.
One-third of all adults are affected by varicose veins.(6) This is a condition that worsens with age and weakens the walls of the veins in the legs, causing them to swell and bulge. Fluid can leak into the surrounding tissue and cause swelling and inflammation. Skin irritation and itching can occur as the immune system responds, producing an eczema reaction. Women are more likely to be affected. Being overweight puts additional pressure on the veins, as does standing for long periods, smoking, and of course pregnancy.
5. Lifestyle habits
Lifestyle habits can worsen eczema.
A lack of sleep can affect eczema because it increases inflammation and aggravates the immune system.
- Easy tips that may help establish a sleep routine: Go to bed at the same time every night. Avoid rich food, alcohol and caffeine in the evenings.
Stress can make our skin sweat or flush. It shouldn't be surprising to learn that it can trigger skin conditions like eczema.
- Stress-relieving tip: Take a deep, slow breath in through your nose. It may help to count to 5 or 7, whatever feels comfortable. Hold your breath for a moment and breathe out as slowly as you can using your mouth this time. Try and count to at least 5. Repeat this cycle for 3-5 minutes. Do it as often as you can, sitting on a bus, in traffic, while the ads are on.
Skin neglect. Chronic dry skin that is not moisturised can get inflamed and this can develop into eczema.
- Moisturising tip: Find active skincare products that suit your skin and apply them as often as you can.
Inactivity is linked to cardiovascular disease and obesity, both of which are associated with an increased risk of developing eczema. Unfortunately, many eczema sufferers find that sweating makes their eczema worse and therefore try to avoid exercise.
- Exercise tip: Take regular breaks to avoid overheating. Drink lots of water and shower then moisturise after exercise and read this article on exercising with eczema.
Certain foods like fizzy drinks, fatty take-outs, cake and alcohol can increase inflammation in the body, which can lead to eczema flare-ups.
- Healthy eating tips: Try to include one food a day (or more!) that is beneficial for the skin and that reduces inflammation. Good oily foods are linseed, hemp seeds and walnuts, which are rich in omega fats. Vegetables and fruit contain lots of anti-inflammatory components. The more intensely coloured they are, the better; like spinach, raspberries or blueberries.
Very dry skin is associated with some underlying conditions, for instance: thyroid disease, diabetes, and certain nutritional deficiencies. Talk to your GP or health care professional if you have accompanying symptoms that you are concerned about.
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