Skin Changes in the Elderly: Identifying and Treating Benign Lesions

Skin changes are common with age, and it is not uncommon for a variety of different marks, such as moles and freckles, to develop because of sun exposure. Here, we discuss some of the most common types of non-cancerous skin lesions seen in the elderly population.

Seborrheic Keratoses

Seborrheic keratoses are common, noncancerous skin growths that often appear on the face, chest, shoulders or back. Typically, they are slightly elevated from the skin surface and appear as waxy brown, black or tan growths. No treatment is necessary, but if a seborrheic keratosis causes irritation, it can be removed by a doctor. Healthcare professionals should advise patients that these growths are benign and do not need to be removed unless they cause discomfort.

Lentigo Senilis

Also known as age spots or liver spots, these are hyperpigmented macules of skin that occur in irregular shapes, appearing most commonly in sun-exposed areas of the skin such as on the face and back of the hands. They are tan to dark brown macules which are typically uniform in colour. Healthcare professionals should reassure patients that these spots are harmless but should be monitored for any changes in size, shape, or colour.

Dermatofibromas

Dermatofibromas are firm bumps that often develop after minor skin injuries or insect bites. They can appear anywhere but are most common on the lower legs. Dermatofibromas are harmless and do not usually need treatment. However, they can be removed if they cause discomfort or for cosmetic reasons. Healthcare professionals should advise patients to monitor these lesions and report any changes in size or colour.

Dermoid Cysts

Dermoid cysts often contain odd contents such as hair, parts of teeth or bone, fatty tissue, etc. They tend to occur in younger women but can persist into old age. Healthcare professionals should advise patients that these cysts are benign but may need to be removed if they cause discomfort or for cosmetic reasons.

Keloids

Keloids are raised overgrowths of scar tissue that occur at the site of a skin injury4. They can occur after minor injuries or after surgery. Keloids can be effectively treated with corticosteroid injections to reduce inflammation or with surgical removal followed by radiation therapy to prevent recurrence. Healthcare professionals should advise patients that these lesions are benign but may need treatment if they cause discomfort or for cosmetic reasons.

Keratoacanthomas

Keratoacanthomas are rapidly growing, dome-shaped skin lesions that resemble a volcano. They typically occur in sun-exposed areas and are more common in older adults. Although keratoacanthomas usually resolve spontaneously within months, they can be difficult to distinguish from squamous cell carcinoma. Therefore, surgical removal is often recommended4. Healthcare professionals should advise patients to monitor these lesions and report any changes in size or colour.

Lipomas

Lipomas are soft, fatty lumps that grow under the skin. They’re non-cancerous and harmless but can be removed if they’re causing discomfort or for cosmetic reasons4. Healthcare professionals should advise patients that these lumps are benign but may need to be removed if they cause discomfort or for cosmetic reasons.

Moles

Moles are small, coloured spots on the skin. Most people have them and they’re usually nothing to worry about unless they change size, shape or colour. Most adults have some common moles, but they often fade by the age of 40. Healthcare professionals should advise patients to monitor their moles and report any changes in size, shape or colour.

In conclusion, there is a wide range of non-cancerous skin lesions seen in the elderly population. Regular skin examinations are crucial for early detection and treatment of any potentially harmful lesions. As healthcare providers, it’s important to educate patients about regular self-examinations and when to seek medical attention.

For further knowledge and understanding of dermatological conditions in older adults, we highly recommend the article Understanding and Managing Skin Lesions in the Elderly, available on the Practitioner Development UK website. This article offers valuable knowledge about different types of malignant lesions common among the elderly, serving as a useful tool for healthcare practitioners.

References:

American Academy of Dermatology, 2021. Age spots (liver spots). [online] Available at: https://www.aad.org/public/diseases/a-z/age-spots-liver-spots-overview [Accessed 12 October 2023].

American Academy of Dermatology, 2021. Seborrheic keratoses. [online] Available at: https://www.aad.org/public/diseases/a-z/seborrheic-keratoses-overview [Accessed 12 October 2023].

American Academy of Dermatology, 2021. Dermatofibromas. [online] Available at: https://www.aad.org/public/diseases/a-z/dermatofibromas-overview [Accessed 12 October 2023].

American Academy of Dermatology, 2021. Sun and age spots. [online] Available at: https://www.aad.org/public/everyday-care/skin-care-basics/care/sun-age-spots [Accessed 12 October 2023].

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