Maintaining skin integrity is important as it is the body’s barrier to protect from bacteria, toxins, sunlight, etc (1). Older adults are at increased risk for impaired skin integrity as a part of the aging process.
Skin loses tone and elasticity with age, putting the elderly at increased risk for impairments. Estimations indicate that 3% of people over 65 years old in the U.S. have a wound at any given time (2).
Types of Impaired Skin Integrity
- Skin tears
- Pressure ulcers
- Excoriation
- Dermatitis
- Cellulitis
- Surgical site
- Vascular ulcers
- Diabetic wounds
- Burns
Factors Impacting Skin Integrity
Many diseases and other factors impact tissue integrity and repair (3, 4).
Intrinsic Factors
- Nutrition
- Vascular disease
- Diabetes
- Incontinence
- Malnutrition
- Edema
- Anemia
Extrinsic Factors
- Falls
- Trauma
- Mobility
- Surgery
- Pressure
- Positioning
- Smoking
Nutrition for Skin Maintenance
Adequate nutrition is important for maintaining skin integrity and healing impairments.
Energy
Eating enough to regularly fuel the body is necessary to support immune function. An optimal immune system is an important factor for maintaining skin integrity.
Wound healing requires increased energy to repair and build new cells (5). Adequate calories are needed to meet this increased demand and for protein sparing, so it can be used in the healing process.
Protein
Protein is needed to make and repair tissue (6). Inadequate protein intake contributes to increased fragility of skin and poor wound healing (7).
Amino acids are the building blocks of protein. Some may be more beneficial to healing, such as arginine and glutamine.
There are specialized wound care protein supplements on the market containing these specific amino acids. However adequate protein intake overall is necessary for these specialty supplements to be of value.
Protein sources include beef, chicken, turkey, pork, fish, tofu, milk, cheese, eggs, yogurt, protein powders, nutritional supplements, etc.
Hydration
Adequate fluid intake is necessary for maintaining and healing skin (8). Those with wounds have increased fluid needs, especially when drainage is present.
Frequent sips of water or other fluids throughout the day, as well as with meals, can help meet hydration needs. Also consuming fluid containing foods, such as soups, jello, ice cream, and popsicles may be helpful.
Vitamin C
Vitamin C is an antioxidant. It is involved in several cell related processes. Insufficient intake of vitamin C can lead to fragile skin and impaired healing (9).
Adequate vitamin C promotes skin healing and can improve skin hydration (10). Sources of vitamin C include citrus, kiwi, red peppers, broccoli, brussel sprouts, and strawberries.
Vitamin A
Vitamin A is involved in several processes regarding skin cells. Its deficiency is linked to delayed healing (11), however too much can lead to toxicity.
Sources of vitamin A include apricots, sweet potato with skin, carrots, spinach, whole milk, and salmon.
Vitamin D
Vitamin D aids in improved immunity and wound healing (12). Sources include sunlight, fortified milk, tuna fish, and egg yolks.
Zinc
Zinc (Zn) is a mineral involved in the process of wound healing. Research does not show, however, improved healing with oral Zn supplementation (13). It may only be helpful for those that are deficient.
Final Thoughts
The elderly are at increased risk for impaired skin integrity and delayed healing. Adequate nutrition is necessary to maintain skin and heal impairments. Some may benefit from supplementation to prevent wounds and promote healing.
Thinning skin and fragile small blood vessels present such a risk for skin tears and bruising in older adults. These situations make nutrition status so important in healing. Your advice on specific foods for skin health are excellent!