Senile pruritus is one of the most common conditions in the elderly or people over 65 years of age with an emerging itch that may be accompanied with changes in temperature and textural characteristics.
[4] The IFSI (International Forum for the Study of Itch) created another classification process for pruritus in the senile population.
Skin moisture keeps the barrier function intact, but reductions can lead to a decrease in the itch threshold needed to be reached.
[8] These alterations may lead to increased immunoreactivity to intrinsic and extrinsic stimuli that can cause the body to become more sensitive and reactive.
The immune system is responsible for a myriad of activities to defend the body from foreign substances via various endogenous and exogenous pathways.
In the case for the aging population, the thymus gland undergoes physical and chemical conformational changes that reduce the organ's size and therefore impacting its function to produce T cells.
[1] The back, legs, arms, scalp, and genitalia are areas of the body that are commonly affected by senile pruritus.
After being treated for xerosis and tested for scabies, if the senile pruritus persists, screening for an underlying systemic disease can be recommended.
However, repeated diagnosis requires further evaluation, taking into account a person's laboratory measurements and medical conditions.
Topical treatments may be used to reduce inflammation and the painful or itchy sensation or flare-ups locally at the site on the skin.
Some common anti-histamine medications may include: Immunosuppressants have seen use at low doses alongside systemic steroids and phototherapy for chronic symptoms of senile pruritus or dermatitis.
[14] Immunosuppressive medications may include: Anticonvulsants have also found use as a substitute for oral antihistamines to treat senile pruritus, and can be adjusted accordingly to individual needs and characteristics.
[6] Topical salicylic acids and cannabinoids have been used for pruritus as well, though their pathway is not clearly known and need more studies before this can be shown as a safe and viable treatment.
Non-invasive brain stimulation, often used to treat neuropsychiatric conditions, has shown to be successful in repressing the itch cycle.
[15] The device works by sending electrical currents that can redirect how the signaling cascade is fired through the peripheral and central nervous systems.
UV light phototherapy has been used to treat various pruritic symptoms such as pruritus resulting from renal disease, eczema, or just of unknown origin.
Recurrent scratching, especially over the same area can lead to skin thickening which may prevent some medications from effectively working to treat the chronic itch.
[19] Even certain ongoing medication usage can have a link to pruritus triggering in the elderly, but current treatments should not be the only thing to be wary of.
[6] Every treatment used with the elderly is managed with caution because of potential risks involved, such as higher toxicity compared to younger individuals since medications are metabolized differently.