7 steps to helping senior skin heal

Two weeks ago, 86-year-old Jim tumbled down his front porch steps. He caught himself before he hit his head but scraped a 3-inch gouge out of his left forearm. When I asked how he was doing, he showed me his left arm, which two weeks later was still open, and oozing a clear fluid.

“I clean it with hydrogen peroxide twice daily and keep a bandage over it at night to protect my sheets. I’m keeping it nice and clean, so why isn’t it healing?”

“Jim, using hydrogen peroxide is a good antiseptic when cleaning a cut or scrape for the first time. Hydrogen peroxide stops bacteria from growing, but it also interferes with your body making new tissue. Every time you clean a wound with peroxide, you’re poisoning all the new cells your body made, trying to heal it.”

“Should I use rubbing alcohol instead?"

“No, because rubbing alcohol on cuts or scrapes isn’t any better than using hydrogen peroxide. In fact, soap and water or plain water will clean wounds just as good or better than rubbing alcohol.

There are two types of rubbing alcohol, ethyl alcohol, and isopropyl alcohol. Both types of alcohol help clean intact skin. But if you use alcohol to clean open cuts or wounds, not only does it burn like fire, it damages your skin cells. This can prevent your wound from healing.”

Our skin becomes more fragile as we age. Many seniors find that when their arm or shin comes in contact with a rough surface, the top layer of their skin peels back

 instead of getting a scrape.

You should seek immediate medical attention if a cut or scrape is deep or bleeding profusely. Otherwise, apply direct pressure for at least 1 minute without letting up to help stop the bleeding. Once the bleeding has stopped, you can clean the open area with plain water or soap and water.

NEVER cut off any skin that is still attached. This creates an open wound that will need to fill, taking much longer to heal. Instead, smooth the peeled-back skin layer down over the damage as best as possible before putting any bandage or dressing over it.

For skin that rips easily, I recommend using a thin, transparent dressing like Tegaderm® instead of a padded Band-Aid®. Tegaderm® dressings keep wounds clean and dry while allowing them to "breathe," which encourages healing. Tegaderm® and other special dressings are available in most pharmacies and in all medical supply stores.

For a skin tear, fitting the top layer of skin back over the wound and using a transparent dressing over the injured area can save “peeled back” layers of skin. They often heal entirely without leaving a scar.

7 Steps to Speed Up Healing Skin Tears:

1.Clean it by flushing it with plain or soapy water.

Avoid using chemicals like hydrogen peroxide or rubbing alcohol on wounds. Soap and water clean wounds just fine and won’t interfere with healing.

2.Control bleeding with direct pressure.

Apply pressure with gauze or a towel over the wound for at least a minute. Resist the temptation to “peek” before the minute is up; letting up on the pressure too soon allows bleeding to restart. Direct pressure jumpstarts your clotting factors to stop bleeding more quickly. Applying cold packs and elevating the arm or leg can also help control bleeding.

3.Smooth any ripped skin over the wound, matching the edges as best you can. If the skin flap is still attached, laying the skin back down where it is ripped from will often heal beautifully without scarring.

4.Cover with a transparent dressing like Tegaderm®.

A transparent dressing keeps the skin flap in place, protects it from dirt and bacteria, and allows it to breathe and stay moist, which promotes healing.

5.Pad with loosely wrapped gauze for protection.

To provide cushioning for forearms, elbows, or shins that can bump into things, wrap gauze loosely over dressings, to allow air to circulate.

6.Wear a Tegaderm® transparent dressing for at least 2 to 3 days before changing it.  Keep transparent dressings in place for several days unless you see a lot of blood or fluid pooling underneath. Peel the old dressing off S-L-O-W-L-Y, then gently pat the area with clean gauze or towel to blot excess fluid or blood before applying a fresh bandage.

 7.If your wound isn’t healing, seek medical attention.

Get medical attention if you see pus, excessive fluid, or blood under the dressing or if your wound becomes painful.

Dr. Louise Achey, Doctor of Pharmacy, is a 43-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Get answers to your medication questions at the website and blog TheMedicationInsider.com. 2022 Louise Achey