British National Formulary. Skin infections: treatment summary. 2020. (accessed 23 October 2020)

Gbinigie OA, Ordóñez-Mena JM, Fanshawe T Limited evidence for diagnosing bacterial skin infections in older adults in primary care: systematic review. BMC Geriatr. 2019; 19

Hahnel E, Blume-Peytavi U, Trojahn C Prevalence and associated factors of skin diseases in aged nursing home residents: a multicentre prevalence study. BMJ Open. 2017; 7

Hussey L, Stocks SJ, Wilson P Use of antimicrobial dressings in England and the association with published clinical guidance: interrupted time series analysis. BMJ Open. 2019; 9

Laube S, Farrell AM. Bacterial skin infections in the elderly: diagnosis and treatment. Drugs Aging. 2002; 19:(5)331-342

Metin A, Dilek N, Bilgili SG. Recurrent candidal intertrigo: challenges and solutions. Clin Cosmet Investig Dermatol. 2018; 11:175-185

Understanding skin infections in older adults

02 December 2020
Volume 31 · Issue 12


Skin infections and soft-tissue conditions are known to be common in older adults. Sarah Jane Palmer covers the basic principles of assessment, investigation and treatment

Skin infections are extremely common throughout the community in older people. Cellulitis and infected ulcers are the most common cutaneous skin infections in older adults, but various other aetiologies can be identified by community nurses and healthcare staff throughout their area's patient population. Staphylococcus aureus is common and increases morbidity so prompt identification is required. Assessment of the skin and appropriate swabbing is necessary and crucial in order to be proficient when looking after people with skin conditions and infections in the community. This article will cover the basic principles of assessment, investigation and treatment, as well as encouraging an awareness of risk, touching on the common predictors of skin infections in older people

Skin infections and soft-tissue conditions are known to be common in older adults (Laube and Farrell, 2002), and the focus of this article is to look at the available research in order to obtain an overview of the guidance when considering if a patient has a skin infection.

Hahnel et al (2017) investigated the prevalence of skin diseases in older nursing home residents while also exploring the possible associations of these with demographic and medical characteristics. Their research was a descriptive multicentre prevalence study and was conducted in a random sample of 10 institutional long-term care homes in Berlin, Germany. A total of 223 residents were included as participants. Hahnel et al (2017) found that 60 dermatological diseases were diagnosed among their sample. The most frequently diagnosed skin disease was xerosis cutis (99.1%), followed by tinea unguium (62.3%) and seborrheic keratosis (56.5%). The study identified only few bivariate associations linking skin diseases and demographic and medical characteristics. Hahnel et al (2017) concluded that their results indicated that almost every individual living in residential care has at least one dermatological diagnosis. Dermatological findings from their research ranged from the highly prevalent xerosis and cutaneous infection to skin cancer. Hahnel et al (2017) explained that not all conditions required immediate dermatological treatment and could be managed by targeted skin care interventions, such as appropriate antibacterial dressings, good hygiene and teaching the patient about skin care and how to avoid infections or to identify possibilities of conditions developing. The researchers also stated that caregivers would need knowledge and diagnostic skills to ensure that the appropriate clinical decisions are made in these situations.

Register now to continue reading

Thank you for visiting Practice Nursing and reading some of our peer-reviewed resources for general practice nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • New content and clinical newsletter updates each month