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What to Know About Wound Care and Older Skin

Treatments for cuts and burns that caregivers can provide at home


spinner image hands wearing gloves bandage an older adult's arm
Science Photo Library/Getty Images

If you care for an older adult, you’ve probably noticed a difference between their skin and yours — it’s thinner, looser and more delicate.

Older people’s skin is more prone to cuts, tears, and bruises due to thinning, decreased collagen, and reduced elasticity,” says Shoshana Marmon, M.D., an assistant professor in the department of dermatology at New York Medical College in Valhalla, New York. “As we age, blood vessels become more fragile and bruises form more easily. Also, wounds take longer to heal due to slower cell turnover and reduced blood supply.”

How to care for cuts

While you might feel tentative about handling wounds on delicate older skin, treatment for minor cuts is pretty much the same as it would be for your own skin or your child’s skin, dermatologists say.

Deep cuts, long lacerations and wounds that won’t stop bleeding within a few minutes need medical attention. Call your doctor or go to an emergency room if you are concerned.

But for minor, shallow injuries, start with these first-aid basics.

Clean the cut gently with mild soap and water. If the wound is in a place that is tricky to hold under the tap or you’d like to be extra gentle, try a wound cleanser, such as a gentle saline solution in a spray bottle. You can find these over the counter at drugstores.

Stop any bleeding. Use gauze or tissue and apply gentle pressure to stop bleeding. If your loved one is on blood thinners (even aspirin), it might take a little longer to stop. If you are unable to stop bleeding either call your doctor or go directly to urgent care or an emergency room.

Replace the skin barrier. “You want to put on a nice, thick emollient — something greasy,” says Danilo del Campo, M.D., a dermatologist who sees patients at Chicago Skin Clinic. In most cases, he says, an antibiotic ointment is unnecessary. What you need is a smear of a thick salve — such as petroleum jelly — to create a protective barrier over the wound.

Bandage. Here’s where you might do things a little differently for an older adult than you would for yourself, del Campo says, “In older adults, I opt for [a wound covering] that has a little more pressure to it than just a loose-fitting Band-Aid. At home … just put a little extra piece of tissue, clean napkin or medical gauze underneath the Band-Aid.” This added padding will give the bandage a tighter fit and keep a little pressure on the injury.

How to handle skin tears

Older skin is more likely to tear. The skin separates and may open up in a straight line, much like tears in fabric or paper.

Clean. As with a cut, first clean it gently under running water. Then gently move the skin back together.

Aid healing. Marmon recommends using a hydrogel for skin tears. These are available over the counter at drugstores. They keep wounds hydrated, speed healing and help with pain.

Protect. You don’t want to place an adhesive bandage over tears. After you apply a hydrogel, cover the tear with a nonabsorbent, nonstick dressing, such as gauze, and secure with first-aid tape.

Assessing burns

Your loved one’s skin may become less sensitive to touch, pressure, vibration, heat and cold. Touching a hot surface might not trigger a reaction in time to avoid injury.

As long as the burn doesn’t cover a large area, you can treat most first-degree burns on your own at home.

How can you tell it’s a first-degree burn? The area is red and turns white when you press on it, like a mild sunburn. First-degree burns are dry and free of blisters.

Second-degree burns have blisters, but if the burn is very small and the blisters remain intact — which protects against infection — it’s OK to treat those at home, too.

Third-degree burns are medical emergency. If the skin is white or charred, get to an emergency room as soon as possible.

You should seek medical attention if you see:

  • The burn covers an area larger than 3 inches across
  • The blister is broken
  • The wound is wet or oozing
  • The skin is white or black, rather than red
  • Your loved one reports numbness rather than pain
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First-aid for minor burns

For first-degree burns and small second-degree burns, follow these steps.

Soothe. Run the burn under cool (not cold) water or soak it in a cool bath for five minutes.

Apply protective coating. Once, you’ve gently patted the skin dry, there are many cooling, soothing burn lotions that you can apply. These are fine to use, but just like with a cut, the key here is a jelly-like protective coating. “The thicker, the better,” del Campo says.

Petroleum jelly is an option, but if your loved one doesn’t have any allergies to bees or honey, del Campo recommends medical-grade honey, which you can find at a pharmacy.

“It’s not the type of honey you find in the regular grocery store,” he explains. “Medical grade is put under gamma radiation to kill off any spores or abnormal stuff. It’s pro-healing. It has lots of antibacterial enzymes and it stimulates skin growth.”

Cover. As with skin tears, you don’t want to place an adhesive bandage over a burn. After you apply honey or ointment to the burn, cover it with a nonabsorbent, nonstick dressing, such as gauze, and secure it with first-aid tape.

Know the signs of infection

For cuts, tears and burns, change the dressing every day to keep it clean. Keep a close eye on the wound to make sure it’s getting better, not worse.

“Signs that [you should seek] medical attention include persistent or worsening pain, redness, swelling, pus or a foul odor; excessive bleeding that won’t stop. Large or deep wounds, blistering burns, or bruises that expand are also concerning,” Marmon says.

You should also talk to your doctor if healing is unusually slow or if a fever develops.

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