Home Diseases Parchment skin: care, causes, therapy

Parchment skin: care, causes, therapy

by Josephine Andrews
Published: Last Updated on 390 views

People with parchment skin (atrophic skin) have exceptionally thin, brittle and dry skin. Those affected are mostly elderly people. In addition, certain medications (e.g. cortisone) or diseases promote the development. Parchment skin is extremely delicate, easily injured, and wounds occur more easily. Those affected can significantly alleviate the symptoms with special care products and prevent injuries. Read everything you need to know about the causes, care and wound care of parchment skin here!

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.


quick overview

  • Treatment: Care of parchment skin with creams (water-in-oil emulsions), protect the affected skin areas, treat the disease that may have triggered it
  • Course: Age-related parchment skin cannot be cured, but is easily treatable. If diseases or medication are the cause, the skin usually regenerates after successful treatment of the disease or discontinuation of the triggering medication.
  • Wound care: Wound dressings with a silicone coating on the adhesive edges, foam dressings or wound dressings with gauze bandages. Band-aids and self-adhesive bandages should be avoided.
  • Prevention: drink enough, eat a balanced diet, avoid injuries
  • What is parchment skin? Dry, brittle, very thin skin
  • Frequency: Parchment skin occurs predominantly in older people, but can also occur in younger people.
  • Signs: The skin appears “transparent”, is dry, extremely sensitive and very thin, can be discolored bluish to gray, bruises (hematomas) occur quickly.
  • Causes: Natural aging of the skin, diseases (e.g. Lyme disease, cirrhosis of the liver) and/or long-term treatment with medication (e.g. cortisone)

What to do against parchment skin?

The right care products alleviate the discomfort of people with parchment skin. At the same time they improve the complexion. By treating the skin carefully and carefully, those affected also prevent injuries and avoid additional skin damage.

Creams and care preparations for parchment skin

When caring for parchment skin, it is primarily important to improve the feel of the skin. It is important to avoid drying out the skin too much. Creams or lotions in the form of water-in-oil emulsions (W/O emulsion) are particularly suitable for caring for parchment skin . They form a fatty film on the skin that protects the top layer of skin and reduces moisture loss.

Cream the skin at least once or twice a day with suitable care products. Be careful with conventional fat creams (e.g. body lotions) from the drugstore: They often contain additives that dry out the sensitive parchment skin even more. When washing, also avoid curd soap and other common soaps from the supermarket. pH-neutral, moisturizing washing lotions are better suited for very dry skin.

As a general rule, avoid care products with preservatives and artificial colors. This also applies to cosmetic products. Also make sure that the products are free of perfumes and alcohol. These ingredients also dry out the skin and can irritate the skin.

Ask your doctor or pharmacist which care products are best for your skin.

protect skin

Protect the affected areas of skin and make sure not to further irritate the parchment skin with external influences (e.g. sun, cold, wind, etc.). This can result in injuries and wounds that often heal poorly and have unpleasant consequences (e.g. inflamed skin, scars ).

Dermatologists therefore recommend the following for daily personal hygiene:

  • Clean your body and face with lukewarm water (not too hot, not too cold).
  • It is best to shower only every other day and rather briefly. The shower should not be too hot (below 36 degrees Celsius); very hot water dries out the skin!
  • It is better to avoid full baths or bathe at most once a week. Put special moisturizing bath oils in the bath water instead of foaming bath additives.
  • In addition to soft washcloths and towels, use skin-friendly toilet paper. Gently towel dry or blot wet skin. Do not rub the affected areas of skin dry!
  • Blood circulation-promoting agents such as hard skin brushes or massage brushes as well as alcoholic household remedies (e.g. rubbing alcohol) are taboo on parchment skin.
  • After washing, cream the skin with a suitable care cream.
  • For people who require care, keep the diaper area clean and dry.

treatment of the underlying disease

If the parchment skin is the result of another illness, for example an infection with Lyme disease or cirrhosis of the liver (shriveled liver), it is important to have it treated by a doctor.

Can you heal parchment skin?

Age-related parchment skin is not curable. If the skin ages and becomes naturally thinner as a result, this can no longer be reversed. However, proper care and lifestyle changes can help relieve symptoms and positively influence progression. If the parchment skin was caused by treatments or diseases, the skin regenerates in some cases after the end of the treatment or after successful therapy of the disease that caused it. However, once the skin has become thinner, for example after years of cortisone treatment, this condition can usually no longer be reversed (irreversible).

Wound care in parchment skin

Parchment skin is extremely delicate and vulnerable. Even light bumps or careless scratching at itchy areas of skin can cause the skin to tear or burst open. In addition, parchment skin regenerates more slowly, so wounds heal more slowly. The skin is therefore also more susceptible to wound infections and wound healing disorders.

Dermatologists advise those affected not to use adhesive plasters and self-adhesive bandages when treating wounds. Not only can these irritate the parchment skin, they can also cause further skin injury and pain when peeled off. For example, wound dressings with a silicone coating on the adhesive edges are more suitable.

Foam bandages or wound dressings that are fixed with gauze bandages are also recommended. They prevent the surrounding skin from sticking to the wound and the dressing material. Regardless of the material used, it is important to carefully remove the wound dressing, moisten it if necessary and only lift the plaster slightly when removing it.

Those affected should avoid so-called fatty gauze, which is covered with a thin layer of paraffin. Because the fat content in the wound dressing dries out after a few hours and the dressing sticks to the wound. When detaching, there is a risk that the wound will enlarge. Silicone gauze, which does not stick to the wound, works better with parchment skin.

Prevent parchment skin

To prevent parchment skin from developing in the first place, it is important to take the right measures to prevent it. For example, avoid direct sunlight, reduce alcohol consumption, avoid cigarettes, eat a healthy, balanced and nutritious diet, drink plenty of water and treat your skin with moisturizing care products.

Drink enough

Another measure to prevent parchment skin from developing is to keep the skin hydrated. First and foremost, it is important to drink enough. The German Society for Nutrition (DGE) recommends 1.5 liters per day. Water and unsweetened herbal and fruit teas are ideal for this. Juice spritzers with three parts water and one part juice are also suitable.

avoid injuries

Since wounds in people with parchment skin usually heal poorly, it is important to protect yourself from bumps, bruises and bruises. Especially for people with walking problems (e.g. frail, elderly people; people with Parkinson’s disease or after a stroke) it is advisable to wear safe shoes. Corners and edges in the household need to be padded and dangerous spots secured, for example with edge protection pads, anti-slip mats or bed rails.

In this way, those affected can largely prevent falls and injuries. It is also advisable to provide endangered parts of the body such as shins, forearms or hands with special pads or silicone protectors.

Other measures

Seat and back cushions help to avoid punctual pressure points and friction on affected skin areas. Doctors recommend that people with parchment skin occasionally change positions, even when lying or sitting. In the case of bedridden patients, it is also important to ensure that they are regularly repositioned so that they do not lie sore ( decubitus ).

Anyone who eats a balanced diet, drinks little alcohol and does not smoke also creates a good basis for preventing parchment skin. For the sake of your skin, you should also avoid extensive sunbathing or frequent visits to the solarium . Day or sun creams with a sun protection factor (SPF) of at least 30 protect the skin tissue from damaging UV radiation.

What is parchment skin

The term “parchment skin” is derived from “parchment” – a dried, oiled animal skin that is considered the forerunner of paper in ancient times. Their wrinkled, transparent surface resembles the appearance of parchment skin, which is particularly common in the elderly.

In medicine, the term “parchment skin” (Latin: cutis membranea; atrophia cutis senilis) is not clearly defined. Doctors use the term to describe thin, tensionless, and injury-prone skin on patients. Parchment skin is also often referred to medically as “atrophic” (“wasting”, “wasting”) or “atrophic skin”. Doctors understand skin atrophy to mean a tissue loss (“atrophy”) of the skin, in which individual or all skin layers (upper skin/epidermis, leather skin/dermis, subcutaneous tissue/subcutis) thin out.

How is aged skin different from parchment skin?

With age, everyone’s skin becomes thinner and drier. It increasingly loses moisture, is less elastic and resistant – this leads to so-called aged skin. This occurs in everyone sooner or later due to the natural aging process. In advanced age, however, a parchment skin can develop from an aged skin. It is significantly thinner (almost “transparent”) and more sensitive, often tears and is more vulnerable than normal aged skin.

What does parchment skin look like?

Parchment skin appears transparent – similar to parchment. Those affected can often recognize them by the fact that when the skin is pressed together (e.g. on the surface of the hand), a skin fold remains. This usually only disappears after a few seconds. With healthy skin, this happens immediately, unless the affected person has not drunk enough water.

Parchment skin is also very sensitive to external influences. Even small scratches, bumps, bruises or friction can injure the skin and lead to wounds that heal slowly and may become infected with germs.

Other typical signs of parchment skin are:

  • The skin is extremely dry and often scaly.
  • There are bluish to gray skin discolorations.
  • The surface of the skin is slightly shiny.
  • Blood vessels are visible (“showing through”) under the skin.
  • The skin is brittle.
  • Even the slightest impact will bruise.

In principle, parchment skin can develop on any part of the body. However, it often shows up in places where the skin stretches taut and unpadded over the bones, such as on the backs of the hands, elbows, forearms, shins or feet. Those affected find the thin, cracked skin in visible areas, such as the face and hands, particularly uncomfortable.

How is parchment skin formed?

Parchment skin has different causes . Not only older people are affected by a parchment skin, but also younger people. In addition to the natural aging process of the skin, medication and certain diseases also promote the development of parchment skin.

Natural skin aging

The most common cause of parchment skin is the natural aging process. The older a person is, the slower their cells renew themselves. Wounds heal more slowly and important skin components such as collagen and elastin are produced less. The skin loses its elasticity and resilience, causing fine lines and wrinkles to appear.

The fatty tissue under the skin (subcutaneous fatty tissue) also decreases progressively. The sebaceous glands produce less oil , which causes the skin to become rough and dry more quickly. Over time, the skin appears thinner and more ‘transparent’. Parchment skin therefore occurs mainly in older people.


Parchment skin also occurs in (younger) patients who have been taking certain medications for years. Examples are:

  • Cortisone (glucocorticoids), e.g. for asthma, rheumatism or neurodermatitis (as tablets, infusions or as skin creams)
  • Insulin in diabetes mellitus
  • Cytostatics (chemotherapy), especially in cancer
  • Anticoagulants (anticoagulants), eg in the case of cardiac arrhythmias or an increased risk of stroke


Parchment skin also occurs in people with certain medical conditions.

These diseases include:

  • Liver disease (e.g. liver cirrhosis)
  • Diabetes mellitus (diabetes)
  • Rheumatoid arthritis
  • As a result of a Lyme disease infection (acrodermatitis chronica atrophicans Herxheimer; skin disease in the late stage of Lyme disease)
  • Systemic scleroderma (autoimmune disease in which the connective tissue of the skin hardens)
  • Cushing’s syndrome (excessive levels of cortisol or cortisone in the blood)
  • Rare hereditary diseases in which organs and tissues age prematurely (e.g. Hutchinson-Gilford syndrome or progeria)
  • Narrowing of the blood vessels in the legs and arms (e.g. PAD or peripheral arterial occlusive disease, chronic venous insufficiency)
  • Malnutrition (e.g. in eating disorders such as anorexia)
  • Nerve damage that leads to an undersupply of oxygen and nutrients to the skin

Since the skin is not sufficiently supplied with nutrients and moisture in these diseases, this favors the development of parchment skin.

Parchment skin that has developed as a result of temporary treatments or underlying conditions usually regenerates once the underlying conditions have been successfully treated or the triggering medication has been discontinued. However, if the treatment or disease has persisted for many years, skin thinning is often irreversible.

Other causes of parchment skin include:

  • UV radiation (e.g. from excessive sunbathing or frequent visits to the solarium)
  • Radiation therapy (e.g. in the treatment of cancer; the skin on the irradiated parts of the body may be red, swollen, dry and tender)
  • Dehydration due to not drinking enough
  • Vitamin and mineral deficiencies (e.g. iodine, zinc , copper, biotin)

The more severe the damage to the cells, the more obvious the symptoms appear. In order to prevent the formation of parchment skin, it is therefore also important to avoid the triggering causes as far as possible.

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