Why Do Some Older Adults With HEDS Suffer from Splitting Lips, Heels, and Cuticles?

As people age, many notice their skin and nails become more fragile and prone to damage. Splitting lips, cracked heels, and damaged cuticles are common complaints among older adults. These symptoms can cause discomfort and affect daily life, but what causes them? One important factor to consider is Hypermobile Ehlers-Danlos Syndrome (HEDS), a genetic condition that affects connective tissue.

People with HEDS typically have:

• Fragile, stretchy skin that bruises easily

• Joint hypermobility leading to frequent dislocations or pain

• Delayed wound healing and scarring

  
  

As collagen weakens over time, the skin and nails become more vulnerable to damage, especially in older adults.

Splitting lips, also called cheilitis, happens when the skin on the lips cracks or peels. For older adults with HEDS, several factors contribute to this problem:

• Fragile skin: The thin, delicate skin on the lips is more prone to cracking when collagen is weak.

• Dryness: Aging reduces natural oils and moisture in the skin, making lips dry and brittle.

• Environmental exposure: Sun, wind, and cold weather can worsen dryness and cause chapping.

• Repeated movement: Talking, eating, and facial expressions stretch the lips, increasing the chance of splits.

  
  

Managing lip splitting involves keeping lips well-moisturized with gentle, fragrance-free balms and protecting them from harsh weather. Avoiding licking lips, which dries them further, is also important.

Cracked heels, or heel fissures, occur when the skin on the heels becomes thick, dry, and splits under pressure. In older adults with HEDS, this problem is more common due to:

• Weakened collagen: The skin loses elasticity and strength, making it less able to withstand pressure from walking or standing.

• Dry skin: Aging skin produces less oil and sweat, leading to dryness and roughness.

• Footwear and activity: Ill-fitting shoes or prolonged standing can increase stress on the heels.

• Reduced sensation: Some people with HEDS may have nerve issues that reduce foot sensation, delaying detection of skin damage.

  
  

To prevent and treat cracked heels, it helps to moisturize feet daily with thick creams containing urea or lactic acid, wear supportive shoes, and gently exfoliate dead skin. Using cushioned insoles can reduce pressure on heels.

Cuticles protect the area where the nail meets the skin. In HEDS, cuticles can become dry, split, or peel because:

• Fragile skin around nails: Collagen weakness makes cuticles less resilient to minor trauma.

• Frequent hand washing or exposure to chemicals: These can dry out and irritate cuticles.

• Nail biting or picking: Some individuals may develop habits that worsen cuticle damage.

• Slower healing: Cuts or tears in cuticles take longer to heal, increasing risk of infection.

  
  

Keeping cuticles moisturized with oils or creams, avoiding harsh soaps, and gently pushing back cuticles instead of cutting them can help maintain nail health.

Older adults with HEDS can take several steps to reduce discomfort and protect their skin and nails:

• Hydrate well: Drink plenty of water to support skin hydration from within.

• Use gentle skincare products: Choose fragrance-free, hypoallergenic moisturizers and lip balms.

• Protect skin from the elements: Wear gloves in cold weather and use sunscreen on exposed areas.

• Avoid irritants: Limit exposure to harsh soaps, detergents, and chemicals.

• Maintain nail hygiene: Keep nails trimmed, moisturize cuticles, and avoid picking or biting.

• Wear comfortable shoes: Supportive footwear reduces pressure on heels and prevents cracks.

• Consult healthcare providers: Dermatologists or specialists familiar with HEDS can recommend treatments or therapies.

  
  

If splitting lips, cracked heels, or damaged cuticles cause pain, bleeding, or signs of infection such as redness, swelling, or pus, it is important to see a healthcare professional. Persistent skin problems may require prescription treatments or further evaluation to rule out other conditions.

Aging naturally reduces collagen production, even in people without HEDS. For those with this syndrome, the decline is more pronounced, leading to increased skin fragility and slower healing. This explains why symptoms like splitting lips, cracked heels, and cuticles worsen with age.

By recognizing these changes, older adults can take proactive steps to care for their skin and nails, improving comfort and quality of life.