Many factors may affect topical drug absorption in the elderly. These factors may be pharmacokinetic in nature or disease-state related. Pharmacokinetic factors include skin changes due to aging such as progressive dermal atrophy and age-related changes in renal function and hepatic function that may affect the excretion of any drugs absorbed into the systemic circulation via the topical route. Disease states and physiological changes that may affect topical drug efficacy and toxicity include xerosis and pruritus, frailty, decreased dexterity or impaired vision (compliance issues), and a weakened immune response. Socioeconomic factors may affect accessibility to topical medications (cost issues) and medication application (may need home care assistance).