This study investigated whether the topical application of essential fatty acids improves hydration and elasticity and helps prevent skin breakdown in individuals with poor nutritional status. Between June 1995 and July 1996, 86 patients, equally divided into two groups, underwent double-blind research (mean age = 60; range 26-78). All patients had a Norton Scale score of 9 and were fed orally a high-protein diet and/or received parenteral nutrition (92% were severely malnourished). Pressure ulcer prevention was the same for both groups. Every 8 hours, approximately 20 ml of solution A (1.6 gr EFA with linoleic acid extracted from sunflower oil, 112 UI vitamin A, and 5 UI Vitamin E) or B (1.6 gr mineral oil, 112 UI Vitamin A, and 5 UI Vitamin E) was applied all over the body inclusive of all potential wound sites for a mean of 21 days. In group A, two patients developed ulcers (both Stage I, one per patient); 42 (98%) had hydrated skin and 32 (76%) maintained skin elasticity. In group B, 12 (27%) developed ulcers (all Stage II, ten with 1 ulcer, two with 2 ulcers); 9 (22%) had hydrated skin while 34 (78%) showed scaly skin/deep dehydration; 10 (24%) maintained skin elasticity while 33 (76%) showed a loss of elasticity. These results lead us to believe that essential fatty acids really do make a difference in the skin.