Dry skin

Definition

Dry skin is a condition associated with the skin not having enough moisture content. This is often accompanied by itching and flaking of the skin. The medical term for dry skin is xerosis or xeroderma.

Description

Dry skin is sometimes called the winter itch since it is more common during the dry months of winter. Dry skin results in itching and flaking of the skin that may even crack, peel and feel rough. The lower legs, upper arms, thighs and sides of the abdomen are the most affected areas. It is one of the most common skin complaints. Well moisturized skin has a shiny look, while dry skin feels tight and looks dull.

Demographics

Dry skin is a common condition experienced by everyone at some point. Its frequency increases with age as the function of the oil glands in the skin decreases. Also contributing to dry skin are natural changes in the lipids and proteins of the skin that occur with age. People living in drier climates are more susceptible and wind, cold and sunlight are environmental factors that contribute to the condition. The use of heating and air conditioning can decrease air humidity and contribute to dry skin. Women tend to get dry skin more often than men with symptoms increasing after menopause . Dry skin has been linked to stress and genetics.

Causes and symptoms

One natural function of the skin is to prevent loss of moisture from the body. Part of this ability of the skin is due to naturally occurring fats or lipids and proteins in the skin. Bathing frequently, with too hot of water and with too harsh of soap or cleanser can wash away this natural barrier of skin. Many soaps and cleansers as well as alcohol based hand disinfectants can be mild irritants that contribute to dry skin. Certain drugs including acne medications such as Accutane and cholesterol lowering can also contribute to dry skin.

Diagnosis

Dry skin is typically self-diagnosed by a patient.

Symptoms are itching, flaking, roughness or even cracking of the skin. Often it is just a feeling of dryness or tightness of the skin. Severe dry skin can show deep cracks in the skin that may even bleed.

Treatment

Treatment of dry skin is two-fold and includes increasing the amount of water in the body by drinking more water and using moisturizers to prevent water loss. Hand and body lotions contain water to help moisturize the skin and oil that coats the skin to lock in the moisture. For this reason, moisturizers or oils are best used on skin that is damp, typically right out of the shower. Prolonged exposure to hot water and cleansers can wash away the natural protective oils of your skin leaving it prone to water loss.

To help put back moisture in the skin first take a 20 minute tub soak and followed by application of a lotion or oil. The soak will rehydrate the skin and the lotion or oil will help keep the moisture in and decrease itching.

Using a more nourishing or ‘super-fatted’ soap can sometimes help. Soaps containing oatmeal and soaps that have a high fat content are more moisturizing to the skin. Herbs used to sooth dry skin include chamomile and calendula and can be included in a bath. Reducing the frequency of bathing to once a day or once every other day may improve symptoms. Use soap only on body areas that need more cleansing; face, hands, feet, groin and underarms. Sometimes using an alpha hydroxyl acid treatment can allow moisturizers to penetrate deeper into the skin providing more moisture. It is not necessary to use expensive moisturizers but the ingredients for all moisturizers should be reviewed to avoid that irritate the skin making the symptoms of dry skin worse.

Nutrition/Dietetic concerns

Occasionally nutritional issues can be related to dry skin, the most important of which is not enough water consumption. Drinking a half gallon (two quarts; about eight 8-oz glasses) of water daily is a good goal. A diet containing fat, especially essential fatty acids found in nuts, seeds, and canola is also important. Vitamin A, which is found in yellow and orange fruits and vegetables such as tomatoes, sweet potatoes, and apricots, can help to heal dry skin.

Therapy

Therapy for dry skin is essentially the same as treatment. It involves increasing the skin's moisture with fluids or moisturizers. Consuming more fluids, especially water, on a regular basis can prevent the onset of dry skin. Using a daily moisturizing lotion can also be effective for keeping skin moist and elastic.

Prognosis

Dry skin can be a chronic or a sporadic condition. It is usually controlled by the use of moisturizers. Severe cracks in the skin that bleed can lead to more severe conditions including infection and should be promptly treated. Dry skin can sometimes be an indication of other skin disorders such as eczema or psoriasis . Dry skin can be an indication of underlying medical conditions such as hypothyroidism, kidney disease or diabetes.

Prevention

Preventing dry skin is not easy, but continuous use of moisturizers minimizes the episodes. Apply moisturizers immediately following bathing while skin is still moist. Decreased use of irritants such as certain skin cleansers can also help prevent dry skin. The use of a humidifier in a house especially during the dry winter months can increase the moisture content in the air and decrease symptoms of dry skin. Natural cotton fabrics retain moisture better than many newer fabrics that have wicking qualities that pull moisture from your skin.

Caregiver concerns

Dry skin should be addressed early on as it can cause severe itching. Patients can sometimes itch to the point of scratching the skin surface, causing it to bleed. For severe cases of dry skin wrap affected areas in a warm, moist towel covered with plastic wrap to keep in the moisture. Remove after 20 minutes and apply cream, lotion or oil while the skin is still moist. If the patient does not respond to the moisturizers used, change brands as the patient may be reacting to an irritant in that brand.

Resources

OTHER

Dry Skin. CNN Health Library. http://www.cnn.com/HEALTH/library/DS/00560.html.

The Science of Beauty. Proctor and Gamble. http://www.pgbeautyscience.com/the-dry-skin-cycle-introducing-a-new-model-for-the-induction-and-propagation-of-xerosis-in-normal-skin.html.

Cindy L.A. Jones Ph.D.