Everyone has either had or will develop dry skin at least once in their lives. This is one of the most common conditions I see in clinical practice next to psoriasis, skin cancers, and acne / rosacea.
The Forecast looks dry…
In most cases dry skin occurs as a result of our environment, genetics, health status, and even aging. (The last two conditions relate more to dehydrated skin which we will address in a later blog post as the two conditions are, in fact, different.)
Harsh soaps, chemicals, hand sanitizers, and even perfume and fragrance (due to alcohol and common irritants in the formulations) can have a drying effect on our skin. The integumentary system is the first line of defense against these ingredients and when repeatedly exposed….will break down and become symptomatically dry.
As it’s summer time, I see alot more pediatric atypia and dryness as being in the
water for too long can have a similar effect. Have you ever been in the bath or pool long enough tohave pruny fingers? That’s because the moisture of your skin wants to leave and join the friendly water molecules in the area. This is called osmosis.
More commonly, in the winter months, we see patients suffering from red, rough,
raw, and itchy skin. This is because cold winter air means low humidity, both outdoors and indoors. This is less of a concern for those of us who live in Florida and the humid south; however, this aptly applies to residents to our north as well as people who travel to cold destination. The lack of humidity in air travel, alone is enough to induce the itch. This is because the water content of the epidermis (the outermost layer of skin) tends to reflect the level of humidity around it.
When dryness is a regular thing…
Some people are born with inherently dry skin and are predisposed to eczema. Icthysosis, or “fish scale”, is a congenital skin condition which manifest with extremely dry skin.
Patients in poor health or with kidney disease also suffer from dry skin.
Unfortunately, our skin loses its ground substances, collagen, and hyaluronic acid as we get older. When this happens, the skin loses its ability to retain water and our skin dries out.
Types of Tools & Why They Work
Dry skin is sometimes unsightly, itchy, flaky, and painful. The good news is that a vast majority of cases are easily managed with some simple tips and regular habits.
The most important step is to moisturize
Skin moisturizers rehydrate the top layer of skin cells – these are the keratinocytes of the stratum corneum which waterproof your skin, protect it from shearing forces and provide environmentally defensive and adaptive functions while continuously sloughing off.
The purpose of these moisturizers is to keep these cells hydrated and help them do their job. They contain three main types of ingredients:
- Humectants, which help attract moisture, include ceramides (pronounced ser-A-
mids), glycerin, sorbitol, hyaluronic acid, and lecithin.
- Another set of ingredients work as “sealants” – for example:
petrolatum (petroleum jelly), silicone, lanolin, and mineral oil – help seal that moisture within the skin.
- Emollients, such as linoleic, linolenic, and lauric acids, smooth skin by filling in the spaces between skin cells.
- Lastly, keratolytics like alpha hydroxyl acids, work by loosening dry and adherent skin and are a key ingredient for tough to treat cases.
In general, the thicker and greasier a moisturizer, the more effective (I didn’t say more comfortable or convenient) it will be. Some of the most
effective (and least expensive) are petroleum jelly and moisturizing oils (such as mineral oil). Because they contain no water, they are best used while the skin is still damp from bathing, to effectively seal
in the moisture while it’s still present.
Other moisturizers contain water as well as oil, in varying proportions. These are less greasy and may be more cosmetically appealing than petroleum jelly or oils.
How to Protect Against Dry Skin
These are a few tips I regularly recommend to patients who want to combat dry skin. They almost always fully prevent dry skin as long they’re practiced consistently and made a part of a daily full body skincare routine:
- Use a humidifier in the winter. Set it to around 60%, a level that should be sufficient to replenish the top layer of the skin.
- Limit yourself to one 5- to 10-minute bath or shower daily. If you bathe more than that, you may strip away much of the skins protective, oily layer and cause it to lose moisture. As a parent, I stopped giving my children baths the minute they were able to stand for this reason. Our children are prone to eczema and atopic dermatitis and this proved to be a real life solution which we share with our neighbors, patients, and friends with children with molluscum contagiosum or moderate eczema.
- Use lukewarm rather than hot water, which can also wash away natural oils.
- Minimize your use of soaps; if necessary, choose moisturizing preparations such as Dove, Olay, and Basis, or consider soap-free cleansers like Cetaphil or Cerave. Steer clear of deodorant soaps, perfumed soaps, and alcohol products, which can strip away natural oils.
- To avoid damaging the skin, stay away from bath sponges, scrub brushes, and washcloths. If you don’t want to give them up entirely, be sure to use a light touch to avoid mechanical breakdown of the skin barrier. For the same reason, pat or blot (don’t rub) the skin when toweling dry or air dry instead.
- Apply moisturizer immediately after bathing or washing your hands. This helps plug the spaces between your skin cells and seal in moisture while your skin is still damp.
- To reduce the greasy feel of petroleum jelly and thick creams, rub a small amount into your hands and then rub it over the affected areas until neither your hands nor the affected areas feel greasy.
- Never, ever scratch. Most of the time, a moisturizer can control the itch. You can also use a cold pack or compress to relieve itchy spots.
- Use fragrance-free laundry detergents and avoid fabric softeners. In severe cases, a second rinse cycle is helpful for those who are severely reactive to detergent ingredients.
- Avoid wearing wool and other fabrics that can irritate the skin.
- Drink 8 to 10 glasses of water a day.
- Keep in mind that drinking more water, eating healthier foods, or taking vitamins will normally not cure dry skin unless a form of moisturizer is added. These factors effect the more chronic hydration status of your skin which is reflective of your internal health and result in dehydrated skin as opposed to dry skin which is more of an acute status.
There are plenty of non-prescriptive preventative and interventional treatments you can adopt for healthy, glowing skin. It’s my goal to share these tips and tricks so that you can be comfortable in your skin. When these measures don’t work, don’t hesitate to call your local dermatologist who can help you understand the cause of your skin condition and customize an individual solution to treat your dry skin.
Your Board Certified Dermatologist,
Dr. Igor Chaplik