Dry skin is an extremely common skin problem and is often worse during the winter when environmental humidity is low (i.e., "winter itch"). It occurs at all ages and in people with or without other skin problems. This article dfiscusses the causes of dry skin and how to treat and prevent this problem. We hope you find it useful.
What does dry skin look like?
Everyone is familiar to some degree with the appearance of dry skin. The normally fine lines in the skin become more visible, the skin feels rough and appears dull and flaky. In more advanced cases, fish net-like cracks resembling the fine fracture lines of cracked porcelain can occur. Dry skin occurs most commonly on the arms and legs, but can also affect the trunk of the body. Dermatologists often call dry skin "xerosis" or "asteatosis".
Problems Associated with Dry Skin
Dry skin very commonly produces itching, which can be severe and interfere with sleep and other daily activities. Repeatedly rubbing and scratching can produce areas of thickened, rough skin (lichenification). Dry, thickened skin can crack, especially in areas subject to chronic trauma (e.g., hands and feet), causing painful cracks in the skin (fissures). Dry skin and scratching may result in a dermatitis when the skin becomes red (inflamed) in addition to dry and scaly. Round, scaly, itchy, red patches scattered over the legs, arms and trunk (nummular eczema) may also appear. The appearance of yellow crusts or pus in these areas indicates that a bacterial infection is developing. This would require specific antibiotic therapy from your dermatologist or family physician.
If your skin is very dry, or if you have an associated red dermatitis, it is a good idea to seek the advice of your dermatologist or family physician. Severe dry skin is a feature of certain genetic diseases such as atopic dermatitis and ichthyosis (fish scale-like skin). Additionally, people with hormone imbalances such as underactivity of the thyroid gland can also experience severe skin dryness (there are other changes in the body that accompany dry skin in this setting that helps doctors recognize this problem). On occasion red, dry skin rashes can be confused with other skin problems such as a ringworm infection or allergic contact dermatitis (i.e., a poison oak-like skin rash), which would need different forms of treatment.
What Causes Dry Skin?
Healthy skin can be pictured as a multi-layer cake covered by a single sheet of clear plastic food wrap used to keep it fresh. The plastic food wrap prevents the frosting and underlying layers of the cake from drying out by preventing loss (evaporation) of the water from the cake into the air. It is the moisture in the cake that gives it its freshness. The outermost layer of the skin, which acts like the plastic food wrap and is about the same thickness, is called the stratum corneum. (This is the layer that peels off after a sunburn). The stratum corneum consists of dead skin cells embedded in a mixture of natural oils (lipids) that are made by underlying living skin cells. These natural skin oils keep the water inside our body from escaping into the air and also keep irritating substances and germs from entering the body. Both the dead skin cells and the skin oils hold a certain amount of water in the stratum corneum and it is this stratum corneum water that helps keep the skin soft, pliable and smooth.
Dry skin occurs when there is not enough water in the stratum corneum for it to function properly. One way this can happen is when protective oils in the stratum corneum are lost and the water that is normally present in the skin is allowed to escape. Too much soapy water, exposure to harsh chemicals, the normal aging process and certain types of skin diseases are some of the causes of decreased amounts of protective skin oils. As the stratum corneum dries out it shrinks and, as it shrinks, small cracks can occur. This exposes the underlying living cells to irritating substances and germs in the environment.
Treatment of Dry Skin
An important aspect of treatment is to identify and tackle any factors that may be contributing to the dry skin. It is natural to think that applying water alone to dry skin would help control the problem. However, water alone (especially hot water) can actually increase the problem of dry skin by removing the normal, protective skin oils. Hot, soapy water depletes the natural skin oils to the greatest degree. Anyone who has tried to wash a skillet covered with bacon grease in cold soapy water knows how effective heat is in softening up oils and fats so that they can be washed away. However, water followed by the application of oil such as a moisturizer (also known as an emollient or lubricant) Ultra Balm is of great benefit for dry skin. The Lanolin in Ultra Balm helps trap and seal water in the stratum corneum and makes the skin softer, smoother and less likely to become dry, cracked and itchy.
Attention to proper bathing techniques and liberal use of the most effective moisturizers. You should take a short bath or shower (no more than 10 minutes) only once in a 24 hour period. For adults, showers are generally better than baths. While longer baths or showers, especially in hot water, can be quite relaxing, they will also increase the loss of natural oils from the skin and worsen skin dryness. The bath or shower should be in warm rather than hot water. Soap should be used minimally and only when and where needed (for example, under the arms, the groin and genitals, the feet, and the face). Milder, less drying soaps include Dove, Neutrogena Dry Skin Formula (unscented), Aveeno Cleansing Bar for Dry Skin, Purpose, Basis, and Oil of Olay Sensitive Skin Soap. Cetaphil is a liquid cleanser that works as a gentle and effective soap substitute for some people. It is especially helpful for cleaning the face and hands.
After bathing or showering, quickly and gently pat the skin partially dry with a towel (do not rub!). Within three minutes of getting out of the water apply Ultra Balm to seal the water in the skin before it can evaporate. Ultra Balm should be reapplied liberally during the day and evening when needed especially to those areas prone to dryness (hands, arms, legs) and when itchy.
Treat any red dermatitis (eczematous or ezcema) patches with a topical cortisone (steroid) cream or ointment for a 5 to 15 day course when perscribed. Over-the-counter strength cortisone creams and ointments can occasionally be helpful, but prescription strength products are often required to calm down this type of dermatitis. Make sure you understand where the cortisone cream or ointment is to be applied (only on the red patches unless instructed otherwise) and how often you should apply it (no more than twice daily). When using both a cortisone product and a moisturizer, always use the cortisone first and the moisturizer second.
Be careful about using other over-the-counter anti-inflammatory and itch-suppressing creams or lotions. Many of these products contain chemicals that can irritate or cause allergic reactions in dry, dermatitic skin. A good general rule is if anything that you apply to your skin causes more burning and itching than you started with, you should stop using it until you can talk with your doctor about it. Anti-itch products containing pramoxine (e.g., Prax, Pramosone) or menthol and camphor (e.g., Sarna) are generally safe to use. However, these products are not treating the cause of skin dryness, they are only temporarily treating the itching that accompanies skin dryness.
Any way that you can increase the humidity level in the air of your home and workplaces would be advisable. If not already present, you should consider adding a humidifier to the central heating system of your home. If you use a portable humidifier, make sure it is used in your bedroom at night.
Use Ultra Balm for Long Term Control & Prevention of Dry Skin.
Dry skin is usually a long-term problem that recurs often, especially in winter. When you notice your skin beginning to get dry, resume your moisturizing routine with Ultra Balm and avoid the use of harsh soaps. If the itchy, dry, skin rash returns, use both Ultra Balm and any prescription steroid cream or ointment.
Some material for this article was excerpted from the following Internet sites that we consider to be reliable: