Dry Skin / Xerosis - Symptom Evaluation

The outer layer of the skin contains nearly 30% water. The skin prevents quick evaporation of this water by secreting oily substances that form a layer over the skin. Loss of the oily layer allows faster evaporation of the water. When the water content is reduced to less than 10%, the patient shows features of dry skin.

Dry skin may appear tight and scaly with an increase in the number of wrinkles. It is often accompanied by itching.

Severe skin dryness can lead to cracks and fissures. Bacteria may invade these cracks resulting in a serious skin infection called cellulitis. If untreated, cellulitis can be fatal.

Dry skin is treated using moisturizers. Moisturizers replace natural skin oils, cover tiny cracks in the skin, and provide a soothing protective film. Thus, they slow evaporation of the skin’s moisture thereby maintaining hydration and improving the appearance and feel of dry and aging skin. In addition, it is necessary to keep the body well hydrated by drinking plenty of water to ensure that the skin has enough moisture content. Diet should also be well balanced with a lot of fresh fruits and vegetables.

Causes of dry skin include:

Age: Age is an important factor that makes the skin less supple and leads to dryness. Skin in older individuals has endured harsh environmental conditions over years. The cumulative damage to the skin results in changes like loss of elasticity and pliability and damage to cell membranes, which contribute to dryness.

Weather: Winter is a time when people commonly complain of dry skin. The cold and low humidity levels dehydrate the skin leading to dryness. On the other hand, prolonged exposure to the ultraviolet rays of the sun also damages the skin and results in dryness. Air pollution could also worsen the condition. Sunscreen lotions with moisturizers are advised when going out in the sun for prolonged durations.

Air conditioners and heaters Air conditioners and heaters reduce the humidity from the air and lead to skin dryness.

Hot baths, showers and swimming: Bathing hydrates the superficial layers of the skin, but the moisture evaporates soon after the bath. Prolonged contact with hot water leaves the skin dry due to removal of the oily layer; hence lukewarm water should be used for bathing. Soaps and shampoos used during bathing act as emulsifiers and assist in removing the oily layer. Swimming in chlorinated water also leads to dry skin. Dry skin may only affect the hands in people who wash hands frequently like home makers, food handles and health care personnel. Use of hand sanitizers that contain alcohol add to the dryness.

Diet: Lack of vitamin A, B and C due to malnutrition or inadequate intake can cause dry skin. Excess caffeine and sweets may also not be good for the skin.

Skin diseases: Skin diseases that result in dryness are:

Atopic dermatitis: Atopic dermatitis is a skin reaction similar to allergy. The skin over the entire body generally appears dry. Other features include the presence of blisters, changes in skin color, and raw or thickened areas of the skin from scratching. The patient may also show the presence of other allergic reactions like asthma or hay fever.

Psoriasis: Psoriasis is a skin condition where the skin turnover is increased, resulting in accumulation of cells, often in the form of plaques. The skin over the lesions is dry and may crack.

Ichthyosis vulgaris: Ichthyosis vulgaris is a skin disorder where the patient suffers from severe dry skin, scaling of skin and thickening of the skin due to itching. It is usually hereditary, appears in infancy and is often accompanied by other conditions like atopic dermatitis, asthma or hay fever. Ichthyosis that appears in adulthood should be evaluated for other associated conditions like cancer, sarcoidosis, leprosy, thyroid disease, hyperparathyroidism, nutritional disorders, kidney failure and HIV infection. Medications like nicotinic acid, cimetidine, and clofazimine can also cause ichthyosis vulgaris in adults.

Diseases affecting the whole body:

Hypothyroidism: Hypothyroidism is a condition where a person suffers from low levels of thyroid hormone. This results in reduced activity of the oil glands of the skin and skin dryness

Renal insufficiency: Severe kidney disease is associated with accumulation of toxic material and leads to dry skin accompanied by itching. Other skin changes may also be present in kidney disease like pale skin due to anemia, yellowish tinge or darkened areas, extensive bruising or formation of plaques and nodules.

Diabetes: Poorly controlled diabetes results in dry skin due to high glucose levels in the blood. Adequate care should be taken since the dry skin can get cracked and harbor bacterial or fungal infections, which are difficult to treat in diabetic patients.

Drugs: Some drugs can cause dry skin. These include diuretics that bring about water loss and retinoids used to treat acne.

Frequently Asked Questions

1. Which doctor should I visit in case I suffer from dry skin?

You should visit a skin specialist or a dermatologist in case you suffer from dry skin.

2. How can I prevent dry skin?

Some tips that could help to reduce dryness of skin are:

Avoid hot baths and harsh soaps. Pat your skin dry and use a moisturizer after a bath.

Eat a well-balanced diet. Do not forget to include fresh fruits and vegetables in your diet.

Drink plenty of water and stay well hydrated.

Treat conditions like diabetes, kidney disease and hypothyroidism adequately.