Dry skin

What is dry skin?

Dry skin refers to skin that feels dry to touch. Dry skin is lacking moisture in the outer horny cell layer (stratum corneum) and this results in cracks in the skin surface.

The inherited forms of dry skin are known as ‘ichthyosis’ (fish-scale skin). There are various kinds of ichthyosis. Dermatologists often call dry skin arising in later life ‘xerosis’, ‘asteatosis’ or ‘acquired ichthyosis’.

Why does dry skin often itch?

The dry areas may result in dermatitis. Dermatitis is also often called eczema, and tends to be very itchy. The most common type of dermatitis in dry skin appears like crazy paving and most often affects the lower legs (‘eczema craquelé;’). Dry skin can also lead to round patches of dermatitis (a dry form of nummular dermatitis). When the dry skin is itchy without a visible rash, it is sometimes known as ‘winter itch’, ‘7th age itch’, or ‘senile pruritus’.

Ichthyosis
Ichthyosis		 Ichthyosis
Close-up of ichthyosis		 Discoid eczema
Dermatitis from dry skin
Dry skin

More images of dry skin …

What causes dry skin?

Factors which contribute to dry and cracked skin include:

  • Inherited factors
  • Metabolic factors such as an underactive thyroid gland, or excessive weight loss.
  • Increasing age, resulting in decreased natural lubrication.
  • Cool weather, especially when windy or the humidity is low.
  • Air conditioning, central heating or sitting close to a fire or fan heater.
  • Excessive bathing, showering or swimming, especially in strongly chlorinated hot or cold water.
  • Contact with soap, detergents and solvents.
  • Frictional irritation and chapping.

What is the treatment for dry skin?

An important aspect of treatment is to identify and tackle any contributing factors to dry skin (see the list of causes above). In addition:

  • Reduce how often you bath or shower, and use lukewarm water. Showers may be better than baths.
  • Replace standard soap with a substitute such as a synthetic detergent cleanser, water-miscible emollient, bath oil, anti-pruritic tar oil, etc.
  • Apply an emollient liberally and often, particularly after bathing, and when itchy. The drier the skin, the thicker this should be, especially on the hands.
  • Treat dermatitis with a topical steroid for a 5 to 15 day course. These are prescribed by your doctor and should be only applied to the red and itchy areas.

Long term control of dry skin

Dry skin is usually a long term and recurring problem, especially in winter. When you notice your skin getting dry, resume your lubricating routine and use a non-soap cleanser. If the itchy dry-skin rash returns, use both the lubricating routine and the prescription steroid cream or ointment.