Managing Dry Skin

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With winter comes the cold, dry air. And with dry air comes dry skin…


Dry skin (also called “xerosis”) is very common during this time of year. The dryness is caused by water loss from the skin’s surface. Dry skin is not the same as other skin conditions such as eczema which involves genetically impaired epidermal barrier function, or psoriasis which is caused by an autoimmune response, although dry skin may be present in these conditions.



What is contributing to my dry skin?


Besides the cold weather in the winter, there are a multitude of other factors that can contribute to dry skin as well:

  • Genetics

  • Abrasion

  • Low humidity

  • Long, hot showers/baths

  • Swimming in chlorinated pools

  • Use of harsh cleansing products

  • Normal aging of skin due to decreased activity in the sebaceous & sweat glands

  • Overexposure to UV radiation (including the sun) and chemicals

  • Certain skin conditions (atopic dermatitis, acne, psoriasis)

  • Certain medications (anticholinergics, chemotherapy agents, niacin, retinoids, vitamin A)

  • Certain medical conditions (hypothyroidism, chronic renal failure, diabetes, liver disease)



What can I do at home to manage it?


There are many things you can do at home to prevent and manage dry skin. In the winter, wearing gloves, scarves, and face masks will not only keep you warm, but will shield your skin from the wind as well. It is also helpful to keep your room at the lowest comfortable temperature possible and use a humidifier when the air is dry. Sunscreen is very important in protecting your skin for the sun’s harmful UV radiation – even in the winter on cloudy days, as UV rays still penetrate through the clouds. Staying hydrated is also key. Besides drinking lots of water, try to avoid caffeine, spices, and alcohol on a regular basis, as they can contribute to dehydration. Also try to avoid wearing clothes with irritating material such as wool. Finally, taking brief 3-5 minute baths or showers with warm water and mild soaps helps keep the skin hydrated rather than long, hot showers with fragrances and other sensitizing ingredients that can irritate and dry out the skin. Bath oils may be added during the last few minutes of a bath, but be careful as it may make the tub slippery. After each bath or shower, it’s important to gently pat the skin dry with a soft towel and apply a moisturizing cream or lotion while the skin is still damp so that the water is retained in the skin. Continue to apply the moisturizer at least twice a day or more often if the skin feels very rough and dry.



What products should I use?


The best thing you can use to help treat dry skin is a good moisturizer! Look for products that say “non-comedogenic,” “non-irritant,” and “hypoallergenic.” This means that they will not clog pores, contribute to acne, irritate the skin, or contain allergens. There are also some specific ingredients you should look out for, outlined below.


Occlusives (beeswax, dimethicone, paraffin, petrolatum, zinc oxide)

  • Acts as a physical barrier to prevent further water loss


Humectants (alpha-hydroxy acid (AHA), glycolic acid, lactic acid, sodium hyaluronate)

  • Draws water into the top layer of the skin and retains water already present

  • Enhances the water-holding ability of the skin when used in combination with occlusives


Emollients (castor oil, cocoa butter, ceramides)

  • Fills open spaces between skin cells with lipids to smoothen and soften the skin

  • May be combined with occlusives to decrease water loss


Barrier Repair Agents (ceramides/cholesterol/free fatty acid combos)

  • Normalizes the skin barrier by replacing ceramides, decreasing water loss, and decreasing triggers for inflammation

  • Also helps with itching


When it comes to ointments vs. creams vs. lotions, they each have their place. While ointments are greasy and not ideal for use on the face, they have longer-lasting effects and are best for very dry and thick skin areas. On the other hand, creams and lotions are easier to spread and are better to use on the face, but have a shorter duration of effect and must be re-applied often. Whichever you choose, ensure to avoid ingredients that may sensitize the skin and contribute to dryness, such as fragrances, lanolin, propylene glycol, or sodium lauryl sulfate. Some great affordable moisturizers available on the market include CeraVe Moisturizer SPF 30, Cetaphil Daily Hydrating Lotion, and Neutrogena Oil-Free Face Moisturizer for Sensitive Skin.


For dry skin that is very red and inflamed, over-the-counter corticosteroid creams such as 1% hydrocortisone can be used in addition to moisturizers to help reduce the inflammation and itching. A thin layer should be applied to the affected area once to twice a day. It is recommended to test the cream on a small area of skin such as your hand before applying it to the entire affected area to make sure that it is compatible with your skin and that no allergic reaction occurs. Bandages or plastic wrap should NOT be used to cover the area after applying the cream as it can increase systemic absorption and, consequently, the risk of adverse effects.


Due to the potential adverse effects of long-term use, corticosteroid creams should be used for the shortest period of time possible. Abruptly stopping steroid creams may cause rebound dry skin, so it is best to gradually decrease the frequency of use over a few days as soon as the inflammation has improved to prevent a flare-up. Moisturizers, however, can and should be continued to prevent recurrence of dry skin.



How do I know when I should see my doctor?


Most cases of dry skin can be self-treated. However, it’s important to know what signs you should look out for that may call for a visit to the doctor. This includes severe itching and inflammation, very large affected areas (greater than 30% of your body surface area), or any signs of infection such as pus, blisters, or crusting. Children under 2 years old with dry skin should also be assessed by a physician. Finally, if your skin worsens or does not improve within 7-10 days of treatment, it may indicate an underlying medical condition that must be evaluated.


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Did we miss anything? Do you still have some unanswered questions about managing dry skin? Let us know in the comments below!


 


References

  1. Kleiman N. Dry skin. In: Compendium of Therapeutics for Minor Ailments. Canadian Pharmacists Association. Updated January 15, 2018. Accessed February 5, 2021. https://myrxtx-ca.proxy.lib.uwaterloo.ca/search


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