Dry skin occurs when there is inadequate skin hydration or increased transepidermal water loss. This lack of water (hydration) of the skin can vary from case to case, and mild to severe cases of dehydration can be observed (very dry skin).
Dry skin or cutaneous xerosis is a skin disease characterized by flaking of certain areas of the body. This skin problem is usually not serious, and in most cases it is caused by external factors such as temperature variations (hot or cold weather), low levels of humidity in the air, continuous immersion in hot water, among many other factors, which we will discuss later in this article.
There are several ways to successfully improve the condition of dry skin, such as using moisturizing creams, which effectively improve the skin’s hydration. There are several ways to successfully improve the condition of dry skin, such as using pathology. In these cases, it is advised to be seen by a dermatologist.
Dry skin tends to affect men and women equally, however, older people (seniors) are typically more prone to developing the condition. The skin in elderly individuals tends to have decreased amounts of lipids (skin oil). Areas such as the arms, hands, and legs tend to be more affected by dry skin.
What are the signs and symptoms of dry skin?
The signs and symptoms of dry skin vary with age and the underlying cause. However, it is likely that when dry skin exists, the patient will exhibit some of the following signs and symptoms:
- A feeling of tightness of the skin, especially after bathing;
- Rough skin;
- Pruritus (itching);
- Peeling of the skin;
- Thin lines that correspond to surface cracks;
- Red spots on the skin;
- Deep crevices that can hurt or even bleed.
What are the causes of dry skin?
There are a wide variety of causes that can cause cutaneous xerosis. External factors are the most common cause and are the easiest to treat. These can include cold temperatures and low humidity, especially during the winter. Inadequate skin hydration (not applying moisturizers or inadequate moisturizers) or poor fluid intake (lack of fluid intake) are other likely causes and are easily resolved by applying a moisturizer or increasing fluid intake (water, tea, etc.).
Other factors include some pathologies, age, genetics (heredity) and others.
Dermatitis or eczema is an inflammatory condition of the skin that often causes dry skin, among other signs and symptoms. There are several different types of dermatitis, namely:
- Contact Dermatitis– Contact dermatitis occurs when we touch some object with our skin, causing localized inflammation, such as a chemical agent (irritant contact dermatitis), or a substance that we are sensitized to (allergic contact dermatitis).
- Seborrheic dermatitis– is characterized by erythema, desquamation of seborrheic locations (scalp, glabella, nasolabial folds, ears, chest, and back).
- Atopic dermatitis– Atopic dermatitis or atopic eczema is a chronic disease that causes desquamative lesions, cutaneous xerosis, and itching. Although it is more common in children, it affects a large number of adults.
What are the risk factors for dry skin?
Anyone can develop dry skin. However, and as mentioned above, there are some factors that increase the risk of developing this pathology, such as:
- Age: The risk of developing dry skin increases with age and mainly affects older adults and the elderly. Almost everyone has dry skin after the age of 60;
- Living in dry, cold, or low-humidity climates;
- Swimming frequently in chlorinated pools;
- Genetics (heredity): some families are more likely to develop cutaneous xerosis and develop atopic eczema or ichthyosis. You are more likely to develop some type of dermatitis such as atopic dermatitis (atopic eczema) or contact dermatitis if there is a history of these conditions or other allergic diseases in your family;
- Taking frequent, prolonged baths with very hot water increases the risk of dry skin;
- Excessive washing of the skin with harsh / rough soaps.
How is the diagnosis of dry skin made?
The diagnosis of dry skin or cutaneous xerosis is usually made by a dermatologist, initially through the patient’s clinical history and a physical examination.
The medical specialist may also use complementary diagnostic and therapeutic tests (PCT) to conclusively identify the underlying cause of dry skin, namely:
- Epicutaneous testing, in order to identify whether the underlying cause of dry skin is an allergic reaction to some product or substance.
- Blood tests to check for problems such as diabetes, kidney disease, thyroid disease, which can cause dehydration of the skin;
- Skin biopsy (removal and analysis of a small sample of affected skin) to check for eczema or other skin conditions.
What are the risks of having dry skin?
When left untreated, dry skin can lead to a number of complications, namely:
- Some types of dermatitis as we saw earlier;
- Infections: dry skin can create cracks, making it easier for bacteria, viruses, or fungi to enter the body, causing infections;
- Permanent changes in the skin such as discoloration in certain areas.
What is the treatment for dry skin?
In most cases, dry skin responds well to changes in the patient’s lifestyle, such as using good skin moisturizers and avoiding long, hot baths. Moisturizing creams should try to replicate the normal composition of the skin and should not contain fragrance.
If dry skin implies a more serious skin disease, such as dermatitis, the medical specialist may choose to prescribe creams and ointments or other treatments in addition to the care you should take in your daily routines at home.
In severe cases of dermatitis, treatment may include corticosteroid ointments. As a general rule, only mild corticosteroid creams such as hydrocortisone should be used on the face, armpits, and groin areas and should not be used for long periods.
Oral antihistamines such as bilastine, hydroxyzine, and cetirizine can also improve the itching caused by dry skin.
How to prevent dry skin?
There are some behaviors to adopt in everyday life that can improve skin hydration and prevent the progression or recurrence of dry skin, namely:
- Moisturize the skin every day with the use of appropriate moisturizing creams;
- Limit exposure to water and avoid bathing in very hot water;
- Avoid strong, corrosive soaps;
- Cover as much skin as possible in cold or windy weather, especially in winter;
- Wear powder-free vinyl or nitrile gloves when spending a long time with your hands in the water or while using aggressive cleaning products;
- Drink plenty of liquids (water, tea, natural juices, etc.).
Doctor Manuel António Campos
Coordinator of Dermatology Services at Trofa Saúde Central Hospital and Trofa Saúde Hospital Vila Real
