Xerotic
(dry) skin is a problem both due to internal causes (i.e. eczema,
hypothyroidism, and natural aging) and external causes (i.e. low humidity, dry
air, frequent bathing and excessive soap).
The stratum corneum (top layer of the epidermis- the outermost later of
skin) is the front line barrier between the environment
and the body. Many authors compare the
stratum corneum to a “brick wall.” The “bricks” are the skin cells of the
epidermis (corneocytes) and the “mortar” are the extracellular lipids that functions
as a glue to keep this barrier intact. The stratum corneum helps detect and
regulate if the skin feels moisturized or dry.
Often dry skin can become itchy and patients can develop an “itch
scratch cycle” that can be tough to break.
During
the winter months, here are some helpful tips to keep your skin from becoming
dry and itchy.
·
Avoid hot showers
- Avoid topical
alcohol, lidocaine, Benadryl, calamine lotion and witch hazel on the skin. Instead try topical ammonium lactate 12%
for dry skin or oral Benadryl for itchy skin.
- Use unscented
soaps
- Use soap
sparingly and try to concentrate in areas that get “dirtier” (i.e. armpits
and groin creases). Soap can
further dry out already xerotic skin!
- The “vehicle”
(the ingredient of the moisturizer or topical medicine that gives it its
consistency) can impact how well the moisturizer or medicine penetrates
the skin. The thicker the emollient/moisturizer
you can tolerate the better. Creams are better than lotions and ointments
are the best (if you can stand the grease)!
- Try to
minimize the perfumes coming into contact with your skin (i.e. spray your
perfume on clothes instead on directly on the skin).
- Use
detergents, fabric softeners, and dryer sheets that are fragrance and dye
free
- Humidifiers
can help combat dry winter air
- Let your
physician know exactly what you are using on your skin. Even if a topical product is not the
underlying cause of your skin problems it can exacerbate dry and itchy
skin
Most importantly, sometimes dry skin will not respond to over the
counter treatments and may require a visit to a physician for further
evaluation and treatment. Topical
medications and oral medications can be prescribed to help with xerosis and
itching.
References:
Bolognia JL, Jorizzo JL and Schaffer JV. Dermatology. Elsevier, 2012.
Lebwohl MG, Heymann WR, Berth-Jones J and Coulson I. Treatment of skin disease: Comprehensive
Therapeutic Strategies. Elsevier, 2010.
Dr. Zoey
Glick, Total Skin and Beauty Dermatology Center
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