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.
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