The most common site for dry skin is the
legs (especially the anterolateral surfaces).
The back, flanks, abdomen, waist, arms,
and hands are also common sites.
Washing the hands with soaps, detergents,
and other lipid solvents several times a day
removes natural skin oils and hastens
desiccation.
Some sites, such as the axillae, groin, face,
and scalp, are less likely to have dry skin.
The feet may be less prone to dryness,
depending on the footwear chosen. After
the morning bath or shower, feet are usually
fully hydrated.
Putting on shoes and socks shortly after
bathing traps moisture in the feet,
preventing dryness of the skin. Sandals or
more open footwear do not protect against
dryness.
legs (especially the anterolateral surfaces).
The back, flanks, abdomen, waist, arms,
and hands are also common sites.
Washing the hands with soaps, detergents,
and other lipid solvents several times a day
removes natural skin oils and hastens
desiccation.
Some sites, such as the axillae, groin, face,
and scalp, are less likely to have dry skin.
The feet may be less prone to dryness,
depending on the footwear chosen. After
the morning bath or shower, feet are usually
fully hydrated.
Putting on shoes and socks shortly after
bathing traps moisture in the feet,
preventing dryness of the skin. Sandals or
more open footwear do not protect against
dryness.
Skin Care
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| Dry / Itchy Skin become less elastic. The skin to padding begins to disappear. With padding begins to disappear. With the loss of fatty and disappear. With the loss of fatty and loss of fatty and connective tissue connective tissue support, the skin support, the skin becomes less becomes less supple with reduced with reduced capacity of the skin to capacity of the skin to moisturize moisturize itself. Thus, the skin becomes itself. Thus, the skin becomes dry and may become itchy with increased dryness. Aging skin may also be more sensitive to fabrics (e.g., wool), soaps, detergents, and other chemicals or cosmetics used in every day living. |
| The skin protects the body from outside substances, chemicals, and bacteria and contributes to temperature maintenance and other homeostatic functions. The outermost epidermal layer is only 1/250th of an inch, with the dermis is only 1/50th to 3/25ths of an inch thick. The skin's protective function can be easily interrupted through exposure to the elements, such as dry air, whether accompanied by cold or heat, leading to drying of the skin and microscopic cracks. |
| Since healthy skin has a slightly acid pH, exposure to substances with an alkaline pH, such as many commercial cleansers and hand soaps, also contributes to interruptions of skin integrity. |
| The best treatment for severely dry, cracking skin is prevention. The hands should be protected from any factors that can interrupt skin integrity. Physical barrier protection, such as reusable kitchen rubber gloves, is needed whenever the hands might come in contact with cleansers. Creams that are touted as forming a protective skin barrier afford significantly less protection than a physical barrier. Remind patients that most cleansers are developed to cut through grease and will do this efficiently, depleting the natural protective oils on the hands. Margaret A. Fitzgerald, MS, APRN, BC, NP-C, FAANP |
| Dry skin is most common in the elderly. One study found that dry and pruritic skin was the most common problem in nursing homes. Norman RA. Xerosis and pruritus in the elderly: recognition and management. Dermatol Ther. 2003;16:254-259. |
| Aging reduces activity in the sebaceous and sweat glands; decreases in sterol esters and triglycerides worsen the problem. Generally, sebaceous activity peaks at puberty, remaining high until the age of menopause/climacteric |
| Male sebaceous activity remains robust until the eighth decade, while in women, levels start to fall much sooner. Women in their 60s have only 60% of the sebaceous activity they had in youth. The decline continues through much of the seventh decade. |
| Dry skin is also more common in patients with zinc or essential fatty acid deficiency, end-stage renal disease, hypothyroidism, neurologic disorders that decrease sweating, HIV, malignancies, or obstructive biliary disease, and in those who have had radiation |
Dry Skin (Xerosis)
Tips to reduce the incidence of dry skin
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| Smoking Tobacco use doesn't cause dry skin per se, but it does accelerate wrinkling, especially around your eyes and upper lip. People who smoke tend to have more wrinkles than do nonsmokers who are the same age and have similar histories of sun exposure. The amount of skin damage increases with the number of years and cigarettes smoked. |
Moisturizers
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| These other measures may also help keep your skin healthy: Moisturize your house. With your home thermostat set high and your central heat blasting, your home may stay warm and cozy. But hot, dry indoor air can parch sensitive skin and worsen itching and flaking. As a rule of thumb, keep your house between 68 and 75 F and use a humidifier to maintain moisture levels at 40 percent to 50 percent. Tabletop humidifiers usually moisturize the air in a single room and require frequent fillings, sometimes several times a day. They also need careful cleaning to prevent the growth of bacteria and fungi in the tank. The bedroom may be the best place for this type of humidifier — your skin is hydrated as you sleep. Although it's a more costly option, you may want to consider a humidifier that's built into your forced air heating and cooling system, especially if you have severely dehydrated skin or live in a climate that's dry year-round. Choose fabrics your skin loves. Natural fibers such as cotton and silk feel wonderful and allow your skin to breathe. But wool, although it certainly qualifies as natural, can irritate even normal skin. If your skin is already sensitive and dry, you may need to forgo cashmere sweaters and pashmina scarves and choose other fabrics for winter. And when you wash your clothes, try to use detergents without dyes or perfumes, both of which can irritate your skin. Look for these products in the grocery store or choose fragrance-free detergents in natural foods stores. |