Dry skin

Signs and symptoms..

Dry skin is often just a temporary problem — one you experience only in winter, for example — but it may be a lifelong concern. And although skin is often driest on your arms, lower legs and the sides of your abdomen, this pattern can vary considerably from person to person. What's more, signs and symptoms of dry skin depend on your age, your health status, your locale, the amount of time you spend outdoors, and the cause of the problem.

If you have dry skin due to normal aging, you're likely to experience one or more of the following:

• A feeling of skin tightness, especially after showering, bathing or swimming
• Skin that appears shrunken or dehydrated
• Skin that feels and looks rough rather than smooth
• Itching (pruritus) that sometimes may be intense
• Slight to severe flaking, scaling or peeling
• Fine lines or cracks
• Redness
• Deep fissures that may bleed

Commom causes

Most dry skin is caused by environmental exposures, such as:

• Weather. In general, your skin is driest in winter, when temperatures and humidity levels plummet. Winter conditions also tend to make many existing skin conditions worse. But the reverse may be true if you live in desert regions, where summer temperatures can top 110 F and humidity levels sink to 10 percent or less.
• Central heating and air conditioning. Central air and heating, wood-burning stoves, space heaters and fireplaces all reduce humidity and dry your skin.
• Hot baths and showers. Frequent showering or bathing, especially if you like the water hot and your baths long, breaks down the lipid barriers in your skin. So does frequent swimming, particularly in heavily chlorinated pools.
• Harsh soaps and detergents. Many popular soaps and detergents strip lipids and water from your skin. Deodorant and antibacterial soaps are usually the most damaging, as are many shampoos, which dry out your scalp.

Other factors

Other factors, including certain diseases, can significantly alter the function and appearance of your skin. These include:

• Psoriasis. This skin condition is marked by a rapid buildup of rough, dry, dead skin cells that form thick scales.
• Thyroid disorders. Hypothyroidism, a condition that occurs when your thyroid produces too little thyroid hormones, reduces the activity of your sweat and oil glands, leading to rough, dry skin.
• Alcohol and drugs. Alcohol and caffeine can visibly dry your skin. Prescription drugs such as diuretics, antihistamines and isotretinoin (Accutane) also have a drying effect.
• Dehydration. Severe diarrhea and vomiting, a high fever, profuse sweating during exercise or simply not drinking enough liquids can cause your body to lose more fluid than you take in. One of the first signs of dehydration is skin that has lost its elasticity.

Risk factors

Dry skin is a nearly universal problem, but certain factors make you more likely to develop tightness, flakiness and fine lines. These factors include:

• Your age. As you age, your skin tends to become drier because your oil-producing glands become less active. Your complexion can appear rough and dull. The lack of oil also causes cells to clump together in flakes or scales.
• Your sex. Although everyone's skin changes with age, a man's skin tends to stay moist longer than a woman's does. Men experience a relatively small decrease in oil production until well into their 80s, whereas women's skin tends to become much drier after menopause.
• Sun exposure. Like all types of heat, the sun dries your skin. Yet damage from ultraviolet (UV) radiation penetrates far beyond the top layer of skin (epidermis). The most significant damage occurs deep in the dermis, where collagen and elastin fibers break down much more quickly than they should, leading to deep wrinkles and loose, sagging skin (solar elastosis). Sun-damaged skin may have the appearance of dry skin.

Complications

Dry skin that's not cared for can lead to:

• Dermatitis (eczema). This condition causes redness, cracking and inflammation.
• Folliculitis. This is an inflammation of your hair follicles.
• Cellulitis. This is a potentially serious bacterial infection of the skin's underlying tissues that may enter the lymphatic system and blood vessels.

These complications are most likely to occur when your skin's normal protective mechanisms are severely compromised. For example, severely dry skin can cause deep cracks or fissures, which can open up and bleed, opening the way for invading bacteria.

How do I treat dry skin?

Drink plenty of water throughout the day.Moisturizers work well to treat dry skin. Choose a moisturizer that is hypoallergenic (it should say so on the label). Thick, greasy moisturizers work best. Avoid products with alcohol. Apply just after a bath or shower, when your skin is still damp.

Put a moisturizer on your skin 3 or 4 times during the day. Put moisturizer on right after you wash or bathe. This will hold in the moisture from the water. If you have very dry hands, put petroleum jelly on them before you go to bed at night and sleep with your hands in cotton-lined gloves.

Changing your bathing habits can also help. If you bathe too often, it may dry out your skin. Try to take short, lukewarm baths or showers. Oatmeal baths (one brand name: Aveeno) may be soothing to dry skin. After a bath or shower, pat your skin dry don’t rub and put a moisturizer on your skin right away. Try mild cleansers like Aveeno or Cetaphil or mild soaps like Neutrogena or Dove.

Apply cool compresses to itchy areas, and try over-the-counter cortisone creams or lotions if your skin is inflamed. If this is not enough, talk to your doctor about possible prescription lotions.

When should I see my doctor because of itchy skin?

Dry, irritated skin is more likely to get infected. Infected skin is red, warm and swollen. It may ooze fluid. You may need antibiotics to get rid of this kind of infection.

Severe itching or pain, especially in older adults, sometimes is caused by a serious medical problem. Call your doctor if you are an older person who has severe itching or