DRY SKIN, medically called xerosis, is a source of discomfort and a frequent cause of itching.  It is most common in the cooler climates, especially during the winter months.  Many people call this the “winter itch.”  The predisposition for dry skin is both genetic and environmental.  Exacerbating factors include frequent bathing, hot water, harsh soaps, irritating clothing, friction, cold air, low humidity and central heating. 

The structure of the skin is analogous to a “brick wall.” The base of the “brick wall” contains dividing cells that migrate from the base to the top.  In young healthy skin, the cells at the base divide rapidly and are readily exfoliated (sloughed) in the upper layers of the skin.  In sun damaged older skin, there is less cellular division and subsequently less exfoliation.  Sun damage also affects the oil glands causing less lubrication of the skin.  This is seen as dry, rough, scaly skin. Sometimes irritation is present and a red itchy rash can result. 

Successful treatment is accomplished by identifying exacerbating factors and changing bathing habits.  Liberal use of moisturizers and occasionally a non-steroid anti-inflammatory cream or cortisone preparation may be necessary to decrease the skin irritation and inflammation before the healing process can take place. 

Recommendations: 

Bathing:  Take brief lukewarm showers instead of baths.  Do not shower more than once a day.    Hot water, long showers and baths rid the skin of its natural protective oils.  If you must take a bath, a lukewarm tub-bath is acceptable, particularly if you put bath oil in the water.  Remember, a quick cool shower, without soap, is preferable to a long hot soapy one.

Cleansing:  Deodorant soaps and detergents remove the natural skin- protective oils, leaving the skin dry and irritated.  Clear water alone will remove accumulated dust, sweat and grime.  If cleansing is necessary, use a mild moisturizing or glycerin soap.  Use soap only in the odor-bearing areas, such as under the arms and in the groin area.   

Soap must be thoroughly rinsed from these areas as this too can cause irritation.  Finally, avoid scrubbing with a washcloth or loofah; this will remove the natural protective oils and irritate the skin.  

Lubrication:  Immediately after towel drying, while the skin is still damp, apply moisturizers.  Ideally, moisturizers should be applied twice daily.  If a rash is present, a topical non-steroid anti-inflammatory cream or cortisone preparation is used before the moisturizing cream or lotion. Generally speaking, the thicker the moisturizer, the more effective it is for severely dry skin.  Moisturizing creams or lotions are preferred over oils.  Lastly, avoid moisturizers with strong perfume smells, as this can be a source of irritation for many people. 

Additional tips:

• Avoid bubble baths
• Do not allow the furnace or car heater to blow directly onto your skin.  The hot, dry air can make your condition worse.
• If you live in a dry climate, consider a humidifier or vaporizer in the bedroom.  If you have baseboard heating, try a large pan of water next to your bed.
• Avoid applications of alcohol, astringents, drying lotions or powders. They can be overly drying.
• Avoid hot tubs or spas. The hot chlorinated water will strip every bit of natural oil from your skin.  It may be soothing at the time, but can make the symptoms worse later. 

Successful treatment of dry skin includes a thorough understanding of the causes and appropriate treatments.  If your skin does not clear with conservative measures, consult your dermatologist.  Dry skin can be the first sign of other underlying medical conditions.