A: Itching skin is a problem dermatologists see on a daily basis. The most common cause is dry skin. I explain to patients that they have a skin sensitivity that is exacerbated by dry skin. The most common irritants to sensitive skin are water exposure,certain clothing such as wool, heat, friction and sweat. The majority of the time the itching can be controlled with moisturizing creams and avoidance of the irritating cause. Your dermatologist can help you if conservative measures don’t work. Read about dry skin in YourSkinDoctor.com.

A: Variations in water can definitely affect the skin. “Hard” water has a higher mineral content and can dry out the skin. I doubt the water is contaminated as municipal water supplies are highly regulated. Many times a local swimming pool company will test your water if you have questions regarding mineral content. Moisturizer use twice a day versus once a day is more effective for dry skin. Make sure the moisturizer is a cream and not a lotion. Read about dry skin in YourSkinDoctor.com.

A: Chronic dry "fish-scale" like skin may be a condition called ichthyosis. This is a group of conditions in which the skin grows with a dry scale like appearance instead of a moisturized smooth appearance. There are genetic forms and acquired forms. Acquired forms may be associated with hypothyroidism, kidney disease, or internal disease. It is also seen with certain medications such as cholesterol lowering agents.Treatment is first finding the cause with a careful history and medical examination. Moisturizers with acids are very helpful in controlling the dry scaling. There is an ichthyosis society. Do a search on the Internet for their site.

A: This is a great question. Contrary to what we would think, daily water exposure can dry the skin. The outer layer of the skin has a lipid (fat) property to it. Excessive washing or water exposure disrupts the integrity of this layer. The result is internal water loss - essentially a drying of the skin. What helps prevent this is the following: minimizing water contact, water temperature being luke-warm and daily use of moisturizers. Read about Dry Skin in YourSkinDoctor.com.

A: Fine lines and dull lustless skin are a combination of a person's genetic make-up, moisture and sun damage. Two of the above we can do something about. Damaged skin from chemicals,sun, acne or trauma has a hard time holding onto moisture. It is important to apply creams that "nourish" the skin. Try a simple approach initially of retinoids two to three times a week and topical vitamin C daily. A moisturizing sunscreen is essential. Maintenance gives life-long results!

A: Dry flaking skin around the nose sounds like seborrhea or dandruff on the face. The cause of seborrhea is unknown. There is some evidence that favors benign fungal involvement by an organism called Pityrosporum ovale. Bacteria and other fungal organisms have also been considered as possible causes. Either cause is treatable with daily attention. See Dandruff on YourSkinDoctor.com for recommendations on daily care. As always, if the condition does not improve with conservative measures, you should seek the advice of your physician.

A: Dry skin can sometimes run in families. There is a condition called Ichthyosis vulgaris that is hereditary.This condition presents as dry "fish-like" scales especially on the lower extremities. It is a condition that is controlled but not cured. Conservative dry skin management is very helpful. (See YourSkinDoctor.com write-up on Dry Skin.) Also helpful are moisturizers with an acid base such as YSD’s Ultra Moisture Body Cream. Remember, improvement is maintained with daily treatment.

A: Acne treatment is not the same for everyone. Instead of just acne, now you've got dry skin and acne. There are acne medications that are not drying. Discuss this with your dermatologist. Make sure your moisturizer is oil free (not water-based). Finally, I have my patients use products every other night if they are too irritating.