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What causes dry skin?

• Aging itself. The medical term for dry skin is xerosis.
• Some people suffer life-long dry skin due to a condition that runs in families called ichthyosis (fish-scale skin).
• Dry, itchy skin can be a symptom of disease, for example, thyroid disorder, diabetes mellitus, or kidney disease.
• Longstanding skin conditions such as eczema or psoriasis can cause dry, itchy skin.
• Some medicines, both prescription and non-prescription, can make dryness and itching worse.

Where does dry skin occur commonly on the body?

• Dry skin can affect any part of the body, particularly exposed areas.
• Legs, elbows, hands and forearms often develop it.
• Mid back between the shoulder blades

What makes dry skin worse?

• Hot, or cold, dry, windy weather
• Air conditioning in summer and heating in winter - moisture is removed from the air
• Sitting too close to a fire or a fan heater
• Swimming, especially in strongly chlorinated water
• Not drinking enough water or other liquids. However, check with your health care provider before increasing your fluids if you are on medicines for blood pressure or to get rid of fluid (diuretics).
• Too much sun
• Smoking
• Long, hot, frequent showers or baths can remove natural oils from the skin
• Deodorant soaps, bath salts, bubble baths or any preparation containing a detergent can irritate the skin and make dry skin worse. Any preparation with a strong perfume is best avoided if you have dry skin.
• Preparations containing lanolin can irritate the skin - many people become allergic to this substance, so you might have to avoid it.

How can I protect my skin from getting dry?

Bathing Techniques

• Avoid bathing in very hot or very cold water
• Daily bathing or showering is not necessary in cooler climates. In hot weather if you do sweat, you can freshen up with warm water alone.
• Limit your bath or shower to 5-10 minutes
• Avoid vigorous rubbing with a washcloth when cleansing
• Rinse your skin thoroughly with warm (not hot) water
• After your bath or shower, pat the skin dry; don't rub it. Wrapping yourself in a thick toweling bathrobe then proceeding to the next step may even be better for the skin than using a towel.
  
  

Skin Applications

• After you bathe, soothe your skin by applying moisturizer while the skin is still slightly damp - this traps more surface moisture than applying it to totally dry skin. You might need to apply moisturizer several times a day
• If you have severely dry skin, after you bathe apply oil to the still moist skin first, then apply a moisturizing cream on top of it. Repeat this process at bedtime.
• Avoid steam baths and saunas - sweating can leach out natural skin oils
• Avoid liquid soap - it is more drying to the skin than a bar of the same soap.
• A mild bar soap like Dove or Olay is gentle to the skin.
• Avoid shower gels and deodorant soaps - they are hard on dry skin.
• If your skin is very dry it is better not to use any kind of soap. An unscented, emollient preparation such as Cetaphil, or a generic version of this, cleanses and soothes dry skin.
• Avoid skin preparations with alcohol in them
• Don't rub your skin when applying cream or lotion - rubbing can trigger itching.
  
  

Sun Exposure

• Avoid direct sun, especially between 12 noon and 3 pm
• Apply sunscreen liberally to all exposed areas 30 minutes before every sun exposure, and even on foggy or cloudy days. (Don't forget your ears, hands, the back of your neck.) Reapply the sunscreen often. Look for a UVA/UVB sunscreen with Parsol 1789, titanium oxide, or zinc oxide, and with a sun protection factor (SPF) of 15 or higher
• Since sunscreen cuts down formation of vitamin D-like substances in the skin, make sure you have enough vitamin D in your diet (or take a multivitamin with vitamin D) to keep your bones strong.
• Cover up, wear a shady hat or carry a parasol when you're in the sun.

Healthy Lifestyle

• Don't smoke! Smoking damages the skin. Nicotine constricts blood vessels, including the tiny capillaries that feed the skin. This deprives the skin of the oxygen and nutrients it needs for good health.
• Get enough sleep - skin cells renew themselves best during sleep.
• Exercise! This boosts circulation and encourages blood flow to all parts of the body. Skin, heart, lungs, bones and brain all benefit from regular exercise, and it nourishes the skin from within.
• Increase the moisture in the air of your home or workplace by placing a bowl of water on a heater in winter, or by using a cool-mist vaporizer or humidifier.
• Drink lots of water (unless your health care provider has told you not to)
• Eat oily fish such as tuna and salmon every week.

Other Hints

• Wear cotton gloves inside waterproof gloves to protect your hands for all household tasks involving water, detergents or chemicals.
• For laundry, use environmentally friendly detergents
• Rinse all clothes and bedclothes thoroughly. Avoid fabric softeners, especially in the dryer.
• Keep irritating fabrics away from your skin. Don't wear clothing made of wool or other "scratchy" fabrics
• Use cotton sheets on your bed.

I am on a limited budget. How can I find a good, low cost moisturizer?

Read labels and compare ingredients. Most name brand cleansers, moisturizers and sunscreens have less expensive generic copies. Learn the difference between ointments, creams, lotions and humectants. They all moisturize. Look for the following ingredients when you read labels:

• Ointments have an oily base, so are greasy and best used at bedtime.
• Creams contain more oil than lotions so are more effective for dry skin
• Lotions feel lighter, but have more water than oil so are less effective than creams or ointments, and need to be applied more often
• Humectants are a class of moisturizer that does not contain oil and may be labeled oil-free. They contain glycerin, propylene glycol, urea, hyaluronic acid, glycolic acid, and lactic acid. Humectants are effective and, some, such as alpha hydroxy acids, actually improve the skin's ability to retain moisture. Avoid lanolin (which may cause an allergic reaction), vitamins, essential fatty acids, collagen, elastin, and keratin, as they have little benefit to the skin, but add to the cost of the moisturizer.
• Baby oil is an effective, low cost skin treatment, applied to the skin during or after showering or bathing, or layered under moisturizer. Be sure not to slip if you are using any oily preparation in the bath or shower.
• White petroleum jelly (the base of many ointments) in a thin layer can soothe dry skin. A layer on hands in bed at night under thin cotton gloves can be effective. Similar treatment works for dry skin on feet, under fine cotton socks.
• Plain white Crisco is an effective remedy for dry skin. Put some in a pretty jar, use it as above, and pretend it is an expensive cream

When should I see my health care provider?

• If you itch all over your body but there is no obvious cause.
• If your dry skin does not respond to the suggestions above, or gets worse. Special ointments or creams by prescription might be needed to treat it.
• If your skin is badly broken or you have sores from scratching
• If dryness, itching or other skin discomfort keeps you from sleeping
• If, when you examine your skin, you discover a new growth or discoloration that lasts longer than 2 weeks, or if an existing mole or discoloration changes in any way.

Where can I find other resources for more information on dry skin?

• Eldercare at Home. Second Edition. Chapter 12. Can be found at www.healthinaging.org or ordered from: Fry Communications Inc. The American Geriatrics Society, 800 west Church Road, Mechanicsburg, PA 17055. Tel: 1-800-334-1429 x2529. Fax 717-691-1493
• http://medlineplus.gov - Has links to many health-related topics including dry skin

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