Dry skin is a common skin condition that results when the skin loses moisture and its natural oils resulting in scaling, flaking, cracking, and itching. It is sometimes also referred to as xeroderma or xerosis. Dry skin affects people of any age and skin type and can occur anywhere on the body.
Dry skin can occur for a variety of reasons, including:
- Weather and climate: Exposure to the cold, low humidity, and dry indoor spaces can lead to dry skin.
- Occupation: People who work in jobs that require repeated hand washing or result in exposure to chemicals are more likely to have dry skin. Examples include: medical professionals, housekeepers, daycare workers, cooks, florists, and hairdressers.
- Lifestyle factors: Taking long hot showers or baths can dry out your skin. Similarly, many popular soaps can be harsh, stripping your skin of its natural oils.
- Skin diseases: Individuals who suffer from conditions like atopic dermatitis, psoriasis, and seborrheic dermatitis commonly have dry skin.
- Systemic disorders: People with diabetes, thyroid disease, or kidney disease may also develop dry skin as a result of their health issues. Cancer survivors and cancer patients can also develop dry skin as a result of their cancer treatments.
- Age: As we age, our skin produces less oils and we become more prone to having dry skin.
- Medications: Certain medications such as retinoids and diuretics can cause dry skin.
- Diet: A lack of water intake, along with vitamin or mineral deficiencies, can lead to the onset of dry skin.
Tips for managing dry skin
- Lifestyle modifications: Limit the duration and frequency of baths and showers. Use warm water instead of hot water for baths and showers. Apply a good moisturizer right after a bath or shower.
- Product selection: Select and use only mild cleansers, good moisturizers, and fragrance-free detergents.
- Treat underlying skin conditions which may contribute to dry skin.
Topical retinoids are available in many over the counter skin care products as well as prescription strength medications. They work to treat a variety of skin care problems ranging from fine lines and wrinkles to acne breakouts and psoriasis. Common side effects of using topical retinoids include: dryness, scaling, peeling, irritation, redness, burning, stinging, itching, and sun sensitivity.
Below are some general tips on how to use a topical retinoid, but individual needs may vary. Follow your doctor’s guidance for how you should use a topical retinoid.
- Topical retinoids are typically applied at bedtime and not in the morning.
- Before applying a topical retinoid, wash with a mild soap or cleanser and pat dry. To minimize irritation, wait until the skin is completely dry (15-20 minutes) before applying a topical retinoid.
- Apply a very thin coat of the topical retinoid to the treatment area. Typically, a dermatologist recommends applying a pea sized amount for the entire face. Do not apply to the eyelid skin.
- As the medication can be irritating and drying, apply every 2nd or 3rd night to start, increasing to nightly application only as tolerated.
- To help minimize dryness and irritation, apply a moisturizer on top of the topical retinoid.
- As the medication causes sun sensitivity, diligent sun protection and sunscreen use is recommended. Use a broad spectrum sunscreen daily, SPF 30 or higher.
- If redness and/or irritation occurs, discontinue use of the topical retinoid but continue moisturizing until the skin returns to normal. Once the redness and irritation has completely resolved, re-start the topical retinoid- applying every 2nd or 3rd night and gradually working up to nightly application only as tolerated.
- Generally, topical retinoid use should be discontinued for a period of time before waxing or other cosmetic treatments such as chemical peels, microdermabrasion, or laser therapy. Discuss with your doctor or skin care specialist before pursuing any cosmetic treatments.
- Do not use topical retinoids if you are pregnant or actively trying to conceive.
Protection from UV radiation is important all year round, even on cloudy or cold days. UV radiation can even reflect off water, sand, and snow. Below are some tips on sun safety:
- Use sunscreen. Pick a broad spectrum sunscreen (one which blocks both UVA and UVB rays) with an SPF 30 or higher. Apply liberally, remembering to reapply every 2 hours.
- Cover up as much as possible. Wear long sleeved shirts and long pants whenever possible. Darker colors and denser fabric with tighter weaves offer more protection. Some clothing are even designed to offer sun protection and have incorporated UPF (Ultraviolet Protective Factor) into their fabrics.
- Wear a wide brimmed hat to offer protection to your scalp, ears, face, and neck.
- Wear sunglasses as UV rays can damage your eyes.
- Don’t forget the feet. As the tops of the feet can be damaged from unprotected sun exposure, wear shoes that cover the feet whenever possible. If wearing flip flops, sandals, or going barefoot, don’t forget to apply sunscreen to the tops of the feet.
- Seek shade. Seeking shade under an umbrella, tent, or tree can reduce the amount of UV radiation reaching your skin.
- Limit the time in the sun. Avoid peak hours between 10am and 4pm when the sun’s rays are the strongest
Sunscreen use is critical to protecting your skin from UV radiation. Wearing the right sunscreen will allow you to maximize your time in the sun while being protected from its harmful rays. Dermatologists recommend picking a broad spectrum sunscreen (one which blocks both UVA and UVB rays) with an SPF of 30 or higher. Apply the sunscreen liberally and thoroughly, ensuring that all sun exposed skin has been covered. As a general rule, a shot glass full of sunscreen is needed to cover an adult’s body. Apply the sunscreen 15 minutes before heading outdoors, and don’t forget to reapply at a minimum of once every 2 hours. Beware that your sunscreen may wash away if you are swimming or sweating. Picking a water resistant sunscreen and frequently reapplying will help you stay protected in the sun even when you are participating in water activities or exercising.
The sun emits UV radiation in the form of UVA, UVB, and UVC. UVA rays, which are the longest, penetrate the deepest in the skin and are responsible for tanning and premature aging. UVB rays are shorter and responsible for vitamin D production in the skin. UVB rays are also the cause of sunburning. UVC rays, which are the shortest, are absorbed by the ozone layer and do not reach the surface of the earth.
Similar to the sun, tanning beds also emit UV radiation. Tanning beds emit mostly UVA, but also smaller doses of UVB. The UVA radiation in tanning beds can be much more intense than that of natural sunlight.
It is important to understand that UV radiation, whether it be naturally through the sun’s rays or artificially through tanning bed use, can have damaging long term effects. These include:
- UV rays can damage the eyes. UV light can be damaging to any and all parts of your eyes including your eyelid skin. Prolonged and chronic exposure can lead to corneal damage, cataracts, and even macular degeneration. These conditions ultimately affect our eyes' ability to see.
- UV rays can damage the skin. Prolonged sun exposure can lead to sunburns, freckling, leathery texture, premature aging, precancers, and skin cancer.
- UV rays can affect our immune system. UV rays have been shown to suppress our immune system responses. While this can at times be useful in treating immune system driven conditions like vitiligo and psoriasis, it can be harmful when it comes to our body’s ability to fight off skin cancer and infections.
- UV rays can worsen certain skin conditions. UV rays can at times elicit skin rashes such as in the case of solar urticaria and polymorphous light eruption. UV radiation can also exacerbate or flare certain conditions such as lupus.