Dry skin

Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, 1997. Updated January 2015.

What is dry skin?

Dry skin refers to skin that feels dry to touch. Dry skin is lacking moisture in the outer horny cell layer (stratum corneum) and this results in cracks in the skin surface.

Dry skin is also called xerosis, xeroderma or asteatosis (lack of fat).

Who gets dry skin?

Dry skin can affect males and females of all ages. There is some racial variability in water and lipid content of the skin.

Dry skin that begins later may be seen in people with certain diseases and conditions.

People exposed to a dry environment may experience dry skin.

What causes dry skin?

Dry skin is due to abnormalities in the integrity of the barrier function of the stratum corneum, which is made up of corneocytes.

The inherited forms of ichthyosis are due to loss of function mutations in various genes (listed in parentheses below).

Acquired ichthyosis may be due to:

What are the clinical features of dry skin?

Dry skin has a dull surface with a rough, scaly quality. The skin is less pliable and cracked. When dryness is severe, the skin may become inflamed and fissured.

Although any body site can be dry, dry skin tends to affect the shins more than any other site.

The clinical features of ichthyosis depend on the specific type of ichthyosis.

More images of dry skin ...

Complications of dry skin

Dry areas of skin may become itchy, indicating a form of eczema/dermatitis has developed.

When the dry skin of an elderly person is itchy without a visible rash, it is sometimes called winter itch, 7th age itch, senile pruritus or chronic pruritus of the elderly.

Other complications of dry skin may include:

How is the type of dry skin diagnosed?

The type of dry skin is diagnosed by careful history and examination.

In children:

In adults:

Sometimes, skin biopsy may be requested. There may be additional tests requested to diagnose some types of ichthyosis.

What is the treatment for dry skin?

The mainstay of treatment of dry skin and ichthyosis is moisturisers/emollients. They should be applied liberally and often enough to:

When considering which emollient is most suitable, consider:

Emollients generally work best if applied to damp skin, if pH is below 7 (acidic), and if containing humectants such as urea or propylene glycol.

Additional treatments include:

How can dry skin be prevented?

Eliminate aggravating factors.

What is the outlook for dry skin?

A tendency to dry skin may persist life-long, or it may improve once contributing factors are controlled.

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