Dry body skin – Causes, symptoms and solutions

The skin is one of the most important organs. It gives us our appearance, sense of touch, temperature control and protection against infections. However, rough, tight, scaly, itchy or painful dry skin loses its ability to function properly - touch becomes less sensitive, and the risks of sun damage and premature ageing are increased, and infections become more likely. Effective solutions are often possible, and are centered on a skin care routine that is suitable for dry skin.

Skin dryness is a leading cause of skin complaints, with over 40% of visits to dermatologists relating to dry skin. It can occur anywhere on the body, but it most frequently occurs on the hands, feet, knees and elbows, and face as these areas are more exposed than others. Dry skin on the face can contribute to premature ageing.

When body skin becomes very dry it may become extremely tight, scaly, flakey, very itchy and painful, even extremely rough and cracked. However, it may not always be obvious that dryness is the cause of these skin symptoms, depending on the severity of the dryness, and the area of the body that is affected.

• Mild dry skin
  At first the dryness may be noticed as a light tightness or mild roughness.
• Dry skin
  Then, as the skin loses further moisture, the skin becomes rougher and may have a chapped or scaly appearance, and is likely to itch.
• Very dry skin
  If this dryness remains untreated or the skin care is ineffective, the skin may become damaged, extremely tight, and potentially very rough and cracked. At this stage the itching can also become very intense.

Dryness on the body often appears on feet and shins. Dry skin on the feet is particularly common, and often results in cracked heels, which when severe is associated with pain and inflammation.

However, dryness due to washing with a strong detergent is likely to affect the whole body equally. Frequent washing tends to contribute to dry skin on the hands, as they are they are always involved in washing.

Dry skin on the body is often sensitive; however, skin sensitivity is not always caused by dryness. Some people’s skin is naturally sensitive, even when well hydrated. In either case, it is important to avoid skin care products that contain irritating ingredients such as perfumes and colourants. Always check that the product is dermatologically tested on sensitive skin.

Dry skin can also be related to certain diseases:

• Xerosis is the medical term for dry skin. It comes from Greek; ‘Xero’, means ‘dry’, and ‘osis’ means ‘disease’. 
• Atopic Dermatitis and Psoriasis are also linked to dryness, although these conditions have underlying inflammatory causes. Typically, skin with these conditions looks reddened, flakey and is very itchy.
• Metabolic conditions such as, diabetes mellitus and kidney disease can also increase the risk of dry skin.

If you are worried or unsure about your symptoms, or they are becoming worse, we recommend you see your doctor or dermatologist for a face-to-face consultation.

If you need further information to help you identify the cause of your skin complaint, and which treatment route to take, the skin test may be a useful diagnostic tool.

There are many causes and contributing factors to dry body skin, from environmental influences and inappropriate skin care to medical conditions like Psoriasis and Atopic Dermatitis. The skin acts as the body’s barrier, but this means it is exposed to both external and internal influences.

• External factors cause the skin’s natural barrier function to become compromised, resulting in an increased moisture loss through the skin.
• A breakdown in the skin’s surface barrier due to vital lipids being washed away prevents the skin from trapping moisture, and the rate of moisture loss out of the skin increases.
• Finally, when the dryness progresses down into the deeper skin layers, the passage of water within the deeper tissues is reduced as important moisture channels become compromised.

The main external causes of the above process are environmental triggers and skin care:

Environmental

• Harsh weather conditions - hot, cold and dry air disrupt the skin's barrier function.
• Seasonal changes - symptoms of dry skin often worsen during either the winter or summer.
• Ultraviolet (UV) sunlight can increase the rate of skin ageing, and skin becomes more prone to dryness as it ages. Read more about age-induced dryness.

Skin care

• Frequent washing, or long, hot baths or showers, removes away the lipids that make up the skin barrier. 
• Inappropriate skin care routine – It is important to follow a routine, and use products, that are suitable for dry skin. It is especially important not to use strong soaps that strip away natural skin lipids.

Medication
Dry skin is a side effect of many medications. Commonly used medications that have this side effect are diuretic blood pressure medications that work by increasing the rate of water excretion from the body, and some antibiotics and oral acne medications. Always check with a doctor or pharmacist if you are concerned a medication may contribute to dry skin.

Genetic influences
The skin's moisture balance is also influenced by genetics. Some people have oily skin and some have dry skin, and these skin types are inherited, although an individual will not necessarily have the same skin type as their parents. Skin conditions like Atopic Dermatitis, Psoriasis, diabetes and ichtyosis often have a genetic link.

Hormonal influences
Changes in the level of certain hormones, particularly estrogen and testosterone can influence the skins moisture and lipid levels. This is particularly noticeable after menopause when skin is becoming dry due to a decrease in estrogen production.
Dry skin may also occur during pregnancy because of hormonal changes as well as the extra demand of bodily fluid.

Diet
Like any other organ, the skin requires a range of important nutrients in order to function properly. These include unsaturated fatty acids and vitamins. A lack of any of these can contribute to dry skin.

Age
As skin becomes older the number of sebaceous and sweat glands in the skin is reduced, resulting in a reduced ability to produce sweat and lipids. Similarly, the water content of skin and its ability to hold moisture is also reduced. These factors lead to dryness which in turn contributes to skin ageing and the development of fine lines and wrinkles. Read more about age-induced dryness.

Additional to the main causes of dry body skin, several other factors also affect the severity of skin dryness. An awareness of these will help avoid them and thereby reduce their impact.

Lack of effective treatment
When dry skin is not treated quickly, the severity of the dryness can increase, and the moisture network in the deeper layers can be disrupted. In these situations, a moisturiser that addresses this condition is necessary.

Sun exposure
When protecting dry skin from sun exposure, it is important that the sunscreen also restores missing moisturising factors, in addition to an appropriate Sun Protection Factor (SPF). It is also important that the sunscreen, and any other skin care products used on dry skin, do not contain irritating perfumes and colourants, as dry skin, especially dry facial skin, is more prone to irritation than normal skin.

Occupational hazards
Some occupations require working in conditions that may increase the risk of dry skin. Typically these are occupations that require exposure to the causes of dry skin, such as working in hot or cold conditions (farmer/fisherman), or frequent use of detergents (doctor/nurse/hairdresser), or exposure to chemicals (mechanic/cleaner).

Dehydration
The skin receives its moisture via the body, and is therefore dependent on the body’s water balance. When dehydrated, the body reduces the supply of moisture to the skin which slows down the natural flow of water through the skin, which can contribute to dry skin. Elderly people are prone to dehydration as the sensation of thirst diminishes with age.

Smoking
Cigarettes contain many toxins, including nicotine, which may reduce the blood flow. This results in a decreased metabolic rate within the skin. This means the skin may age prematurely and dry out.

Dry skin is caused by a breakdown in the skin’s barrier function which leads to the loss of moisture and water binding capacity due to a deficiency of moisturising factors. Therefore, dry skin needs a skin care routine that does not cause further deterioration of the skin barrier and replaces missing natural moisturising factors.

Dry to very dry skin, dry skin due to diabetes or Psoriasis requires adequate products, depending on the severety of dryness, and Atopic Dermatitis requires specific products for the daily skin care of babies and young children. When choosing a skin care product for children, always check the age recommendation.

Cleansing dry body skin
Dry skin is most likely dry due to the skin’s surface barrier breaking down, and therefore it is important that the cleanser is gentle enough not to wash away the skin’s natural protective barrier. Additional natural moisturising factors, such as Urea, will also help to restore the skin’s moisture balance. 

Moisturising dry body skin
The first requirement for moisturisers for dry skin is to restore the moisture balance in the upper layers of the skin. So called “natural moisturising factors” (NMF) compounds like Urea and Lactate bind moisture into the stratum corneum, or upper layer of the skin. The minimum recommended concentration of Urea, even for mild dry skin, should be 5%. Very dry skin generally requires a higher concentration of Urea and other moisturising factors. The Eucerin Urea range for dry skin contains a range of 5% and 10% Urea body cremes and ointments, including hand and foot creams.

Dry, rough and tight skin can be caused by breakdown in three main areas of moisture control – a broken surface barrier due to a deficiency of skin lipids, a dehydrated stratum corneum due to a lack of natural moisturising factors, and poor moisture distribution in the lower layers of the skin. Eucerin Complete Repair Moisture Lotions deal with the three main factors behind dry skin with dermatologically proven active ingredients.

• Firstly, Urea and other water-binding natural moisturising factors are replenished resulting in improved hydration in the stratum corneum.
• Secondly, Ceramide-3 repairs the lipid skin barrier to lock in moisture, and
• finally Gluco-glycerol stimulates the skin’s Aquaporins, and helps to enhance the natural upward flow of moisture to the upper skin layers. 

Eucerin Complete Repair Moisture Lotion 5% Urea is ideal for the daily care of dry, rough and tight skin, while Eucerin Complete Repair Intensive Lotion 10% Urea is ideal for daily care of extremely dry, scaly and itchy skin.

Protecting dry body skin against sun-exposure
It is advisable to reduce sun-exposure by wearing protective clothing and a sunscreen when going outdoors. Additionally, it is important that the sunscreen blocks UV rays and also contains moisturising factors too. A sunscreen for dry skin should not contain irritating perfumes and colourants, as dry skin is prone to irritation. Eucerin Sunscreens for dry skin offer sun protection with COLIPA- and EU-compliant UV filters, antioxidant Licochalcone A to protect against UV-induced oxidation and premature ageing.

In addition to having a good cleansing and moisturising routine, avoiding factors that contribute to dry skin is important. This will help to reduce the impact of dry skin and the need for treatment:

• Avoid dry air by spending less time outdoors in hot and cold weather, and by using a humidifier indoors when the heating is on.
• Reduce the time spent in hot water by having quick showers instead of long baths.
• Using gloves when washing dishes will help to avoid hot water and strong detergents.
• Wear clothes made of natural materials like cotton and silk that do not irritate the skin. Wool is natural but can irritate, and should be avoided.
• Try to use a clothes detergent without dyes or perfumes, as these can remain on the clothes after washing and irritate dry skin.
• Use care products without perfumes, colourants and parabens to avoid irritation.
• Ensure that you drink adequate amounts of water - especially recommended for elderly people.