Dry Skin Care Essentials

We all want healthy, hydrated skin, but the reality is that skin can become dry, flaky, and rough. Why? The outer layers of your skin are put together in a type of brick-and-mortar system. Healthy skin cells are stacked with oils and other substances that keep skin moist. When those substances are lost, skin cells can crumble away, which leads to dry skin.

Itching is the No. 1 symptom of dry skin, says Angela Lamb, MD, assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York. Dry skin tends to be flaky, red, and irritated. Your skin may also look dull or ashy (if you have dark skin), which can progress to skin being scaly or cracked. In the worst-case scenario, skin can become thick and leathery.
What Causes Dry Skin?
Dry skin often results when the skin loses water or oil, particularly in climates with low humidity, or during winter months when low humidity and indoor heat affect the natural balance of healthy skin. “Your skin is the primary barrier to the environment and prevents water from evaporating off the surface,” Dr. Lamb says. When humidity is low, more moisture is lost from the skin’s surface and it dries out.
On top of that, certain medical conditions can make you more prone to developing dry skin, including:
Keratosis pilaris. As many as 40 percent of adults and up to 80 percent of teens have an inherited dry skin condition called keratosis pilaris, according to the American Academy of Family Physicians. The condition causes tiny red or flesh-colored bumps on the skin, particularly on their upper arms and thighs or on the cheeks in children. The bumps are dead skin cells and make skin feel rough, like sandpaper. Skin may also itch during the winter or in low humidity.
Atopic dermatitis. Up to 20 percent of children and 3 percent of adults around the world have atopic dermatitis, according to a 2015 study published in Annals of Nutrition & Metabolism. This is a common type of eczema in which itchy patches of skin form. When the skin is scratched, it may become red and swollen and could crack, weep fluid, or scale. This type of eczema often occurs in people who also have asthma or hay fever.
Hormonal changes. When your body is going through hormonal changes, you may notice dry or flaky skin cropping up. It’s something that happens even in babies. Newborns commonly develop cradle cap — flaky, scaly skin on the scalp — as a result of being exposed to mother’s hormones in the uterus, according to The Nemours Foundation. Hormonal changes after menopause can also lead to dry skin.
Thyroid disease. One of the early symptoms of hypothyroidism, a condition where the thyroid gland doesn’t produce enough thyroid hormone, is dry skin.Diabetes or kidney disease. People with diabetes or kidney disease may notice dry, itchy skin on their legs due to poor circulation. This happens when the skin is not getting the proper amount of blood flow. In fat, very dry skin is a warning sign of diabetes, according to the American Academy of Dermatology.
How to Go From Dry Skin to Healthy Skin
The main step you can take to heal dry skin: Moisturize, moisturize, moisturize. Apply moisturizer to your body and face at least once a day, when your skin is still damp from the shower, recommends Alisha Plotner, MD, a dermatologist at the Ohio State University Wexner Medical Center in Columbus. In the summer, a thinner lotion will do the job, but in the winter when skin becomes drier, a thicker cream or ointment is a better choice, she says.
Good ingredients to look for in a moisturizer are lactic acid, glycerin, petrolatum, and hyaluronic acid, says Nazanin Saedi, MD, a dermatologist, director of Jefferson Laser Surgery and Cosmetic Dermatology Center, and an assistant professor at Thomas Jefferson University Hospitals in Philadelphia. Persistently dry areas can also benefit from petroleum jelly, she says.
If over-the-counter moisturizers aren’t enough for your skin, your doctor may prescribe an ointment that contains ceramides, or proteins that help rebuild the skin barrier, Lamb says. Prescription-strength products are especially helpful for eczema and other severe skin conditions. People who have eczema may also get relief from applying cold compresses on itchy skin. Over-the-counter or prescription corticosteroid creams may also be needed to heal the skin barrier and calm inflammation, Dr. Saedi says, but prolonged use can thin your skin, so carefully follow your doctor’s directions about using them. Your doctor may also prescribe oral corticosteroids, but they’re not intended for long-term use.
Another over-the-counter or prescription option is a barrier cream. Barrier creams penetrate a little deeper than standard moisturizers. “Anyone prone to dryness with repeated exposures to detergents, soaps, water, and other irritants would benefit from a barrier cream,” Dr. Plotner says.
For those with keratosis pilaris, moisturizing with creams that have urea or lactic acid helps the itch, but doesn’t necessarily smooth the skin. However, mild chemical peels or topical retinoids may soften the skin.
Other dry skin remedies include:
Taking short, warm (instead of hot) showers
Using moisturizing soaps
Placing a humidifier in your home to add moisture to the air
Although it hasn’t been studied, some doctors believe that polyunsaturated fats, found in fatty fish like salmon and mackerel and soybean and safflower oil, can help keep the skin healthy, Lamb says.
With the right tender, loving care — and a good moisturizer — you can restore a healthy luster to dry skin.