Dry skin is a common problem, especially in older age groups. Some people have a lifelong tendency towards dry skin which may be familial. More commonly, it tends to be a seasonal problem with worsening in the winter.
Dry skin results from excessive water loss through the top layer of skin. The skin has an outer lipid barrier which normally holds in moisture. This barrier may be damaged by repeated exposure to solvents, harsh soaps, and excessive bathing or hand washing. Environmental factors, such as cold air, low humidity, and central heat also tend to pull moisture from the skin, which is why dry skin is so much more common in the winter.
Dry skin, when severe, can become itchy and inflamed, leading to rashes. It can also exacerbate skin conditions such as eczema, as the damaged lipid barrier allows irritants and infectious agents to penetrate the skin more easily.
Treatment of dry skin is aimed at restoring the lipid barrier and preventing further moisture loss. There are thousands of moisturizing products on the market, but there are basically two kinds of formulations: oil-in-water preparations and water-in-oil preparations. Oil-in-water formulations are lotions, and are useful for mildly dry skin or for daytime facial moisturizing. Water-in-oil formulations are thicker and creamier and will generally be more helpful for severely dry or chapped skin, and for patients with eczema. Urea and lactic acid can enhance water uptake by the skin and can be found in some therapeutic moisturizers.
General Tips for Moisturizing Skin
Bathing with hot water can be very drying, even though it may feel good. We recommend bathing with warm but not overly hot water. Mild synthetic cleansers such as Dove Unscented, Oil of Olay Unscented, Cetaphil Non-Soap Cleanser or CeraVe cleanser are preferable to soaps, which tend to be more drying. After leaving the bath or shower, gently pat the skin dry with a soft towel, then apply moisturizing cream while the skin is still damp. This helps to lock the moisture in the skin. If you have been prescribed a cream for eczema, it is helpful to apply it first, followed by your moisturizer.
The following is a list of some of our favorite moisturizers:
Note: Some of these items are not on the shelf, and may be “behind the counter”. Ask your pharmacist.
Nia Creme (sold in our office) Skin Therapy Cream (sold in our office)
Olay Regenerist Perfecting Cream Replenix SPF 50 (a creamy tinted moisturizer with SPF, soothing green tea, and tint - sold in our office)
DML Facial Moisturizer
Neostrata Facial Ultra Moisturizing Cream (sold in our office)
Neostrata Bionic Face Cream (for severely dry skin; sold in our office)
Kinerase cream, lotion CeraVe PM Facial Moisturizing Lotion
Cetaphil Therapeutic Hand Cream
Gloves-in-a-Bottle Topix Intensive Hand Cream (sold in our office)
Neutrogena Norwegian Formula Hand Cream
Body Cetaphil Cream Replenix Green Tea Antioxidant Moisturizing Lotion (sold in our office)
Vanicream (good for sensitive skin; contains no preservatives, fragrances, etc. sold in our office or at specialty pharmacies)
Vaseline Intensive Rescue Clinical Therapy Skin Protectant Body Lotion
U-lactin lotion (contains lactic acid)
Lac-hydrin 5 lotion (contains lactic acid)
Carmol 10, Carmol 20 cream (contains urea)
Betamide Lotion (contains urea and lactic acid)
Neostrata Problem Dry Skin Cream: contains several alpha hydroxy acids for problem areas like feet, elbows, etc. Available in our office.