Question of the Week

March 9, 2009


For some people, dry skin is a seasonal problem.

"Dry skin is a very common skin problem and is often worse during the winter when environmental humidity is low (i.e., 'winter itch'). It can occur at all ages and in people with or without other skin problems. ... Everyone is familiar to some degree with the appearance of dry skin. The normally fine lines in the skin become more visible, the skin feels rough and appears dull and flaky. In more advanced cases, fish net-like cracks resembling the fine fracture lines of cracked porcelain can occur."

While it may be worse during the winter months for some, dry skin can be a problem year round for others. Some people live in areas where the summer months tend to have very low environmental humidity, others are just predisposed to struggle with dry skin.

"Some people also have a genetic, or hereditary, tendency to develop dry skin. In addition, elderly people tend to have more trouble with dry skin due to the natural changes in skin that occur with age. Treatment is important because extensively dry skin can lead to dermatitis, a more severe inflammation of the skin. ... Some flaking along with redness, however, may be a sign of an underlying dermatitis. There are different types of dermatitis that may cause dry, itchy, flaking skin. They include: * Seborrheic dermatitis. This type involves a red, scaly, itchy rash on various areas of the body, particularly those areas that contain many oil glands. ... * Allergic contact dermatitis. This occurs when the skin comes into contact with a substance that causes an immune reaction ... * Atopic dermatitis. Also known as eczema, this is a long-lasting type of dermatitis that often runs in families.... * Athlete's foot. In many cases, athlete's foot, a fungal infection, shows up as dry flaking on the soles of the feet."

While some may see dry skin as merely a cosmetic health issue, it can have more serious health ramifications that should not be ignored.

"Dry, irritated skin is more likely to get infected. Infected skin is red, warm and swollen. It may ooze fluid. You may need antibiotics to get rid of this kind of infection. Severe itching or pain, especially in older adults, sometimes is caused by a serious medical problem. Call your doctor if you are an older person who has severe itching or pain that doesn't have an obvious cause and doesn't get better within 2 weeks."

One way for people to prevent, treat, and/ or help reduce problems with dry skin is for them to make sure that they are drinking enough fluids, stay well hydrated, and treat it from the inside out. Another way is to take care of the skin and help it from the outside.

"Although it may not be possible to achieve flawless skin, the following measures can help keep your skin moist and healthy:

  • Moisturize your skin. Moisturizers provide a seal over your skin to keep water from escaping. Thicker moisturizers work best... If your skin is extremely dry, you may want to apply an oil, such as baby oil, while your skin is still moist....
  • Use warm water and limit bath time. Hot water and long showers or baths remove oils from your skin. Limit your bath or shower time to about 15 minutes or less, and use warm, rather than hot, water.
  • Avoid harsh, drying soaps. If you have dry skin, it's best to use cleansing creams or gentle skin cleansers and bath or shower gels with added moisturizers. ...
  • Apply moisturizers immediately after bathing. After washing or bathing, gently pat or blot your skin dry with a towel so that some moisture remains on the skin. Immediately moisturize your skin with an oil or cream to help trap water in the surface cells.
  • Use a humidifier. Hot, dry indoor air can parch sensitive skin and worsen itching and flaking. ...
  • Choose fabrics that are kind to your skin. Natural fibers such as cotton and silk allow your skin to breathe. ..."

Ideally, people are keeping themselves healthy inside and out. Water is a wonderful, no calorie drink, but figuring out how much water one needs to drink any given day in order to stay well hydrated can be confusing for some. For more information about how much water people need to drink during the day, please visit the Question of the Week: "Water" from April of 2008.

"There have been recent reports that question the need to drink eight 8-ounce glasses of water throughout the day. For years people have been told that this is important, but no one seems to know why."

Just as knowing how best to hydrate from the inside can be confusing, it can be difficult to know the most effective ways to keep skin hydrated from the outside.

"Bathing provides the skin will moisturize temporarily, but it removes the skin's oily lipid layer and in the long run causes more moisture loss than gain. The wrong moisturizing lotion can have the same effect. Generally, water-based lotions (Lubriderm, Keri lotion, others) are best cosmetically but oil-based creams are more effective in trapping moisture."

Additionally, just because skin looks dry and flaky doesn't mean that additional moisture is the cure.

"Seborrhea is not just skin dryness. Actually, the word 'seborrhea' means 'too much oil.' Seborrhea is also known as seborrheic dermatitis or common dandruff. Seborrhea can present as a variety of conditions such as dandruff, thick scales on the scalp, redness on the face or in the armpits, or raw, red patches below the breasts. Although some of these conditions may feel 'dry,' moisturizing only makes them redder. In other cases the skin may seem oily or even oily and dry at the same time. Seborrhea (dandruff) is a skin disorder that results from neither too little moisture nor too much oil. It is a form of skin inflammation (dermatitis) which has no known cause. This condition can appear at any time from infancy to old age, and can come and go more or less at random. Treatment of seborrhea (dandruff) is directed at fighting the skin inflammation...."

When people know the cause of the irritated and/ or flaky skin, it is easier for them to find the best way to treat it (without inadvertently making it worse).

"Dandruff can almost always be controlled, but dandruff treatment may take a little patience and persistence. In general, mild dandruff can often be helped by daily cleansing with a gentle shampoo to reduce oiliness and skin cell buildup. When regular shampoos fail, over-the-counter (OTC) dandruff shampoos may succeed. But dandruff shampoos aren't all alike, and you may need to experiment until you find one that works best for you. Dandruff shampoos are classified according to the medication they contain..."

Questions of the Week:
What personal risk factors or environmental factors might increase a person's risk of developing dry skin? What are ways to reduce the risk of developing dry skin? How can it be helpful to know the cause of dry skin when attempting to treat it? What should you do if one course of treatment doesn't seem to work right away? When should dry and/ or irritated skin be seen by a health care professional?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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