This article is a continuation of Changes in the structure of the skin related to aging
Dry skin is a common skin condition, where there is insufficient moisture in the epidermis or the outermost layer of the skin. The elderly, in particular, are more prone to developing dry skin. It is also important to note that the risk increases after the age of 40.
As you age, your skin tends to contain reduced amounts of lubricants and oils. According to estimates, greater than 50% of the elderly people suffer from skin dryness. Areas of the body that are more prone to develop dry skin include arms, hands and lower legs.
If you are elderly with dry skin, then your condition can be made worse by the following factors:
- Heat: Fireplaces, central heating, space heaters and wood-burning stoves all decrease humidity and aggravate dryness of skin.
- Weather: You live in a region that has a dry or cold climate or low-humidity.
- Hot showers and baths: The dryness of your skin can become worse by taking hot baths or showers for a long duration.
- Harsh detergents and soaps: Many detergents, shampoos and soaps may remove moisture from the skin as they have been formulated to strip excess oil from the skin; thereby, worsening dry skin.
- Occupation: Your job requires that you immerse your hands in water, like hairstyling or nursing.
- Lifestyle: You swim quite often in chlorinated swimming pools.
- Other conditions of the skin: If you are an elderly with dry skin and you also suffer from other skin conditions including psoriasis or eczema (atopic dermatitis) then these conditions can aggravate the dryness of your skin.
Things to know about dry skin
It isn’t necessary for dehydrated skin to be dry. Dehydrated skin can be combination, normal or oily skin, which lacks waters and it feels tight. If you have tight skin, it doesn’t imply that it’s dry. When your skin is dehydrated it lacks moisture or water, but it may still secrete oil. In fact, in this state, it may be probably over-secreting oil so that it can compensate for the reduced water content in the skin.
Hence, you can easily mistake dehydrated skin for oily skin. People who have oily skin that is prone to acne and who frequently use harsh skincare products that remove the moisture from the skin are more susceptible.
What is NMF (Natural Moisturizing Factor)?
Natural moisturizing factor is your skin’s own moisturizing tool. NMF is made up of free amino acids and their derivatives like urocanic acid and inorganic salts, sugars, urea and lactic acid. The inorganic salts present are the phosphates, citrates and chlorides of sodium, calcium, magnesium and potassium.
The NMF is present in the horny layer of the epidermis. The role of NMF is to maintain optimum hydration of the skin. Thereby, it maintains the plasticity of the skin and protects it from damage.
Drinking enough water? How much is enough?
Drinking enough water every day is imperative to maintain your general well being; however, it is also important to maintain the health of your skin. Similar to any other body organ, skin is also made up of cells, which require water to function properly. Insufficient intake of water will lead to dehydration and it results in dry, flaky and tight skin. Dry skin is at more risk of developing wrinkles.
The usual recommended amount is 8 glasses of water per day. Some experts recommend drinking half of your body weight (pounds) of water (in ounces) per day. You can increase your intake of water gradually over a period of days, by drinking two glasses of water after waking up in the morning or carry a bottle (750 ml) of water where ever you go. Additionally, you can make it your goal to refill the bottle four times in the day.
Why some people drink a lot of water and yet still have dry skin?
Consume sea salt along with water daily. Salt (and potassium) helps in regulating the total water present in your body. This implies that when you don’t consume adequate salt, your body is unable to use water properly and it is mostly expelled and flushes out lots of vital electrolytes and minerals along with it.
Alcohol used in skincare products as a cause of dry skin
Alcohol has hygroscopic properties, which extracts water or moisture from your skin. Hence, moisturizing creams that contain ethanol moisturize your skin initially. But when you apply them repeatedly, the ethanol present in these creams dries your skin. Hence, you are forced to apply more to prevent feeling dry.
Any skincare or cosmetic product that has an alcohol content of more than 5% has a drying effect on your skin. Hence, as you get older the effect is seen more as your skin is already dry due to reduced production of oil. If the alcohol content in the product is less than 5%, it may not have such a significant drying effect.
Signs and symptoms of dry skin
- A feeling of tightness of skin particularly after bathing, showering or bathing
- Skin that looks and feels rough
- The appearance of cracks or fine lines on the skin
- Ashy, grey skin
- Redness of skin
- The appearance of deep cracks, which may bleed
What medical conditions can cause dry skin?
Apart from aging, the below mentioned medical conditions may result in dry skin:
- Atopic dermatitis (Eczema)
- Malnutrition (for instance, Vitamin A deficiency)
What are the complications of dry skin?
Dry skin and the associated itching may result in secondary infection by bacteria. Bacterial infections can be mild that may resolve on their own or they can be severe, requiring treatment with antibiotics. Severe itching results in repeated scratching leading to the ‘itch-scratch-itch’ cycle. The persistence of this cycle results in thickening of the skin in these regions. This may result in two chronic conditions of the skin (localized)-prurigo nodule and lichen simplex chronicus.
When to visit a doctor for dry skin problem?
- There is no improvement in the symptoms of dry skin even with best efforts.
- Dry skin symptoms are associated with redness.
- Itching and dryness of skin interfere with your sleeping.
- You have developed infections or open sores due to scratching.
- You have developed large regions of peeling or scaling skin.
How is dry skin diagnosed?
Your doctor will perform a physical examination. They will ask questions regarding your medical history that includes:
- When did you start having dry skin?
- What are the factors that make it worse or better?
- What are your dietary habits?
- How are your bathing or showering habits like?
- How is your skincare routine like?
They may suggest some diagnostic tests to rule out certain underlying diseases such as hypothyroidism as the cause of your dry skin.
Treatment of dry skin
One of the best treatments of dry skin is to daily apply an emollient (it is a substance that prevents evaporation of moisture or water from the skin).
Dry skin due to aging can be relieved by treatments that are applied externally such as lotions and creams. Quite frequently, dry skin is improved simply by application of a bland OTC moisturizer. The main goal is to stop itching, prevent water loss and restore hydration of the skin.
In case you have severe dry skin, your doctor may ask you to use an OTC cream containing urea and lactic acid.
Mild moisturizing lotions
For the treatment of mild dryness of skin:
- Cetaphil lotion
- Curel lotion
- Lubriderm lotion
Highly moisturizing products
For severe dryness of skin (which do not drizzle out of the bottle when it is inverted):
Topical creams containing steroids
Usually prescribed in therapeutic cases of skin problems:
- Hydrocortisone 1% (mild strength)
- Triamcinolone 0.1% (medium strength)
- Pramosone 2.5% (mild strength)
- Fluocinonide 0.05% (strong strength)
You should use only mild strength steroid creams such as hydrocortisone on the underarms, groin and face areas. Applying strong strength steroid creams in the long term may result in serious side effects such as stretch marks, skin breakdown and skin thinning.
Home and lifestyle remedies
Take the following measures to keep your skin healthy and moist:
Apply moisturizers after bathing and several times in a day. Alternatively, apply baby oil when the skin is moist. Oil stays for more time than moisturizers and prevents water from evaporating from the skin’s surface.
Use a cream or ointment instead of a lotion
Creams and ointments are less irritating and more effective than lotions. Opt for an ointment or a cream that have oils like jojoba oil or olive oil. Shea butter is also a good choice. There are other ingredients which help to relieve dry skin, such as glycerin, hyaluronic acid, dimethicone, urea, lactic acid, mineral oil, petrolatum and lanolin.
Gentle & unscented products
Use gentle and unscented cosmetic and skincare products. Additionally, avoid using products containing alcohol and fragrance.
Reduce hot bath time
While bathing, use lukewarm water and restrict your bathing time. Long baths and showers, particularly with hot water, strip oils from the skin. Restrict your shower or bath time to 5-10 minutes.
Avoid harsh and drying soaps
Instead, use gentle cleansers and shower or bath gels that have added moisturizers. Opt for mild soaps with added fats and oils.
Use moisturizers after bathing
Apply moisturizer immediately after bathing. Gently pat dry your skin using a soft towel and apply a moisturizer immediately, as this helps in trapping water in the skin cells.
Install a humidifier
Dry, hot air in your room can dry your skin and make flaking and itching worse. To prevent this, use a portable humidifier in your room to add moisture into the air. Also, make sure to clean the humidifier to prevent fungal infections.
Wear natural fabrics
Choose fabrics, which are gentle on your skin. Natural fabrics such as silk and cotton allow the skin to breathe. Wool, though natural, may irritate your skin. Use detergents that do not contain perfumes or dyes to wash your clothes, because these may irritate the skin. Use detergents which are labelled “hypoallergenic.”
Minimize unnecessary heat exposure
Don’t sit in front of a heat source or open flame as it may dry your skin.
What are the supplements that you can use for dry skin?
Vitamin E is powerful anti-oxidizing and anti-inflammatory that helps in soothing your dry and itchy skin.
Fish oil is rich in omega-3 fatty acids, and these help in relieving dry skin. They also help to prevent inflammation of skin.
Zeaxanthin and Lutein
These two carotenoids are potent antioxidants, which have to be replenished via diet because your body is unable to produce them. Taking a supplement containing these two carotenoids increases the hydration of skin.
A low level of Vitamin D causes dry skin; hence, include a vitamin D supplement in your daily routine.
Evening Primrose Oil
Evening primrose oil helps in relieving dryness of skin and keeping skin moist because it is a rich source of essential fatty acids (both omega 3 and omega 6).
Home remedies (natural and organic ways)
There are a wide variety of natural and organic ingredients that you can use to alleviate dry skin. Some of these are:
Apply some fresh gel from the leaf of Aloe Vera on your face and massage it gently, then leave it overnight. As a rule, repeat it every night as the polysaccharides present in Aloe Vera helps in retaining the moisture in your skin and relieving dryness.
Apply virgin coconut oil on the affected areas and massage it gently. Apply it one or two times a day. Saturated fatty acids are present in coconut oil that works as an emollient and smooth and hydrate the skin naturally.
You can add powdered oatmeal to your bath or use creams containing oatmeal to relieve dryness of skin. Oatmeal extracts have anti-oxidant and anti-inflammatory properties; therefore, it can help in relieving dry skin.
Sunflower seed oil
Sunflower seed oil improves hydration and is an excellent remedy for dry skin, as found in a study published in the ‘Pediatric dermatology.’
According to a review published in a journal of Ayurveda, honey is beneficial for multiple skin diseases. Honey is healing, anti-inflammatory and moisturizing. Hence, it has several qualities that make it an ideal treatment to relieve dry skin. You can apply honey directly to the affected areas and leave for some time. Rinse it with lukewarm water.
What you can eat in your daily diet to reduce dryness
When you have dry skin, it implies that your skin cells are getting damaged faster in comparison to the speed with which your body is able to repair them. In this case, there are certain foods that may help to maintain the health of your skin.
Foods that are rich in antioxidants may help in minimizing the damage caused by toxins, and some of these foods include:
- Peas, beans and lentils
- Apricots, carrots and other orange and yellow coloured vegetables and fruits
- Leafy green vegetables such as spinach
- Fatty fish such as mackerel and salmon
Lipids form an important part of the skin barrier, as they include phospholipids, cholesterol, ceramides and free fatty acids. Without these lipids, water can escape easily, thus allowing the skin to get dehydrated. Polyunsaturated fatty acids (PUFAs) are essential for the synthesis of the lipids present between skin cells.
The two kinds of fatty acids, which are essential and should be consumed through your diet, are omega 3 fatty acids and omega 6 fatty acids.
- Foods rich in omega-3 fatty acids: Fatty fish such as herring, salmon, sardines, anchovies, mackerel, flaxseed oil, grass-fed beef and eggs.
- Foods rich in omega-6 fatty acids: Borage seed oil, corn oil, safflower oil and evening primrose oil.
Drinking milk can also offer relief from dry skin. According to a study published in the ‘Journal of Dermatological Science,’ phospholipids present in milk improved skin barrier in the study of mice.