Normal skin has a soft, supple texture because of its water content. For skin to feel soft, pliable and "normal," its top layer must contain a minimum of 10% water -- and ideally between 20% and 35%. To help protect the outer layer of skin from losing water, the skin's sebaceous glands produce an oily substance called sebum. Sebum is a complex mixture of fatty acids, sugars, waxes and other natural chemicals that form a protective barrier against water evaporation. If the skin doesn't have enough sebum, it loses water and feels dry. If environmental factors cause more water evaporation and overwhelm the ability of sebum to prevent water loss, the skin will shrivel and crack.
Dry skin, also called xerosis, is a very common problem in modern societies, affecting people of all ages, even infants. In the United States, most cases of dry skin are related to one or more of the following factors:
Dry skin is a common problem in people with diabetes or skin allergies (atopic dermatitis). Less often, it can also be a symptom of hypothyroidism, kidney failure or Sjogren's syndrome. In addition, dry skin sometimes develops as a side effect of medication, especially acne products that are applied to the skin.
Sometimes, the only symptom of dry skin is itching, although most people also will notice that their skin is flaky and slightly more wrinkled than normal. Symptoms of dry skin may worsen during the winter months, especially if you spend a lot of time indoors, where the heated air is dry.
In most cases of uncomplicated dry skin, you can make the diagnosis yourself. Begin by examining your normal skin care routine. Do you often take long, hot baths or showers that may be washing away your skin's protective sebum? Do you shower several times a day or scrub your skin surface with harsh soaps? Do you have a job that requires frequent handwashing?
Next, examine your environmental risk factors, both indoors and outdoors. Do you live in a dry, desert climate? Do you usually spend your winter months indoors, in heated rooms without a humidifier? When you do go outdoors, do you protect your skin with appropriate clothing or with a sunscreen on exposed surfaces? When was the last time you used a moisturizer?
Once you begin to take care of your skin properly, the flakiness and itch of dry skin should improve within one or two weeks. In many cases, a good moisturizer will begin to make your skin look softer and suppler within minutes.
Without proper care, dry skin can become a chronic problem that can lead to skin thickening, cracking and bleeding. This may increase your risk of skin infections.
You can help to prevent dry skin by taking these steps:
If you have a simple case of dry skin, begin by trying the suggestions outlined in the Prevention section. If your dry skin persists, contact your doctor's office for advice.
Call your primary care doctor or a dermatologist (a doctor who specializes in skin problems) if you have:
Overall, the prognosis is excellent. You can often prevent dry skin by making a few simple changes in lifestyle. If dry skin develops, there are many soothing and effective treatments available. Most can be purchased without a prescription.
National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
National Institute on Aging
Building 31, Room 5C27
31 Center Drive, MSC 2292
Bethesda, MD 20892
American Academy of Dermatology
P.O. Box 4014
Schaumburg, IL 60168-4014