Dry Skin - Patients ask, Dr. Ringpfeil answers
Please feel free to use the blog below to share information about Dry Skin or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery
Dry Skin - Xerosis
It is common for people to experience dry skin during cold weather, in arid climates, and as they age. It is caused by a loss of water from the top layer of the skin, the stratum corneum. Factors such as low humidity and excessive exposure to soaps and detergents can cause water loss by damaging the skin's barrier.
There are several causes of itchy skin, but xerosis is the most common one. During the winter months, dry skin is more common due to windy cold air and indoor heating.
Diagnosis
Dry skin can be diagnosed clinically by looking for fine scales, cracks, or fissures on the skin surface. Sometimes, dryness is just one sign of underlying inflammation, and a biopsy may be necessary to exclude inflammatory dermatoses such as atopic dermatitis, psoriasis, or a fungal skin infection.
When dry skin does not respond to treatment, additional tests may be necessary to rule out certain diseases, such as hypothyroidism, HIV, and Sjogren's syndrome.
Management
Dry skin can be treated by replenishing its moisture content. If possible, you should bathe in cool water, use a mild soap, and apply moisturizer liberally afterward.
Don't wash your hands excessively. Making modifications to the environment, like keeping the room temperature as low as possible during the winter and using a room humidifier, can also be beneficial.
Prevention
Dry skin problems can be prevented by following gentle bathing habits and applying moisturizer daily. During the winter months, exposed skin should be protected through the use of creams, gloves, and scarves. Moisturizer should be applied to dry hands every time you wash them. You should wear gloves when you use chemicals or wash dishes. Hand sanitizer should be used sparingly.
Coping
In the event that the patient follows the above recommendations but the dry skin persists, a dermatologist may be necessary to determine the cause of the persistent xerosis.
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Help!
The skin around my eyes is so dry and itchy! Have tried cetaphil, mometasone and even an Rx w/neosporin and dexomethasone! I give up!
I recommend moist/wet cool compresses with a wash cloth x 10 minutes twice daily, followed by a thin layer of Vaseline or Cerave Healing ointment to the damp skin (the topical sealant is not optional). After 3-5 days of treatment and as long as your skin has normalized, apply your favorite hyaluronic acid based moisturizers three times daily. You can use Cerave hyaluronic acid serum, Neutrogena Hydroboost eye cream, or our RAD Hyla-ssential (https://www.ringpfeildermatology.com/store/product/hyla-ssential/). After 14 days, please continue to use hyaluronic acid at night before you go to sleep and use a protective eye cream during the day.
If your skin has not normalized after 5 days of superhydration with wet compresses/Vaseline, please schedule an appointment with your dermatologist.
Dr. Ringpfeil,
I have noticed the skin on my face is extra dry this winter, especially under the eyes. I have been using Cetaphil DailyAdvance Lotion, which claims it is ultra hydrating for dry, sensitive skin. When marketing, this lotion says it is ideal for the entire body. Therefore, I am wondering if it is still okay for the face? I have been experiencing a minor breakout on my forehead as well, so I do not want to put anything on my face to irritate that. Is it okay then, to put a product on the face that may be used on the entire body?
Cetaphil Daily Advance Lotion can be used on dry skin all over the body including the face. It supports dry skin whether it is naturally dry or dry from acne treatment. If you have combination skin on the face, it is probably best to use a cream designated for the face. Facial creams often have a lesser lipid content to avoid clogging pores. I recommend a hydrating eye cream for dry eyelids, such as Cerave eye repair cream or any eye cream that states that it is hydrating. Avoid eye gels or formulations that promise tightening.