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
Dry skin, also known as xerosis, is a common complaint during cold weather, in arid climates and among the elderly. It is caused by water loss from the uppermost layer of the skin, the stratum corneum. Environmental factors such as low humidity and excessive exposure to soaps and detergents can foster water loss through damaging the skin barrier. Dry skin is often itchy and xerosis is the most common cause of itchy skin. Dry skin becomes more prevalent during winter months because exposure to both cold windy air and indoor heating is drying to the skin.
Diagnosis
Dry skin is usually a diagnosis that can be made clinically by observing skin with fine scale, cracking or fissuring. Sometimes dryness is just one manifestation of underlying inflammation and a biopsy may be needed to rule out inflammatory dermatoses such as atopic dermatitis, psoriasis or a fungal skin infection. Certain diseases such as hypothyroidism, HIV and Sjogren syndrome can cause dry skin and if dry skin does not respond to treatment additional testing to rule out such diseases may be necessary.
Management
Treating dry skin involves replenishing the water content in the skin. This is best achieved by bathing in cooler water with a gentle soap immediately followed by liberal application of moisturizing cream. Excessive washing should be avoided. Environmental modifications such as keeping room temperature as low as comfortable during the winter and the use of room humidifiers can also be beneficial.
Prevention
Consistently adhering to gentle bathing habits and daily use of moisturizer can prevent dry skin problems. Exposed skin should be protected from winter cold through the use of gloves and scarves. For dry skin on the hands, moisturizer should be applied each time the hands are washed. Rubber or vinyl gloves should be worn when cleaning with chemicals or washing dishes. Excessive use of hand sanitizer should be avoided.
Coping
If a patient follows the above recommendations but dry skin persists, evaluation by a dermatology professional may be needed to discover the reason for the persistent xerosis.
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.