Dry skin

Overview

Dry skin (xerosis) occurs when the skin lacks sufficient moisture, causing it to feel tight, rough, and itchy. It is a common, usually benign condition that can affect any area of the body and worsens with cold weather, low humidity, and frequent bathing.

How common is it?

Dry skin affects the majority of people at some point, particularly in older adults where skin oil production declines naturally with age.

Causes and risk factors

Skin normally forms a protective barrier that holds moisture in. When this barrier is disrupted or when skin does not produce enough oil, moisture evaporates, causing dryness.

Common risk factors

• Cold, dry weather or low-humidity environments
• Frequent hot showers or baths
• Harsh soaps and detergents
• Older age, as skin tends to become drier
• Certain medical conditions: eczema, psoriasis, hypothyroidism, diabetes
• Diuretics and retinoid medications
• Genetic predisposition

Symptoms

• Feeling of tightness, especially after bathing
• Rough or flaky skin texture
• Itching (pruritus)
• Cracking skin, sometimes bleeding in severe cases
• Fine lines or cracks
• Dull-looking skin
• Chapped lips and hands

When to see a doctor

See a doctor if dry skin is severe, affects sleep, is associated with a generalised rash, or is not responding to emollients. Persistent itching without a rash can occasionally signal internal conditions. If you have diabetes, a new foot wound, blister or signs of infection need prompt assessment; contact your foot-care team the same day.

Diagnosis

Clinical diagnosis. Blood tests for thyroid function, kidney function, or blood glucose are done if a systemic cause is suspected.

Treatments

Self-care and lifestyle

• Moisturise regularly, not just when skin feels dry. If you have diabetes, check your feet daily and moisturise dry skin on the feet, but not between the toes.
• Wear gloves when working with water or cleaning products
• Use a humidifier in centrally heated rooms in winter
• Avoid wearing wool directly against the skin

Prevention

Regular moisturising, avoiding harsh soaps, wearing gloves outdoors in cold weather, and shortening and cooling bath or shower temperature prevent most dry skin.