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
- Age (skin produces less oil from the 40s onwards)
- 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.
Diagnosis
Clinical diagnosis. Blood tests for thyroid function, kidney function, or blood glucose are done if a systemic cause is suspected.
Treatments
Moisturisers and emollients
The cornerstone of treatment. Apply immediately after bathing while skin is damp. Choose thick creams or ointments (e.g. white soft paraffin, Diprobase) over thin lotions for best effect.
Soap substitutes
Replace soap with soap-free wash products or emollients used as soap to reduce skin barrier disruption during washing.
Short baths or showers in lukewarm water
Limit to 10 minutes. Hot water strips skin oils. Pat skin dry gently and apply moisturiser immediately.
Self-care and lifestyle
- Moisturise at least twice daily, not just when skin feels dry
- 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.