Dry Skin

As people age, the outer layer of skin (not the inner layers) loses water. As a result, the skin surface often becomes dry or rough. Noticeably dry skin is called xerosis.

Causes and Symptoms

Older people often have xerosis. With aging, the outer layer of skin becomes less able to keep water in. Some drugs can worsen xerosis by changing the chemical composition of the skin's outer layer.

Dry skin, particularly on the forearms, hands, and lower legs, tends to itch and flake (scale). Itching can be distracting and distressing. Symptoms are often worse in winter because low humidity indoors (due to heating) and outdoors (due to cold and wind) dries the skin even more.

Many soaps, detergents, and alcohol (applied to the skin alone or as an ingredient in some skin care products) dry the skin, worsening symptoms. Using hot water during bathing dries the skin. The hotter the water, the drier the skin becomes. Occasionally, dry skin cracks. If irritating substances enter the cracks, the skin may become red, itchy, swollen, or painful. This condition is called eczema craquelé or asteatotic eczema.

Prevention and Treatment

Usually, xerosis cannot be cured. However, people can usually take steps to avoid drying the skin and thus control symptoms. For example, they can bathe or shower only once a day (in warm, not hot, water) and use a mild soap. Patting rather than rubbing dry can help. Clothing made of wool or other potentially irritating materials should not be worn next to the skin. Increasing humidity in the air, for example with a humidifier, relieves xerosis.

Certain moisturizers, such as those that contain lanolin or white petrolatum, trap and hold water in the skin. They can help if applied generously and frequently, particularly after bathing or showering. Many such moisturizers are available without a prescription. Skin care products that contain alcohol should be avoided. Scented products are more likely than unscented products to cause allergic reactions and should be avoided by people prone to allergies.

Occasionally, prescription products are needed. Creams and lotions that contain a high concentration of lactic acid or glycolic acid can help remove scales and keep the skin moist. Some products contain urea, which can help moisturize the driest areas. If the skin becomes temporarily red, swollen, or painful, corticosteroid ointments can be very helpful.