Xerosis

What is Xerosis?

Most people have experienced Xerosis, or dry skin, at some stage of their life. When it becomes severe it can affect people both physically and emotionally. Understand the various causes and the relevant solutions helps you to tailor your routine to your skin’s needs, enhance its efficacy and control the symptoms of Xerosis.

Xerosis is the medical name for dry skin. It comes from Greek: ‘Xero” means ‘dry’ and ‘osis’ means ‘disease’ or ‘medical disorder’. Xerosis is caused by lack of moisture in the skin, which may be the result or ageing (senile Xerosis) or due to underlying diseases such as Diabetes. The result is dry or very dry, rough, and tight skin, which can progress to become extremely rough and scaly, flaky, and itchy.

Skin ability to regulate the amount water in its upper layers depends on three different factors:

• The efficiency of the hygroscopic molecules in the epidermal layers of skin. In normal skin, molecules such as Urea, Lactate, Pyrrolidone Carboxylic Acid (PCA), salts and amino acids attract and bind in water.
• The effectiveness of skin’s own barrier lipids (e.g Ceramide) which perform the vital function of reducing water loss due to evaporation.
• In normal skin, this delicate system works well and adapts to the skin’s hydration requirements, maintaining and adequate concentration of water in changing environment. However, several internal (Endogenous) and external (Exogenous) factors can disrupt in system and cause skin to dry out.

Who is at risk?

Dry skin can be seen in people of any age, of any race and of either gender. However, the incidence of dry skin increases with age; nearly all individuals over the age of 60 have some degree of dry skin. Dry skin is caused by several environmental factors including:

• Low humidity
• Frequent bathing
• Harsh soaps
• Dry skin is caused by several medical conditions including:
• Ichthyosis
• Atopic Dermatitis
• Diabetes
• Hypothyroidism
• Down syndrome
• Liver or kidney disease
• Malnutrition
• HIV/AIDS
• Lymphoma

What are the signs and symptoms?

Xerosis is a common condition experienced by millions of people, either chronically (repeatedly) or acutely (a one-off occurrence). Just as multiple factors support skin hydration, a lack of water within the skin can present in a variety of ways. Dry skin will normally display a couple of these symptoms, while very dry skin commonly has all these symptoms too:

• Tightness – Caused when number of dead skin cells increases, leaving a layer on skin’s surface that causes it to dry out and feel tight
• Roughness – Cause by dryness. This dryness increases the rate at which skin cells die off, leaving a thicker layer of dead cells at skin’s surface which makes it feel rough.
• Flaky skin – Occurs when the large scales of the epidermis peel off and sometimes may be seen like a form fine dust.
• Itchy skin- Another result of dryness and is an impulsive reaction to the discomfort caused by tight, poorly functioning skin. The urge to scratch increases according to the severity of the dryness.
• Cracking or Peeling, in more severe case.
• You may see ultra-fine lines across the surface. The skin may take on a white, grey, or ashy appearance, and it may look like you can see a “layer” of dry skin on the surface atop of your normal skin. If Xerosis gets worse, it can cause redness and irritation. Cracks in the skin can become deep and may bleed.
• Xerosis can happen over entire body, but most common on the arms, legs, hands, and feet. The face is also a typical place to develop extra-dry skin. It is less common on the trunk.
• You may not have Xerosis all the time, it may come and go especially as the seasons or climate change. Xerosis is more common during the extremes of winter and summer.

What causes Xerosis?

Two key deficiencies in the skin have been shown to contribute to Xerosis:

• A deficiency in skin barrier lipids – The skin contains sebaceous glands, small glands that create your skin’s natural oil. This oil, called sebum, helps to keep your skin lubricated and moisturized. Sebum helps to seal moisture into your skin and hair. It also plays role in waterproofing your skin and, along with your sweat, regulating body temperature.
• Natural Moisture Factor – But sebum is not the only thing that keeps your skin hydrated. Your skin also produces, within the stratum corneum layer, many different substances that keep the skin moisturized, preventing it from becoming dry, scally and damaged. These substances include ceramides, Hyaluronic Acid, Urea, and Amino Acids.

Risk and factors that triggers Xerosis

Dry skin can happen to anyone, at any time. But there are certain factors that make your skin more susceptible to developing Xerosis.

• Age – As you age, sebum production slows down. Your skin does not produce enough of the substances that make up the skin’s natural moisture factor, either. This accounts for why so many people develop Xerosis as they age.
• Weather – Extremely hot and extremely cold weather contribute to dry skin. Living in a low humidity area also is a contributing factor because of the dry air can suck moisture from the skin, so too does dry indoor air.
• Bathing habits – Bathing/washing too often, using water that is too hot, and using soaps in over excess can strip natural lipids, can damage the skin’s natural barrier.
• Medication – Some medication can cause dryness of the skin. These include diuretics, certain cholesterol medications and most acne medications (Isotretinoin, Retin-A, and Benzoyl Peroxide)
• Underlying health problems – In certain cases, dry skin may be caused by an underlying health problem. You are more likely to develop dry skin if you have Atopic dermatitis (Eczema), Hypothyroidism, or Diabetes. Diabetes especially can cause Xerosis of the feet. This can quickly become a more serious problem in people with diabetes because of slow wound healing.
• Sunlight – Cause skin dryness as the UV light increases the rate of water evaporation from the skin. In the longer term, this can cause skin to age prematurely which affects its ability to maintain adequate hydration.
• Diet – It is important as vital nutrients are necessary for healthy skin.

How to prevent Xerosis?

Besides moisturizing regularly, there are some lifestyle steps you can take to help manage Xerosis, and in some cases prevent it from happening again in the future.

• Use a humidifier in your home to add much – needed moisture into the air.
• Cut back on the frequency of your bath or showers and cut down the time you spend in the shower.
• Take lukewarm, rather than hot showers. Hot water can strip the skin of natural oils.
• Choose mild cleansers. You may want to go with a soap – free cleanser or non-foaming wash, as these are not as drying as other options. Fragrance-free products are less likely to irritate your already sensitive skin, as well.
• Use fragrance-free lotions, cleansers, and laundry detergent. Highly scented products may irritate your skin.
• Treat your skin gently. Do not use harsh scrubs or rub at your skin too hard with a towel, rough washcloth, or loofah.
• Shower immediately after spending time in a pool or hot tub. Chlorine can be rough on the skin. Do not forget to also slather on your moisturizer.
• Using gloves when washing dishes will help to avoid direct contact with hot water and strong detergents.
• Wear clothes made of natural materials such as cotton and silk that do not irritate the skin. Wool is natural may cause irritation to extremely dry or Atopic skin and should be avoided by people with these conditions.

Treatment

• Dermatological skincare (Shower gel & Moisturizers)
• Topical steroid creams or ointments
• Oral medication to decrease itching
• Chemical Peel (Body)
• Medlite (Scars/Post Hyperpigmentation)