Dry Skin and Dry Skin Eczema
What is it?
This is a very common skin condition and the most common cause of itchy skin in the Western world. It is caused by shortage of oil production by the glands in the skin and can cause anything from very minor to quite severe symptoms and changes in appearance. Being so common, it has attracted lots of different names:
Eczema Hiemale (“Winter eczema”) In winter the humidity – the amount of moisture in the air, falls and so patients prone to dry skin suffer a lot more.
Eczema Senilis: (“Eczema of the elderly”) Whatever your natural skin type, as you age, you will produce less oils on your skin and hence the ‘dry skin problem’ will tend to worsen with age.
Asteatotoic Eczema: “No grease Eczema” The basic fault is the shortage of oil production by the skin.
Eczema Craquele: “Cracked skin eczema” – a descriptive term.
What are the Symptoms?
The main symptom is itch. This can sometimes be very severe, tends to be worse where the oil glands are sparse – from the knee to the ankles, the forearms and the back. It tends to be worse at night, the theory being that when you lie in bed at night and you sweat, the salt from the sweat gets into the little cracks in your skin and you may even feel as though you are being bitten by ants! A bath or shower will immediately relieve the symptoms by washing away the salty sweat, but after you return to bed, the sweating and the irritation begin again. There may or may not be skin changes; if they do occur they are usually most prominent on the lower legs, with cracks, scaling and a rough texture. There may also be colour changes, especially in dark-skinned patients and on the face of children before puberty.
How is it treated?
- Don’t use soap on the itchy areas! Fortunately the areas of the body which need “soap attention” to keep them smelling sweetly, tend to be very rich in oil – especially the armpits and groins! The rest do not need soap. Indeed they don’t need water as excess water tends to wash away these natural preserving oils and make your symptoms worse! So only use soap on the ‘smelly areas’ and keep even water away from the itchy ones! You may use oilatum or related products as a soap substitute if you really must.
- Replace the oils! My own favourite is by ointments. These are not so pleasant to use as creams or lotions, but remember that ointments by their very greasy nature tend to lubricate the skin and trap in those natural oils produced by your body so that they work for longer. Also, ointments rarely contain preservatives which can irritate and sensitise the skin (most creams do contain these substances)
Anything else I should know about it?
Dry skin can complicate eczema (steroid ointments are quite brilliant for eczema by the way). In both conditions, however, do try to avoid anything which makes the symptoms worse, such as wool, contact with pets and even such dietary factors such as dairy products; if you suspect an item of making things worse, try avoidance for a while; as elsewhere common sense rules! However, you cannot alter the skin oils by diet. The wrinkling of the skin is in the very outermost layer which is replaced every few days and is therefore not permanent.
Certain underlying medical conditions may bring on dry skin (especially an underactive thyroid) and a general medical screen might be worthwhile; similarly medications prescribed by your doctor may make dry skin worse, though usually they are prescribed for a very good reason and should be continued!
Please feel free to contact me if there are any unexplained areas or indeed if you can improve on this handout!
Above all Good Luck
Bernard Shevlin b.shevlin02@gmail.com
(with credits to the inspirational John RT Reeves, the world’s favourite dermatologist!)