Keep patients skin hydrated this winter 

Dry skin (also known as xerosis or xeroderma), can be a problem for many people over the cooler months. A combination of the damaging effects of colder weather, lower humidity, and indoor heating can play havoc with skin, leaving it dry and itchy. Anyone can be affected, but the elderly are more at risk, due to the natural changes in skin as it ages. Those with pre-existing skin conditions such as eczema can also suffer more than the average person.

If your patient has dry skin, it may: 

  • look dull
  • feel rough
  • feel tight, particularly after being wet
  • have fine lines or even cracks in it
  • look scaly or flakybe extremely itchy

The protective barrier 

The skin is the largest organ in the body and its primary role is to act as a barrier from impact, variations in temperature, micro-organisms, radiation, and chemicals. It also regulates the loss of fluids and electrolytes from the body. 

Complications of dry skin 

Dry skin is usually not serious. However, any damage to the skin means that its function may be compromised, and the patient may be at risk of developing several complications. . 

  • Itching, cracking and bleeding - When the skin lacks moisture it becomes less elastic and is more likely to split. Initially, the skin becomes red and develops fine cracks, often along the natural lines of the skin. These cracks can become deeper, extending through the epidermis, into the dermal capillaries, which causes bleeding.
  • Infection  - Once the skin cracks, breaching the barrier between the body and the external environment, the patient is at risk of infection due to bacteria being able to enter the body. Red or inflamed skin can be an early sign of a developing infection. If left untreated, the infection will continue to spread, and skin may become hot and sore when touched.
  • Dermstitis (atopic eczema)  - Characterised by redness, inflammation and cracking, dermatitis can be triggered by very dry skin. In some patients, who are predisposed to dermatitis, dry skin can cause an onset or flare-up of the condition. When skin becomes itchy, the risk of bleeding is increased, due to excessive scratching.

Preventing dry skin 

Effective remedies can provide much-needed relief from the irritation of dry, itchy skin. However, because of the potential for adverse effects and complications, it’s important that patients understand how to prevent dry skin in the first instance. This is particularly important for older people, for whom dry skin is more common.

To ensure skin stays smooth and hydrated during winter patients should: 

  • Use soap-free hand-wash and shower gel
  • Wash in lukewarm water - not too hot or too cold and avoid spending long periods of time in the water. You shouldn't wash more than once a day. 
  • Pat skin dry, rather than rubbing it.
  • Use Creams and Lotions designed to protect dry skin, after bathing.
  • Apply moisturiser immediately after bathing while the skin is still moist. This will help trap moisture in the skin.
  • Use hypoallergenic cosmetics, where appropriate
  • Use a humidifier in the home or office to add moisture to the air.
  • Wear natural fabrics that are kind to the skin such as cotton or silk. Wool can scratch skin, irritating it further.
  • Use sunscreen when outdoors, to avoid exposure to UV rays 
  • Avoid scratching itchy skin, which increases the likelihood of breaking the skin, thereby leading to skin infections. 

While not serious, dry skin can interfere with quality of life and leave the patient feeling irritated and miserable. 

 

 References 

Cleveland Clinic, Dry Skin, Itchy Skin, https://my.clevelandclinic.org/health/diseases/16940-dry-skinitchy-skin

Mayo Clinic, Dry Skin, https://www.mayoclinic.org/diseases-conditions/dry-skin/symptoms-causes/syc-20353885

myDr.com.au, Dry skin, http://www.mydr.com.au/skin-hair/dry-skin

my Virtual Medical Centre, Looking After Your Skin in Winter, https://www.myvmc.com/lifestyles/looking-after-your-skin-in-winter/