Ordinarily, dry skin isn't serious, but it can be uncomfortable and unsightly, creating fine lines and wrinkles.

Serious dry skin conditions — an inherited group of disorders called ichthyosis — can sometimes be disfiguring and upsetting. Fortunately, environmental factors that can be at least partially controlled cause most dry skin. These factors include hot or cold weather, low humidity and soaking in hot water.

Chronic or severe dry skin problems may require evaluation by a doctor who specializes in skin (dermatologist). But first you can do a lot on your own to improve your skin, including using moisturizers and avoiding harsh, drying soaps.

Dry skin is often temporary — you get it only in winter, for example — but it may be a lifelong condition. And although skin is often driest on your arms and lower legs, this varies from person to person. What's more, signs and symptoms of dry skin depend on your age, your health, where you live, time spent outdoors and the cause of the problem.

Dry skin is likely to cause one or more of the following:

  • A feeling of skin tightness, especially after showering, bathing or swimming
  • Skin that feels and looks rough
  • Itching (pruritus)
  • Slight to severe flaking, scaling or peeling
  • Fine lines or cracks
  • Gray, ashy skin in people with dark skin
  • Redness
  • Deep cracks that may bleed

When to see a doctor

Most cases of dry skin respond well to lifestyle and home remedies. See your doctor if:

  • Your skin doesn't improve in spite of your best efforts
  • Dry skin is accompanied by redness
  • Dryness and itching interfere with sleeping
  • You have open sores or infections from scratching
  • You have large areas of scaling or peeling skin

Though most cases of dry skin (xerosis) have an environmental cause, certain diseases also can significantly affect your skin. Potential causes of dry skin include:

  • Weather. In general, your skin is driest in winter, when temperatures and humidity levels plummet. But the reverse may be true if you live in desert regions, where temperatures can soar, but humidity levels remain low.
  • Heat. Central heating, wood-burning stoves, space heaters and fireplaces all reduce humidity and dry your skin.
  • Hot baths and showers. Taking long, hot showers or baths can dry your skin. So can frequent swimming, particularly in heavily chlorinated pools.
  • Harsh soaps and detergents. Many popular soaps and detergents strip moisture from your skin. Deodorant and antibacterial soaps are usually the most damaging. Many shampoos may dry your scalp.
  • Sun exposure. Sun dries your skin, and its ultraviolet (UV) radiation penetrates far beyond the top layer of skin. The most significant damage occurs deeper, leading to deep wrinkles and loose, sagging skin.
  • Other skin conditions. People with skin conditions like atopic dermatitis (eczema) or a skin condition marked by a rapid buildup of rough, dry, dead skin cells that form thick scales (psoriasis) are prone to dry skin.

Although anyone can develop dry skin, you may be more likely to develop the condition if you:

  • Are older than age 40
  • Live in dry, cold or low-humidity climates
  • Have a job that requires you to immerse your skin in water, such as nurses and hairstylists
  • Swim frequently in chlorinated pools

In some people who have a tendency toward eczema, dry skin that's not cared for can lead to:

  • Atopic dermatitis (eczema). If you're prone to develop this condition, excessive dryness can lead to activation of the disease, causing redness, cracking and inflammation.
  • Infections. Dry skin may crack, allowing bacteria to enter, causing infections.

These complications are most likely to occur when your skin's normal protective mechanisms are severely compromised. For example, severely dry skin can cause deep cracks or fissures, which can open and bleed, providing an avenue for invading bacteria.

You're likely to start by seeing your family doctor. However, in some cases, you may be referred directly to a specialist in skin diseases (dermatologist).

Here's some information to help you get ready for your appointment and know what to expect from your doctor.

What you can do

Preparing a list of questions will help you make the most of your time with your doctor. For dry skin, some basic questions to ask include:

  • What is likely causing the dry skin?
  • What are other possible causes for my symptoms?
  • Do I need tests?
  • Is it likely the condition will clear up on its own?
  • What skin care routines do you recommend?

Don't hesitate to ask any other questions you have.

What to expect from your doctor

Your doctor is likely to ask you several questions, such as:

  • Do you have other symptoms?
  • Have your symptoms been continuous or occasional?
  • What, if anything, makes your skin better?
  • What, if anything, makes your skin worse?
  • What medications are you taking?
  • How often do you bathe or shower? Do you use hot water? What soaps and shampoos do you use?
  • Do you use moisturizing creams? If so, which ones, and how often do you use them?

Physical exam and medical history

Your doctor is likely to conduct a physical exam and ask about your medical history, including when your dry skin started, what factors make it better or worse, your bathing habits, your diet, and how you care for your skin.

You may have certain diagnostic tests if your doctor suspects that your dry skin is the result of an underlying medical condition, such as an underactive thyroid (hypothyroidism).

In most cases, dry skin responds well to lifestyle measures, such as using moisturizers and avoiding long, hot showers and baths. If you have very dry and scaly skin, your doctor may recommend you use an over-the-counter (nonprescription) cream that contains lactic acid or lactic acid and urea.

If you have a more serious skin disease, such as atopic dermatitis, ichthyosis or psoriasis, your doctor may prescribe prescription creams and ointments or other treatments in addition to home care.

Sometimes dry skin leads to dermatitis, which causes red, itchy skin. In these cases, treatment may include hydrocortisone-containing lotions. If your skin cracks open, your doctor may prescribe wet dressings to help prevent infection.

The following measures can help keep your skin moist and healthy:

  • Moisturize. Moisturizers provide a seal over your skin to keep water from escaping. Apply moisturizer several times a day. Thicker moisturizers work best, such as over-the-counter brands Eucerin and Cetaphil.

    You may also want to use cosmetics that contain moisturizers. If your skin is extremely dry, you may want to apply an oil, such as baby oil, while your skin is still moist. Oil has more staying power than moisturizers do and prevents the evaporation of water from the surface of your skin.

    Another possibility is ointments that contain petroleum jelly (Vaseline, Aquaphor). However, these may feel greasy, so you might use them only at night.

  • Use warm water and limit bath time. Long showers or baths and hot water remove oils from your skin. Limit your bath or shower to five to 10 minutes and use warm, not hot, water.
  • Avoid harsh, drying soaps. It's best to use cleansing creams or gentle skin cleansers and bath or shower gels with added moisturizers. Choose mild soaps that have added oils and fats. Avoid deodorant and antibacterial detergents, fragrance, and alcohol.
  • Apply moisturizers immediately after bathing. Gently pat your skin dry with a towel so that some moisture remains. Immediately moisturize your skin with an oil or cream to help trap water in the surface cells.
  • Use a humidifier. Hot, dry, indoor air can parch sensitive skin and worsen itching and flaking. A portable home humidifier or one attached to your furnace adds moisture to the air inside your home. Be sure to keep your humidifier clean to ward off bacteria and fungi.
  • Choose fabrics that are kind to your skin. Natural fibers, such as cotton and silk, allow your skin to breathe. But wool, although natural, can irritate even normal skin. Wash your clothes with detergents without dyes or perfumes, both of which can irritate your skin.

If dry skin causes itching, apply cool compresses to the area. To reduce inflammation, use a nonprescription hydrocortisone cream or ointment, containing at least 1 percent hydrocortisone. If these measures don't relieve your symptoms or if your symptoms worsen, see your doctor or consult a dermatologist.

Jan. 28, 2014