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Don’t Give In to Dry Skin

A dermatologist offers 6 tips to relieve dry, cracked skin

It happens to millions of people every winter: dry, cracked, red skin. It becomes the norm — something you resign yourself to during the season's cold, dry months. You slather on countless lotions and creams morning, noon and night. You tell yourself that spring is right around the corner, and you'll just deal with it until then.

It doesn't have to be that way. Don't let dry skin take over your life. 

Why you're dry

Dry, scaly skin isn't just a normal seasonal variation. It's also a medical disorder with a clinical name: ichthyosis vulgaris.

Genetics play a huge part in whether you'll experience dry skin, according to Michael Tharp, MD, a dermatologist at Rush University Medical Center.

"It's a very common condition," Tharp explains. "People who have it lack natural moisturizing factor (NMF), which allows the surface of your skin to hold onto water. If you make less NMF or completely lack it, you're more likely to have dry skin, especially in the winter."

If you have children and can remember back to when they were born, you might recall how important it was to keep their skin moisturized. Babies who have ichthyosis vulgaris are more likely to have dry skin and thus a defective skin surface barrier. This abnormal barrier allows potential allergens to penetrate the skin and cause atopic dermatitis (eczema), and eventually hay fever and asthma. The progression through these disorders is called the atopic march. While atopic dermatitis may resolve in childhood, hay fever and asthma can persist throughout life.

Another factor causing  dry skin is repeated hand washing — especially with antibacterial soaps. Soaps damage the skin's surface and thus its ability to retain water.

"Soaps have surfactants, which is what causes lathering that we all like to see. These surfactants also rob the skin of it natural oils (lipids)," Tharp says.

Salving your skin

To help combat dryness and keep your skin soft and supple, Tharp offers these tips:

1. Start with the right soap.

If you wash your hands frequently, use soaps that contain low levels of surfactants but also have added oils (e.g., Dove, Olay), which will help moisturize skin.

2. For doctors, nurses and other people working in a clinical setting who constantly wash their hands for patient safety, it's important to moisturize with hand creams in between washings. Creams are much more effective than lotions, which most people use. 

Tharp recommends skin creams that contain ceramides (lipids), such as Cetaphil, Vanicream and CeraVe. Ceramides help repair the skin, thereby allowing the skin surface to make more NMF and hold onto water molecules.  

3. Soak your hands in lukewarm water for five minutes. Then apply a thin coat of petroleum jelly (e.g., Vaseline) — a great emollient for skin — or another cream and slip your hands into nonlatex gloves (cotton gloves will remove the petroleum jelly). This helps to heal wounded skin and creates a moist environment. 

4. For overall dry skin, wet the skin in the bathtub or shower, then lightly pat dry and apply a thin coat of cream or petroleum jelly to the skin surface. This will trap moisture in the skin's upper layers.  

5. To help alleviate dry skin in the winter, put a humidifier in your bedroom if your furnace doesn't have one.

6. Wear nonlatex gloves when you're cleaning and washing dishes to protect your hands. Dish soap and certain cleaning products can be very harsh on skin.

When you've tried all the right creams and creating a more humid environment and nothing improves, then you need to see your dermatologist.

When to see a doctor

If your skin is still dry after trying these techniques, it's time to see a dermatologist.

"When you've tried all the right creams and creating a more humid environment and nothing improves, then you need to see your dermatologist," Tharp says."You may have developed a contact dermatitis and need prescription topical corticosteroids to overcome the skin barrier damage and inflammation."

Contact dermatitis is a rash that can result from something touching  the skin surface serving as  either an irritatant or allergen. When the skin surface is damaged, allergens can get through the skin and stimulate an immune response. Your body also can't produce important proteins on the skin surface called antimicrobial peptides (APs). These APs protect our skin from bacteria and viruses. 

Repair of the damaged skin with either moisturizing creams or prescription topical steroids allows the skin surface to make more NMF, retain water and heal. Once repaired, the skin can then repel potential allergens and fight off bacteria and viruses through the production of APs.

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