As we’re buffeted by changing weather, many people have been grappling with dry skin and chapped lips. It’s a common problem at the best of times. Not only can dry skin be annoying and cosmetically challenging, it can lead to more serious problems, particularly if it’s accompanied by itchiness or a rash.
The clinical professor and dermatologist Saxon Smith says dry skin, or xerosis as it’s otherwise known, becomes more common as we get older. “Part of the reason is our skin doesn’t hold moisture and those natural moisturising factors,” he says. “So our skin starts to be a little drier.”
Environmental causes of dry skin include wind and cold air, which create lower humidity, indoor heating, and hotter, longer baths and showers. In summer hot breezes “are a bit like fan-forced oven on us”, Smith says. They can be drying, as can intense sun exposure. Even indoors on a hot day, air conditioning sucks the moisture out of the air.
Frequent hand washing and hand sanitisers, particularly those with alcohol, have a drying effect, too. These hygiene measures, along with long periods of wearing face masks, have led to increased skin problems including dry skin and itchiness.
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On top of this, typical soaps these days are like detergents, says Smith — that’s why they lather and foam up, removing more moisture from the skin. This wasn’t always the case: the concept of lather originated in the 1960s. “It was … advertising about a particular brand of soap product at the time,” Smith says. The sales pitch worked so well it became the norm.
The general skin measures
Xerosis, the medical term for dry skin, literally means lack of fat. The skin retains moisture and prevents infection by secreting an oily substance called sebum.
Exposure to the elements, overwashing and aggressive exfoliation can all flush our sebum away, but its production by the body also slows as we age, and can be compromised by a host of other factors including hormones, medication, smoking, allergies and diet.
To protect the skin, three simple daily habits are a good start. “Soap-free wash, moisturiser and lukewarm showers are a mantra in dermatology about how to look after your skin,” Smith says. “They’re what they call the general skin measures.”
Although you may want a lighter moisturiser in summer, in colder weather he strongly recommends thicker cream, because the skin craves more hydration to help it normalise, as well as shorter showers that are not too hot. To help counteract the effects of regular hand washing, Smith advises applying hand moisturiser at the start of the day and before bedtime. Regular application of lip balm will help prevent and treat chapped lips.
Other recommendations to prevent dry skin include using a humidifier in dry indoor environments, avoiding alcohol-based skin products, staying hydrated by drinking plenty of water, avoiding excess sun exposure and quitting smoking.
Any suspected irritants should be avoided — these could include perfumes and dyes in skin products, and some laundry products used for clothes.
The microbe brigade
“Our skin and our body is covered in bacteria and other microbes,” Smith says. A whopping trillion of them live on our skin, and they are “a natural part of the defence mechanisms against the slings and arrows of outrageous fortune — to quote Shakespeare — of our environment, and keeping them in balance is really important”.
These microbes help maintain a healthy skin barrier, explains Dr Chris Callewaert, researcher for Belgium’s Centre for Microbial Ecology and Technology. “They convert sebum and produce an ‘acid mantle’ on our skin, protecting it from other harmful pathogens or viruses,” he says.
“The skin microbiome trains our immune system and creates a healthy balance in immune response. Without that balance, we would be prone to any harmful vector, or have asthma or allergic reactions all the time.”
Beyond the drying effects of soaps and washes, the antimicrobial ingredients and preservatives in deodorants, antiperspirants, shower gels, body washes, shampoos and cosmetic products have also taken their toll. “In virtually every product that we apply on our skin there are some kind of ingredients that will kill or inhibit bacteria,” Callewaert says. “We are doing a ‘mass murder’ on the skin on a daily basis, without even knowing or thinking about it.”
These products also impact the microbes indirectly, as the detergents and fat-removing ingredients alter their natural environment and the ecosystem that supports them. Ultimately, the strong survive — but they aren’t always the most beneficial ones.
To protect the healthy skin bacteria, Callewaert suggests considering avoiding antiperspirants and cosmetics altogether, or at least familiarising ourselves with the ingredients in our products so we can avoid those known to be harmful. The Inci Decoder, a plain English guide to cosmetics ingredients, can help with this.
What lies beneath
“The skin is the biggest organ in the body, in terms of surface area,” Smith says. “And it is very complicated because it’s both a barrier to keep the outside out and the inside in.”
Dryness “can lead to cracks in the paving, like the cracks in the surface of a flood plain that dries out”, Smith says. “And with cracks in the skin, this can allow more things to penetrate through and activate the immune system.” This can cause flare-ups in people with eczema or sensitivity to allergens.
“So maintaining that skin barrier in that broad sense is so important for all of us. It’s not just about the fact that the itch drives us mad when the skin is dry; it’s also about ensuring that we are minimising our risk and exposure to the things that our skin is supposed to be protecting us from.”
A healthy diet can help support healthy skin, and it will also support a resilient gut microbiome, which emerging research has linked to the skin. “Having a healthy gut will lead to healthy skin,” Callewaert says. “If something is not right in the gut, that can definitely impact the skin and the skin microbiome.” Many gut disorders are linked to skin disorders, he adds. People with psoriasis, for instance, have higher incidence of inflammatory bowel disease, ulcerative colitis, coeliac disease and lactose intolerance.
When to see a health professional
Dry skin can lead to rashes and itchiness. When a rash starts to become red and the skin becomes irritated and thicker or infected — with or without itching — this could signify a skin condition such as eczema or psoriasis, according to Smith.
He suggests this is the time to see a health professional, and recommends your GP as a good start. — Guardian