Dry skin, often accompanied by skin reddening, scaling and a tendency towards eczema, is becoming more and more frequent. In particular, children and elderly people are most affected, with approximately two-thirds of children under the age of 10 and almost all people over the age of 60 suffering . Dry skin is also a common symptom of a number of chronic skin diseases such as atopic dermatitis, psoriasis and ichthyosis.
Causes
One important function of the skin is the formation of a barrier between the external environment and the inside of the body. The barrier function is mostly implemented by the stratum corneum and the hydrolipid systems. Various exogenous factors (e.g. harmful environmental influences), as well as structural and metabolic disorders of the skin can lead to dry skin conditions and disturbances in the functionality of the barrier function.
Eczema
Eczema accounts for 30% of skin diseases in general practice and 14% of those seen in Dermatology units (Gawkodger D.G, 2002). UK national statistics show 24% of children aged between 2-15 diagnosed with eczema (www.statistics.gov.uk) and affecting 1 in 12 adults (Williams H. C, 1997).
Atopic dermatitis patients may face a lifetime of isolation, bullying and discrimination, the ISOLATE study on 2,002 patients (Zuberbier Te et al, 2006) presented:
- 73% worry about their appearance
- 63% don’t want others to see their skin
- 27% have been teased or bullied
- 21% have difficulty forming a relationship
- 14% feel eczema has hindered their career progression
Management of Conditions
The aims of dermatological care of dry skin are:
- To maintain and restore the skin’s barrier function which protects the skin from exogenous harmful influences.
- To normalise the increased transepidermal water loss in skin diseases associated with dry skin conditions.
- To soothe the affected skin, helping to reduce subjective sensations such as pruritus and prevent physical damage to the skin.
- To reduce the tendency of the skin to inflammation and eczema.
Emollient Therapy
Dry skin is deficient in lipids and moisture. Emollients, which can be in the form of ointments, creams, lotions or bath oils, replace missing lipids and restore the skin’s barrier function, measurable by a reduction of the transepidermal water loss (TEWL).