- Dry skin (xerosis) is a common skin condition that results in flaky, irritated skin.
- Dry skin can be caused by genetic or environmental factors, or an underlying medical condition.
- Other causes include sleeping habits, alcohol consumption, excessive washing and occupation.
Dry skin results from a lack of moisture. The skin may lack moisture for various reasons, including water loss, or a lack of hydrating oils that maintains skin softness.
In its mildest form, dry skin can appear flaky and accompanied by some itchiness or redness. In more extreme cases, dry skin can be rough or scaly in texture, and may begin to chap or even crack.
What Causes Dry Skin?
Skin maintains proper moisture through various mechanisms such as the natural moisturizing factor (NMF), a protective barrier consisting of of humectants that draw in water molecules from the environment for moisturize.
Skin also uses its own natural oils to moisturize and protect itself. Sebum that is produced by sebaceous glands, and fatty molecules such as ceramides that are found in large quantities in the skin’s outer layer, work together to create a barrier to prevent moisture loss.
Dry Skin Symptoms
Dry skin can develop suddenly and if left untreated, can worsen over time. Some symptoms include:
- dry, flaky skin
- skin tightness
- mild to extreme itchiness
- irritation or pain
- rough or scaly skin
- redness and inflammation
- skin thickening or cracking
Causes of Dry Skin on the Face
Patches of dry, flaky skin on the face are quite common. Dry skin can emerge on the face for most of the same reasons that it develops on other parts of the body.
Can your skin care routine cause dry skin?
Yes, you may be inadvertently be causing dry skin by:
- Washing your face too often, particularly with hot water
- Using harsh cleansers, such as those with isopropanol and n-propanol, or using cleansers with a high pH
- Using the wrong types of moisturizers for your skin type and condition
Lifestyle Causes of Dry Skin
There are a wide range of lifestyle factors that can cause dry skin. Following are some important lifestyle behaviors to consider.
Lack of sleep
Not getting enough sleep ages the skin. A recent study analyzed people’s sleep patterns and identified their average sleep duration. Those who slept on average less than or up to 5 hours were identified as poor sleepers; those who slept between 7 and 9 hours were identified as good sleepers.
When tested for transepidermal water loss using an evaporimeter, results showed poor sleepers lost 30% more water from their skin than good sleepers. This indicates that the skin barrier is less efficient in those who lack sleep and this can have a detrimental effect on skin.
Drinking too much alcohol can cause dry, red, itchy skin. Alcohol dehydrates and inhibits absorption of vitamins and minerals – notably vitamin B6 which contributes to the skin’s moisture level.
Smoking tobacco reduces blood flow, leaving skin dry and discolored. It also depletes vial nutrients such as Vitamin C which is known to aid in protecting and repairing skin. Chronic smoking ages skin at an increased rate, causing sagging and deep wrinkles.
Overexposure to water
When skin is in contact with water for long periods of time, the water will begin to break down the skin’s natural protective barrier, making it dry and tight. Hot water breaks down the skin’s barrier even faster, as does washing with harsh soaps.
The Center for Disease Control (CDC) has compiled a list of the most common occupational skin diseases. Occupations that can cause dry skin are often found in the food service, agriculture, healthcare and cleaning industries, due to skin damage resulting from exposure to the sunor to harmful chemicals.
Environmental Causes of Dry Skin
Many environmental factors can also cause dry skin; identifying the source can help to address the problem.
Cold and hot weather can result in dry skin as both can see a drop in humidity. When the air is dry, the skin cannot extract adequate moisture from the environment, and this can exacerbate existing dry skin symptoms or cause dry skin to develop.
Using air conditioning or heating systems also negatively impacts dry skin. These systems reduce the level of humidity in the air, similar to cold or dry weather.
The sun’s heat dries out the moisture from the outer layer of the skin, and the UV rays can cause damage below the skin’s outer layer. Dry skin from the sun is often characterized by wrinkles and loose skin.
Allergies do not directly cause dry skin. However, allergies can irritate the skin, leading to mild or excessive itching, and this itching can cause dry and flaky skin.
Genetic Causes of Dry Skin
The genetic causes of dry skin include certain dermatological conditions, gene anomalies and skin type. The symptoms produced by these causes can emerge anytime from childhood into late adulthood.
The Fitzpatrick classification of skin types identifies six different skin types, from lightest (type one) to darkest (type six). Light, medium and dark skin types are likely to develop dry skin for particular reasons.
For instance, dark skin is at risk of drying out due to low levels of both ceramide and water content and high levels of water loss through the skin; medium-toned skin due to irritants and moderate levels of water loss; light skin due to its ceramide levels,skin sensitivity and low water content.
The FLG gene
This gene produces filaggrin, a protein that protects the skin against allergens and other foreign substances. A significant percentage of people with recurring dry skin have an altered version of the FLG gene that produces fewer protective proteins, leaving the skin vulnerable to dryness.
- warm or burning sensation on the skin
- thickening and drying of facial skin
- visible blood vessels under or around the eyes
- eye sensitivity and irritation
There is no clear consensus on what causes rosacea, but it is linked to genetic rather than environmental causes, and it is most common in those with light-colored skin.
Eczema and atopic dermatitis (AD)
Eczema is a genetic condition, while atopic dermatitis can be caused by genetic and environmental interaction and have similar symptoms. Both result in rashes with symptoms that include redness, intense itching and thick or dry skin.
These rashes can occur anywhere on the body, but are most common between the joints, on the palms of hands and soles of feet.
Psoriasis is a genetic skin condition caused by an overactive immune system, with symptoms that include:
- scaly skin
- itchy, sore skin
- thick, dry skin that develops in patches
Patches of dry skin will appear most commonly in areas between joints, lower back, on the palms of hands and soles of feet.
Preventing and Treating Dry Skin
Excessive dry skin can be uncomfortable, but there are many measures that can be taken to prevent or treat it. In most cases, this can be accomplished with some simple solutions.
Adjust to your environment
If you live in a dry climate, or are affected by dry skin in winter, keeping skin covered can help prevent dryness, and using a humidifier can help restore moisture to the air.
Although it can be difficult to alter certain habits, some lifestyle changes have been proven to reduce dry skin, such as quitting smoking or drinking alcohol, getting adequate sleep and limiting bathing or showering time.
Drinking enough water and using hyaluronic acid supplements have been proven effective in reducing dry skin.
Moisturizers are helpful in both preventing and treating dry skin and other related symptoms, such as inflammation, itching and burning. Certain moisturizers can also help heal wounds or even function as antibiotics.
There are many types of moisturizers available such as gels, creams, lotions, ointments and oils that are formulated with different ingredients to address specific skin concerns.
Emollients soften the skin by using fatty acids and cholesterol to help maintain and strengthen the skin’s moisture barrier. Emollients are a good choice for everyday moisturizing.
Occlusives are very effective in preventing moisture loss, but the base ingredients of these moisturizers, typically petroleum jelly or lanolin, have an oily consistency that some people may find uncomfortable. These ingredients have also been known to cause allergic reactions.
Humectants are often used specifically on the face because they do not contain the oils that create an uncomfortable greasy consistency. Rather than creating an oily barrier to keep moisture in, humectants are made up of substances such as sorbitol and glycerol to draw water into the skin.
Some humectants have been found to irritate those with sensitive skin, but they are generally considered mild moisturizers.
A relatively new product, ceramide cream works in the same way as the skin’s natural moisturizing lipid ceramide. It has been proven not only to reduce dry skin but also to improve the skin’s barrier function.
Skin has its own system for regulating moisture, but environmental, lifestyle and genetic factors can interfere with the skin’s natural moisture level and cause dry skin. Symptoms of dry skin can range from mild irritation to painful cracking or peeling.
Dry skin can occur at any time. It may be acute or chronic in nature, but dry skin can be successfully treated by adapting to your environment and identifying the cause of your dry skin to respond effectively.
This may involve adopting healthy habits: sleeping adequately, drinking plenty of water, using a good moisturizer and avoiding harmful habits such as excessive smoking and alcohol consumption.
If, however, you find your dry skin still persists after incorporating these improvements, contact your dermatologist to discuss appropriate solutions.
- Ananthapadmanabhan, K. P., Moore, D. J., Subramanyan, K., Misra, M., & Meyer, F. (2004). Cleansing without compromise: The impact of cleansers on the skin barrier and the technology of mild cleansing. Dermatologic Therapy, 17 Suppl 1, 16–25. ncbi.nlm.nih.gov/pubmed/14728695
- Andriessen, Anneke. (2013) Prevention, recognition and treatment of dry skin conditions. British Journal of Nursing 2013 22:1, 26-30. https://doi.org/10.12968/bjon.2013.22.1.26
- Augustin, M., Kirsten, N., Körber, A., Wilsmann-Theis, D., Itschert, G., Staubach-Renz, P., … Zander, N. (2019). Prevalence, predictors and comorbidity of dry skin in the general population. Journal of the European Academy of Dermatology and Venereology: JEADV, 33(1), 147–150. https://doi.org/10.1111/jdv.15157
- CDC – Skin Exposures and Effects NIOSH Workplace Safety and Health Topic. (2018, October 2). Retrieved July 12, 2019, from https://www.cdc.gov/niosh/topics/skin/default.html
- NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2016) Rosacea. niams.nih.gov/health-topics/rosacea#tab-symptoms
- NIH: U.S. National Library of Medicine. (2019) Atopic dermatitis. ghr.nlm.nih.gov/condition/atopic-dermatitis?fbclid=IwAR0BPEP4ENiI6WtQnDds65fwtfFqlZG3R9hyGVbdom03sZ8YWyW6Q5-PS4g#definition
- National Clinical Guideline Centre (UK). Psoriasis: Assessment and Management of Psoriasis. London: Royal College of Physicians (UK); 2012 Oct. (NICE Clinical Guidelines, No. 153.) 1, Introduction. Available from: https://www.ncbi.nlm.nih.gov/books/NBK327727/
- NCFH: Occupational Health & Safety Factsheet. AGRICULTURAL WORKER OCCUPATIONAL HEALTH & SAFETY. ncfh.org/uploads/3/8/6/8/38685499/fs-occ_health.pdf
- Purnamawati, S., Indrastuti, N., Danarti, R., & Saefudin, T. (2017). The Role of Moisturizers in Addressing Various Kinds of Dermatitis: A Review. Clinical Medicine & Research, 15(3–4), 75–87. https://doi.org/10.3121/cmr.2017.1363
- Reference, G. H. (n.d.-a). Atopic dermatitis. Retrieved July 12, 2019, from Genetics Home Reference website: https://ghr.nlm.nih.gov/condition/atopic-dermatitis
- Reference, G. H. (n.d.-b). FLG gene. Retrieved July 12, 2019, from Genetics Home Reference website: https://ghr.nlm.nih.gov/gene/FLG
- Spada, F., Barnes, T. M., & Greive, K. A. (2018). Skin hydration is significantly increased by a cream formulated to mimic the skin’s own natural moisturizing systems. Clinical, Cosmetic and Investigational Dermatology, 11, 491–497. https://doi.org/10.2147/CCID.S177697
- Strom, M. A., & Silverberg, J. I. (2016). Utilization of Preventive Health Care in Adults and Children With Eczema. American Journal of Preventive Medicine, 50(2), e33–e44. https://doi.org/10.1016/j.amepre.2015.07.029
- Vyumvuhore, R. , Tfayli, A. , Biniek, K. , Duplan, H. , Delalleau, A. , Manfait, M. , Dauskardt, R. and Baillet‐Guffroy, A. (2015), The relationship between water loss, mechanical stress, and molecular structure of human stratum corneum ex vivo. J. Biophoton, 8: 217-225. doi:10.1002/jbio.201300169
- Wan, D. C., Wong, V. W., Longaker, M. T., Yang, G. P., & Wei, F.-C. (2014). Moisturizing Different Racial Skin Types. The Journal of Clinical and Aesthetic Dermatology, 7(6), 25–32. ncbi.nlm.nih.gov/pmc/articles/PMC4086530/#__sec1title
- Oyetakin-White P, Suggs A, Koo B, Matsui MS, Yarosh D, Cooper KD, Baron ED. Does poor sleep quality affect skin ageing? Clin Exp Dermatol. 2015 Jan;40(1):17-22. doi:10.1111/ced.12455