We all suffer from at least a few patches of dry skin from time to time, but not all of us know how to tackle it, or what might be best for our skin in different circumstances. Alex Gazzola looks at what dry skin really means, and what can be done about it – especially if you have sensitivities and allergies to worry about too.
Xerosis is not a word with which many of us are familiar. It’s derived from the Greek ‘xero’ – meaning ‘dry’ – and ‘osis’ – meaning ‘disease’, and it’s the medical name for an incredibly common condition with which many of us most certainly are familiar – dry skin.
As our largest organ, and our first-line defence against the elements and the world at large, our skin is vital to us and our wellbeing. Keeping it in optimum condition is not only a superficial or cosmetic concern – the skin is key to protecting us from the sun’s rays, regulating our temperature, producing vitamin D, and guarding against bacteria and germs.
Symptoms of dry skin include flaky, scaly or rough skin, which may appear greyish in those with darker skin. There may be itching, chapping and cracking. Milder dry skin can simply feel drier and ‘tighter’.
Although dry skin is not commonly serious, it can be an early warning sign of inflamed skin – or dermatitis – which, if it gets worse, can get infected, and becomes more serious.
Although we hope some of the information in this article will help, if you are worried about your dry skin – perhaps it has been steadily worsening – or if you’ve had it for a long time and nothing you’ve tried seems to be working, it is worth speaking to your GP. Dry skin is not always too trivial to be referred to a dermatologist, and a doctor is best placed to decide what course of action might be recommended.
What are the causes of dry skin?
Lack and/or loss of water or oil from the layers of the skin are the underlying factors in xerosis, and these may be caused by a number of different reasons.
It is only natural for our skin to become drier as we get older, thanks to metabolic changes, natural thinning of the skin, reduced fluid intake in the elderly, the menopause in women, and reduced activity of oil glands in the skin.
* Climate – both internal and external
Colder climates can exacerbate dry skin, and many find their problems worsen in winter, when alternating exposure to low humidity and temperature and internal central heating is difficult on the skin, drying it out. Hot summers and dry hot climates can also dry skin – again when alternating with regular exposure to air-conditioned offices, for example, which are also drying.
* Washing and bathing
Any detergent – such as soap – removes natural oils from the skin, but some are harsher than others. Long hot baths and showers are drying, especially if you take them frequently. Swimming in chlorinated pools can exacerbate dry skin.
* Disease and medication
Some autoimmune diseases – such as psoriasis, thyroid disease, Sjogren’s syndrome and others – can contribute to dry skin. Those with eczema are of course particularly prone. Many with diabetes have dry skin problems. Some drugs and medicines, such as diuretics, anti-histamines, anti-spasmodics and chemotherapy drugs, can worsen problems.
How can you prevent and treat it?
Moisturising your skin with the right emollients is essential, and we’ll look at that in the next section, but here are some general lifestyle tips which may help.
* Bathing and showering
Avoid hot water and aim for slightly cooler showers. If you can’t live without your regular hot baths, try to minimise the time you soak in them, which will help reduce the loss of oils from the skin – ten minutes maximum, if you can. Don’t use any exfoliating mitt or cosmetic scrub on areas of dry skin; don’t scrub yourself dry with a rough towel – instead, pat with soft towels.
* Shave well
Shaving can be very harsh on the skin, so really make time to do it properly and well. Soften the hair with hot damp cloths or shave after or during bathing or showering. Use a shaving oil, plus shaving cream or gel on top, and only sharp blades that haven’t been overused. Shave in the direction of hair growth, and don’t rush the process. Moisturise afterwards.
Don’t wear ‘itchy’ clothing – and stick to cottons and silks for both clothing and bedding if you can, as these are less likely to aggravate than woollens and synthetics. Cover up well in winter – gloves, hats and scarves protect the skin against the harsh elements – and likewise brimmed hats in summer to protect your skin from the sun.
Changing laundry washing products can help those with both dry and sensitive skin. Try fragrance free and natural options – brands such as Ecover’s Zero range, and Surcare’s non-biological liquids may be worth a trial – and set your washing machine for an extra rinse.
Alcohol is dehydrating, so if you do drink, ensure to drink water in between alcoholic drinks when socialising. Similarly, in hot weather, and during exercise, remember to replace lost fluids. Although two litres daily is the often recommended amount of water we should be drinking, the piece of research which this figure stems from actually found that the two litre figure is total fluid intake – including water naturally present in food you consume, and in all types of drink. The supposed dehydrating effects of coffee and tea are often exaggerated by natural practitioners, although intake of both should not be excessive for other health reasons. Herbal teas, soft drinks, juices all count towards your intake – as well as plain water.
* Oil up your diet …
We should not fear fats and oils – but it’s important to choose the right kind. The oils in fish, nuts, olives, avocados and seeds such as flax and hemp are the ones to go for and include in your diet. These are rich in essential fatty acids which offer abundant health benefits – and which will also reflect in your skin.
* Try a humidifier…
This can help in the home during dry weather or when the central heating is on in winter.
Which skincare products should I use?
This is not a straightforward question to answer, and it is almost unavoidable that some experimentation will be required for you to discover and settle on products which are suitable for you.
Ingredients to avoid
Firstly, it’s important to avoid any ingredients to which you are sensitive. Botanicals are widely used, mostly in organic, free-from or natural skincare, but also in conventional or high-street skincare products. These can include food allergens. Ingredients have to be declared by law, but due to cosmetic labelling regulations, may only appear in Latin. This is particularly troublesome for those with multiple nut allergies, as nut oils (typically almond and macadamia, for instance) are widely used. See the sidebar for Latin terms for food allergens, which you will need to check for.
Allergies to other cosmetic ingredients – typically to preservatives and to fragrance compounds – are also potentially problematic. There is no way to diagnose these other than through patch testing. If you have reacted to cosmetics previously, it is important you do not self-diagnose, which is notoriously unreliable, and instead see a GP who can refer you to a dermatologist for testing. Precise identification of ingredients to which you are allergic is key.
There are other ingredients you might look to avoid if you have dry skin:
Usually denoted as ‘ethanol’ or ‘alcohol denat’ in cosmetics, try to avoid cosmetics with alcohol. Cleansers sometimes contain it, for instance. Definitely avoid when alcohol is high in the list of ingredients, as this implies significant alcohol content. Ingredients such as isopropyl alcohol, benzyl alcohol, cetearyl alcohol and other such variations, which you may see in lots of cosmetics, do not denote true alcohol.
Alkaline soap works against the skin, which is acidic. Soap strips the skin of its oils. If you must use soap, look for very natural unscented varieties, or else soaps marketed as moisturising, which should have moisturising agent added.
This is sodium lauryl sulphate, a widely used and cheap detergent and foaming agent, which is found in shower gels and shampoos. It is very cleansing and foaming, but can strip too many oils and water from the skin.
Once you have identified ingredients you should avoid, careful label reading is vital. Don’t rush the process, and check with manufacturers when purchasing online, as not all declare full ingredients on their website.
Ingredients to try
When it comes to moisturising agents, there are two types of ingredients which are key to look out for.
The first are humectants. These are ingredients which attract and hold water, boosting moisturisation.
These include hyaluronic acid / sodium hyaluronate, lanolin (derived from sheep’s wool), glycerin, squalane (derived from olive oil), sorbitol, aloe vera, AHAs (alpha hydroxy acids), salicylic acid and honey.
The second are emollient oils. These trap water underneath under a layer when you apply them to skin, and can soothe dry skin, as well as provide antioxidants which may help delay the appearance of wrinkles.
Some oils that may suit you include shea butter, coconut oil, almond oil, jojoba oil, rosehip oil, avocado oil, pomegranate seed oil, hemp seed oil, chamomile oil and calendula oil.
Another good ingredient is oats, incidentally. These have been used for many years as a traditional skin treatment and remedy. More recently, scientists have validated this in their discovery of compounds called avenanthramides, naturally occurring in oats, which are anti-inflammatory, anti-itch and soothing.
Oils or oil blends, and oil-rich ointments, balms or butters, may be best for extremely dry skin. Pure liquid oils have the added benefits of ‘plumping’ up skin. You may only need a few drops for the face.
Creams and their ‘wetter’ counterparts, lotions, have less oil content, but more humectant and water content.
The more oil-rich the moisturiser, usually the less you need.
Try moisturiser within your budget, and which feels good on your skin. Adverse reactions excepted, give
Remember that less can be more: don’t overdo moisturisers. Follow instructions on labels for ideal quantities. When applying, don’t ‘drag’ over the skin. Warm or melt moisturisers between hands before applying to skin, and do so gently and evenly.
To remove make-up, oil-based cleansers and cream-based cleansers are the ones to go for. There are also natural cleansing balms which can be highly effective.
Foaming or soapy cleansers are likely to be too drying – for both the face and body. Any cleanser which leaves your skin ‘squeaky clean’ is likely to be too drying – you may be using too strong a cleanser, or perhaps too much of it. Lots of liquid make-up removers contain alcohol, which should be avoided, as should wet cleansing wipes. High-street soaps and shower gels are very likely to be too drying on already dry skin, as they are likely to contain sodium lauryl sulphate, or similar ingredients.
For your cleansing agents, soap salts may suit some people, although others will find them drying. They include sodium cocoate, potassium olivate and sodium sunflowerate – which are produced from the action of sodium hydroxide (or lye) or potassium hydroxide on the oils of coconut oil, olive oil and sunflower oil, respectively. Natural and free from skincare brands may use these in liquid soaps or shower gels, but look for humectant ingredients (such as glycerine) in such products, to replenish moisture and counteract the drying effect of the soap ingredients.
Gentler non-soap cleansing agents include decyl glucoside / coco glucoside, ocamidopropyl betaine, caprylic/capric triglyceride, sodium cocoyl isethionate and sodium lauryl sulphoacetate, and many others.
These are not as strong, therefore offer less cleansing potency, which may be ideal if you like to wash and bathe regularly – but they are usually gentler for most people.
All Natural Soap (www.allnaturalsoap.co.uk)
For those who love their soaps, ANS offer a Castile Olive Oil soap (£3.75) which won the FreeFrom Skincare Awards’ Achievement Award in 2015. It contains only saponified olive oils, water and vegetable glycerin – the latter a natural by-product of the soap manufacturing process which is of course highly hydrating. Free of all food allergens, preservatives and fragrances.
Green People (www.greenpeople.co.uk)
Well known and much loved brand of organic and natural skincare, whose range is newly wheat / gluten free, as well as dairy and peanut free. Have a range of scent-free products (grey-colour logo) including the excellent Hydrating Calming Serum (£17.50, 50ml) which has glycerin, seaweed, aloe vera, olive oil and plant gums – and is free of all food allergens and fragrance allergens.
JASON (www.jason skincare.co.uk)
It’s not easy to find an affordable, moisturising, gentle, fragrance free and food allergen free shower gel, but JASON have a very good Fragrance Free Body Wash (£9.99, 473ml) using gentle detergents, and including glycerin and aloe vera, which could fit the bill.
Myroo Skincare (www.myroo.co.uk)
Small ‘free from’ brand which is notable for being free from all 14 food allergens, and offering a fragrance free version of each of its products, which are additionally free from the 26 declarable fragrance allergens. Its Fragrance Free Superfood Balm (£25, 40g) boasts sunflower and coconut oils, and mango seed and avocado butters.
Pai Skincare (www.paiskincare.com)
An organic and alcohol-free brand entirely devoted to sensitive and dry skin, which never uses detergent ingredients, including the gentler varieties. Their Camellia & Rose Gentle Hydrating Cleanser (£28, 100ml) contains oils of castor, camellia, sweet almond and some coconut derivatives to gently cleanse without drying and stripping oils from the face.
Saaf Skincare (www.saafskincare.com)
Alcohol free and grain free range of natural skincare, characterised by seed oils (sesame, safflower, pomegranate), shea butters, beeswax and essential oils. Their use of a lot of essential oils does mean there are lots of fragrance allergens, should you be sensitive to them, but water-free formulations mean they’re a suitable choice for those with allergies to preservatives. Their Super Hydrating Body Balm (£24.99, 150g) might be a good one to try.
Food Allergens in Latin
Almond – prunus [amygdalus] dulcis/amara/sativa Barley – hordeum/hordeum vulgare Brazil nut – bertholletia excelsa Cashew – anacardium occidentale Celery/celeriac – apium graveolens Egg – ovum Fish/fish oil – pisces/piscum iecur Hazelnut – corylus rostrata/avellana Lupin – lupinus albus/luteus Macadamia nut – macadamia ternifolia Milk – lac Oat – avena sativa Peanut – arachis/arachis hypogea Pistachio – pistacia vera
What is YOUR favourite safe moisturiser or skin care product? Do write in and share your skin care secrets.
This article first appeared in Allergy Newsletter No. 117, Summer 2016.