Dry Skin

Dry Skin and Keratosis Pilaris

Dry skin and keratosis pilaris are common. Dry skin can occur at any age and for many reasons. Keratosis pilaris is an inherited skin condition that develops in up to 40% of the population. Sometimes a dermatologist’s help is necessary to get relief from dry skin and keratosis pilaris.

Skin becomes dry when it loses too much water or oil. This is why skin generally becomes drier as we age, during the winter, and in low-humidity climates such as Arizona. Restoring lost moisture can make the skin softer, smoother, and less likely to crack. Below are some tips that can diminish dry skin.


• SHAVING It is best to shave after bathing when hairs are soft. To minimize the irritating effects of shaving (face or legs) on dry skin, make sure you use a shaving cream or gel. Allow the product to remain on the skin approximately 3 minutes before starting, and shave in the direction that the hair grows. Changing blades often, most certainly after 5 to 7 shaves, also will help minimize the irritating effects of shaving.

• AVOID HOT WATER Hot water removes your natural skin oils more quickly; warm water is best for bathing.

• USE A MILD SOAP Deodorant bars, strong fragrances in soaps, and products containing alcohol can strip natural oils from the skin. This dries the skin. Look for a mild, fragrance-free soap or cleanser that moisturizes.

• MOISTURIZE IMMEDIATELY AFTER BATHS AND SHOWERS A 5- to 10-minute bath or shower adds moisture to the skin. Spending more time in the water often leaves your skin less hydrated than before you started. To retain moisture from a bath or shower, apply an ointment or cream while the skin is still moist, within 3 minutes of bathing.

For severely dry skin, a moisturizer that contains urea or lactic acid may be helpful. Both ingredients help the skin hold water. These ingredients are so effective that over-the-counter and prescription moisturizers contain them. The one drawback is that these ingredients can be irritating if you have eczema or cracked skin. Keeping your skin well moisturized should improve dry skin. If the dryness worsens despite following the above self-care measures, contact your dermatologist.

In some people, areas of seriously dry skin can lead to a condition called eczema or dermatitis. Dermatitis means inflammation of the skin. When dermatitis is present, your dermatologist may prescribe medication such as a corticosteroid (cortisone-like) or an immunomodulator (tacrolimus, pimecrolimus). Applied to the affected skin for a prescribed time, these medications tend to be very effective. Regularly using a moisturizing lotion or cream can help avoid eczema flares.

The tiny, flesh-colored to slightly red bumps of keratosis pilaris that give the skin a sand paper like texture, are most common on the upper arms and thighs. In children, they also are common on the cheeks and can be mistaken for acne. Each tiny bump is a plug of dead skin cells.

Most common in children and adolescents, keratosis pilaris occasionally itches, especially during the winter and in low-humidity climates. When humidity increases, usually during the summer, the skin is less itchy and the reddish color becomes somewhat camouflaged.

While keratosis pilaris is harmless, people often seek treatment to alleviate the itch or diminish the appearance of these tiny bumps. Moisturizers may help with the dryness and associated itch. Creams that contain urea or lactic acid are often effective moisturizers, but moisturizers do not generally clear the bumps. A mild chemical peel can effectively remove the excess skin. Topical retinoids also may be used. Your dermatologist can provide both of these treatments. While keratosis pilaris can be effectively treated, results are often temporary. Therapy must be repeated regularly or the keratosis pilaris returns. Some patients respond to treatment better than others. For many, keratosis pilaris resolves by adulthood.