What Causes Dry Skin On Face & Body And How To Treat It

AUTHOR - DR. DAVID JACK

Dryness and flaking is a common skin problem - numerous underlying causes can cause the skin to become more dry and some people will be more predisposed to dry skin than others. Skin conditions such as eczema, rosacea and psoriasis, as well as certain fungal infestations can make the skin dry and flake, but most cases of dry skin are not caused by any specific condition. It is always important if you do have severe symptoms to consult a doctor or dermatologist to rule out any underlying issue.

In this blog I will cover how skincare can help with dry skin, and will cover which skincare ingredients to look for in products for treating dry skin.

Why Is My Skin Flaking?

The major function of the epidermis of the skin (the most superficial, constantly renewing layer) is as a protective barrier to the outside world. It protects against external factors that could damage deeper structures of the skin, such as UV light and pollution. It also provides the first defence layer of the body’s immune system against microbes and functions to prevent trans-epidermal water loss (TEWL) to maintain hydration levels in the deeper layers of the skin.

This epidermal barrier relies on a number of factors to maintain its integrity, namely:

• Sufficient production of new skin cells (known as keratinocytes) that divide at the bottom layer (stratum basale), which die and fill with a waterproof protein known as keratin
• Sufficient production of the natural skin oils that contribute to the waterproofing of the epidermis
• Correct maintenance of the pH levels of the surface of the skin
• The delicate balance of ‘healthy’ skin microbes (known as the skin’s microbiome) which help to optimise this layer and prevent infection.

When any of these factors are disrupted, then the balance is put out and dryness and flaking can ensue. The most common causes of disruption are related to environmental exposure (such as changes in air humidity, exposure to UV light etc) and changes in the internal environment of the body - particularly fluctuations in hormone levels. The latter tends to upset the production of oils in the skin by the sebaceous glands.

When the epidermal barrier is disrupted, this tends to expose deeper layers of the skin to damaging factors causing a vicious cycle of irritation and inflammation, causing further dryness and flaking.

Why Is My Skin So Dry Even When I Moisturise?

Even with regular moisturising, some people continue to experience skin dryness. It is thought this is largely due to reduced sebum production causing barrier disruption, or overexfoliation or sensitivity in relation to certain skincare products. In some cases reduced sebum production can be due to hormonal disruptions but in others it is more likely to be environment related.
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Dehydration in the deeper layers of the skin generally comes from general body dehydration, although impaired skin barrier function in the epidermis may in turn lead to increased loss of water through the epidermis from the dermis (‘trans-epidermal water loss or TEWL), causing dehydration. This can worsen the appearance of fine lines/wrinkles and make the skin feel less supple. Regardless of moisturisation, dehydrated skin will still feel dry.

How To Get Rid Of Dry Skin From My Face?

Whilst year round skincare staples (including antioxidants, SPF and a good cleanser is the mainstay of any skin maintenance, whatever the season, people who err on the dry side will benefit from extra moisturising steps in their daily routine, with humectants and emollient skincare products. Emollients work by trapping water in your skin, whilst humectants draw water into the skin by the chemical nature of the molecules. Emollients include ingredients such as shea butter and coconut butter, whilst hyaluronic acid and glycerin are examples of humectants. Often moisturisers will contain a combination of both.

The drier and cooler weather in winter vs summer often causes the skin to become dry and irritated, so maintaining a healthy skin barrier through use of hydrating and reparative ingredients is important during the cooler months. Sebum production tends also to be lower in the winter months, again decreasing this protective layer. I tend to see patients coming in with drier, more irritated skin, and even rosacea flares (thought to be partly due to compromise of the natural barrier). To counteract this I usually recommend using skincare products that contain azelaic acid, and also using a humidifier in the wintertime (particularly when central heating is being used) to improve air moisture levels.

How To Stop Dry Skin

For people with dry skin, moisturisation and barrier repair is key to reducing dryness and flaking. I would generally say to patients to avoid anything that is going to over-exfoliate the skin and cause irritation. The skin’s natural barrier is often disrupted when the skin is dry. The key is to help repair this. Ingredients such as salicylic acid, as well as high concentrations of certain AHAs such as glycolic acid - which may be drying for the skin - are best avoided. Retinoid use has to be carefully controlled, and whilst gentle retinoids can be suitable, stronger retinoids and prescription retinoids may over-dry the skin, enhancing irritation and inflammation.

Generally speaking I would recommend moisturising dry skin at least twice per day. Given the higher risk of sensitivity and irritation, and in turn inflammation, sunscreen use is exceptionally important to prevent further irritation from UVA and UVB exposure. When it comes to moisturisers I usually recommend using ingredients such as ceramides (the fatty acids that help maintain your skin’s barrier) to help prevent water loss, and also use plenty of humectants such as hyaluronic acid and glycerin (which will be present in many moisturisers). Vitamin E is a particularly nourishing and hydrating fat soluble vitamin (which also has important antioxidant effects), and low levels of the AHA lactic acid can also drive hydration into the skin. Another favourite ingredient of mine is azelaic acid, which is an anti-inflammatory dicarboxylic acid, present in many skincare products designed to treat rosacea. It is especially useful as it can help calm down any inflammation and redness when the skin’s barrier is compromised, and help the skin repair its natural barrier. Niacinamide (vitamin B3) is another important barrier repairing ingredient. In all of my daily trio I’ve used a blend of Azelaic acid, Niacinamide and Hyaluronic acid to help maintain the skin’s natural barrier, and help minimise any inflammation on a daily basis.

Which Moisturiser Is Best For Dry Skin? The key ingredients to look for:

Hyaluronic acid is a structural molecule found throughout the body, in the skin and almost every other tissue that acts as a natural ‘humectant’ meaning that it draws water to itself. It is made from long chains of amino acids and sugar molecules so is known as a glycosaminoglycan. Hyaluronic acid in skincare utilises this humectant effect to draw water to the skin and act as a moisturiser. Often humectants such as glycerin, which gives a short term hydrating ‘glow’ are taken as a ‘result’ and many cult products rely on this for their popularity rather than longer term benefit. By applying hyaluronic acid or glycerin topically, you can increase the moisture content of the upper layers of the skin by virtue of its humectant effect - i.e. it draws water molecules from deeper in the skin to the more superficial layers. It can be used in moisturisers, serums and even home peels - it is a very useful and generally non-irritating ingredient.

Ceramides: Minimising moisture loss from the skin using molecules such as ceramides is also important. These are essentially fatty acids (which occur naturally in the skin) that help maintain the skin barrier and assist the skin in retaining moisture. These fatty acids also act as a food source for the good bacteria of the skin’s microbiome, which is also important for the barrier function of the skin.

Vitamin E, or tocopherol, is a fat soluble vitamin that is important in many cellular processes throughout the body. It is found in many sources in nature and there are eight main subtypes. Alpha-tocopherol is the most abundant in human tissues. It has been used for over 50 years in skincare for its soothing and rejuvenating properties. As a potent antioxidant, vitamin E helps to both repair damage to the skin and protect the skin against future damage. There is increasing evidence for vitamin E having strong photoprotective properties (ie it helps protect against future skin damage by UV light from the sun). Being fat soluble, it can help repair the skin’s natural barrier and also has some collagen stimulating ability - hence its popularity as a key ingredient in anti-ageing skincare.

Panthenol The ultimate hydrating vitamin, panthenol (or pro-vitamin B5) has anti-inflammatory effects and is deeply hydrating in the skin - particularly in combination with hyaluronic acid, it can hydrate multiple levels of the skin. Both molecules also have antioxidant effects and panthenol in particular has been shown to reduce redness associated with UV exposure (i.e. sunburn). It can also reduce itch sensation for people with dry skin conditions e.g. eczema

Azelaic acid. Azelaic acid is an increasingly popular ingredient in skincare. Often found in anti-acne and anti-rosacea products, it has potent anti-inflammatory and antioxidant effects so can be useful when the skin is dry and irritated.