The Toronto Dermatology Centre is one of the premiere places in Canada to manage your skin. Our staff of outstanding dermatologists and estheticians can offer both a comprehensive assessment and diagnosis of your skin, and also discuss all the treatment options including: moisturizer selection, discussion of clothing choices, humidifiers, and other behaviours that affect skin hydration, and physician-grade skin products exclusive to our clinic. In some cases prescription creams are required, particularly if eczema develops or the skin becomes itchy; in other cases, our clinic provides OHIP-covered phototherapy to treat the skin.
Dry skin can occur at any age and for many reasons. In general, skin becomes increasingly dry as we age; it is drier in winter months than in summer months, and drier in low humidity environments. Certain skin diseases make skin more susceptible to drying and irritation ‑ eczema, psoriasis, etc. Harsh detergents and soaps further irritate the skin. In the winter there is a tendency to want to take nice long hot showers that further degrease the already dry skin, aggravating the situation. Using detergents and soaps with the hot water and its degreasing action adds insult to injury.
As the skin dries, it cracks and feels rough. Areas of redness develop. Scratching or rubbing the skin causes burning and itching sensations, leading to more itching and scratching.
Dry Skin Care Tips
- Bathing or showering should be brief. Prolonged showers or baths hydrate your skin, but the process of drying your skin after the shower or bath with towels or evaporation can leave your skin less hydrated than before you started. Therefore, bathing and showering should be kept between 5-10 minutes in warm water.
- Avoid hot water. Hot water removes your natural skin oils more quickly.
- Use a mild soap (mainly for armpits & groin). Soaps can be drying to the skin. Try to use a mild, super-fatted soap or preferably non-soap cleanser.
- Do not rub to dry your skin after bathing. Instead pat your skin dry with a towel.
- Moisturize immediately. Apply a cream (preferable to lotion) right after bathing while your skin is still moist. This will make bathing a moisturizing experience, rather than a drying experience for your skin. When you let your skin become completely dry after washing, some of the skin’s natural moisture is lost through evaporation. Apply cream throughout the day as needed.
Consequences of Dry Skin
In some people, areas of seriously dry skin can lead to inflammation of the skin called dermatitis. When dermatitis is present, your dermatologist may prescribe a corticosteroid cream or ointment (cortisone). The corticosteroid cream is applied to the affected areas to treat the problem. Discontinue when the dermatitis clears up. The use of a moisturizing lotion or cream should be continued to help avoid recurrences. Keeping your skin well moisturized should improve dry skin.
Moisturize, Moisturize, Moisturize
The object of treatment is rehydration of the skin. This is done with a good soak (three to five minutes) in plain water. The water should not be too hot, just comfortably warm. Little to no soap should be used. A cleanser is preferred such as Cetaphil or CeraVe cleanser; if a soap bar is preferred, CeraVe hydrating cleansing bar is best.
After the soak, while the skin is moist, a lubricant is needed. This is applied after patting the skin to remove the excess water but must go on while the skin is still moist. Excellent lubricants include Cliniderm cream, Lipikar Baume, Exomega cream, Eucerin Complete Repair and XeraCalm among others. Consider adding bath oil to your baths (e.g. A-Derma), but be careful not to slip.
Your hands and feet can be particularly difficult; feet because they are in warm, moist, occlusive footwear most of the day. When footwear is removed, the soggy skin rapidly dries out and cracks. Keep socks and slippers on in the house so the feet do not dry out too much. A special plain water soak for the feet may be necessary, followed by Cliniderm cream, Dermaflex cream, CeraVe SA cream, Cetaphil Therapeutic Barrier Cream or Neutrogena Foot Cream. These types of products should be left on overnight, with or without socks. Take your socks to the bathroom with you and wear them immediately after applying ointment to prevent slipping on your floor as well as tracking ointment through your house, and for enhanced penetration. Don’t walk around barefoot or with slippers where heels are exposed.
Hands that are in and out of water are damaged by repeated cycles of over-drying, leading to fingers skin cracking. To protect hands, use thin cotton gloves under vinyl gloves for all wet work. Around the fingernails and for deep cracked areas either plain petrolatum (petroleum jelly) or Lipikar hands or Dermaflex cream is best. Cleansing the hands with Cetaphil or Spectroderm or CeraVe cleanser rather than soap is often much safer. For a light hand moisturizer, try Neutrogena’s Norwegian Formula hand cream (unscented) or Cliniderm cream.
Many of the over‑the‑counter “moisturizer” products are light lotions. Avoid these. They may be adequate for lubrication in the southern parts of North America but are not adequate for our harsh winter climate with prolonged low humidity. Indeed, they often make matters worse.