Dry skin, or dermatitis, is a generic term used to encompass multiple conditions. Sometimes it’s difficult even for doctors to know exactly what is the cause of dry skin is as there are a variety of dry skin conditions. At Janiga MDs Dermatology in Reno, we are skilled at determining the cause of dry skin and treating it appropriately. Today were going to go through some of the common causes of dry skin that we often see with our Reno dermatology patients.
Typical Dry Skin
Let’s start with the most common cause of dry skin, the weather. In climates with low humidity readings such as Reno, Nevada, it is common for people to have dry skin from lack of moisture. The dry air in Reno sucks the moisture from our skin to maintain equilibrium.
This will manifest usually as dry flaky skin on the entire body that may look like the bottom of a dried-out riverbed. The skin is driest usually on areas of friction and areas that are difficult to get lotion onto, such as the front of the legs and back. This form of dry skin is mostly environmental, and is treated with thick moisturizers to increase the moisture in the skin and create a barrier from evaporation. My favorite moisturizers are Cetaphil cream, Cereve cream, and Eucerin cream. Make sure you are applying these creams right when you get out of the shower when the skin is still moist. Apply a thick layer all over the body. Also make sure that you are using the cream and not the lotion, cream is thicker and comes in a tub not a pump.
Red, Itchy Patches
Another common form of dry skin is what I call “dry skin gone wild.” This condition is when dry skin goes untreated for long periods of time, and begins to change into itchy, red areas that resemble eczema. People with this condition usually have dry skin on the entire body, and then localized areas of red, itchy skin where small areas have become inflamed. At this point more aggressive treatment is needed. This form of dry skin will usually require a prescription to treat the inflammation from your primary care doctor or dermatologist. Once the inflammation has calmed down, the treatment is the same as regular dry skin- using heavy moisturizing creams.
Keratosis pilaris is a form of dry skin that manifests itself as small little bumps on the back of the arms, top of the thighs and sometimes the buttocks. This type of dry skin is typically genetic, and while it usually does not itch, the red bumps can look unsightly. In most cases we see, small bumps that are less than 1 mm in diameter stud the back of the arms where the skin cells are sticky around the individual hair follicles.
Keratosis pilaris can be treated with over-the-counter creams such as lactic acid 12%, AmLactin, Lac-Hydrin, glycolic acid creams, and even acne preparations that contain salicylic acid. The acid in these formulations is mostly a fruit-based, and helps exfoliate those sticky skin cells so the skin appears smoother. If you stop using the cream, the bumps will return to their normal state. This condition is not harmful overall, but can be a nuisance.
Atopic dermatitis, or true eczema, is a condition that most people are born with. Research has shown that these people have abnormalities in their skin that does not allow them to hold on to moisture as well. More research is being done in this area all the time.
Children as young as six months old can have atopic dermatitis, and while most people will outgrow it, there is a small percentage of people who will have this condition even into adulthood. Atopic dermatitis is treatable, but not as easily as dry skin, or “dry skin gone wild.” Eczema is related to seasonal allergies, other allergies, allergic sinusitis, keratosis pilaris and may run in families. Patients with atopic dermatitis are usually treated by a team of doctors including an allergist, dermatologist and pediatrician.
Another form of dry skin can be a true allergy. If you have ever been exposed to poison ivy or poison oak, you know exactly what I’m talking about. Most people are allergic to poison ivy and poison oak, however there are some people that have contact allergies to regular environmental things as well. The allergen that most people are familiar with is nickel, this is a metal found in a lot of jewelry. Exposure to this metal gives some people a rash. If they have had a significant amount of exposure overlong periods of time, this itchy, red rash can disseminate to the entire body.
The last type of dry skin that I’m going to talk about is what I call irritant dermatitis. The term â€śirritant dermatitisâ€ť is exactly what it sounds like; a rash from an irritation. Rather than being allergic to something specific, your skin can be irritated by chemicals, friction, solvents such as cleaning solutions, paint thinners and even some soaps, as they remove the fat and barrier protection of the skin.
Irritant dermatitis can cause fissures and cracks in the skin. This is the most common form of dermatitis that I see on the hands, and is very common in nurses, healthcare workers, painters, carpenters and any person with a job where they work with their hands a lot. Irritant dermatitis can also come in the form of a frictional variant. This is common on the thighs and armpit area of men and women from the clothing rubbing against the skin. Irritant dermatitis is treated by identifying the irritant, trying to avoid contact with it, rehydrating the skin barrier and protecting yourself from the irritant in the future. At times a prescription may be needed if it is very severe.
Less common forms of dry skin include conditions such as psoriasis, perioral dermatitis, lichen planus, granuloma annulare, and many others. Each one is a topic in and of itself and has specific treatment protocols.
As you can see, the evaluation of dry skin is sometimes difficult and varied. Visit our Reno dermatologist office for evaluation of your dry skin to see what category you fall into. But, before you make your appointment, make sure you’re putting on a nice thick moisturizer to the entire body from the neck down after each shower to give us a good baseline of hydrated skin to evaluate.
~ Dr. Jennifer Janiga