Healthy skin

Healthy skin isn’t just the body’s gorgeous gift wrap, it’s our first line of defence. Here are four amazing things that our skin cells produce every day to keep us safe:

1. Antibacterial and antifungal agents like lauric acid and sapienic acid.
2. Melanin and proteins that protect us from cell-damaging ultraviolet (UV) radiation.
3. Natural moisturising factors (NMFs) like urea, pyrrolidone carboxylic acid, lactate (lactic acid) and hyaluronic acid that bond with moisture to keep skin soft and supple.
4. Three surface lipids – ceramides, free fatty acids and cholesterol – which work to hold our skin cells together, maintaining the skin’s barrier function to keep moisture in and harmful substances out.

How does skin become dry?

When the skin’s processes are disrupted (by environmental factors in the world around us, or internal factors like the body’s autoimmune responses), our skin stops being able to produce enough of the NMFs and lipids it needs to protect us. When we don’t have enough surface lipids, such as ceramides, moisture evaporates from the skin, and the vital moisture-binding substances, the NMFs, are easily lost. NMFs don’t just draw moisture from the environment, they bond with moisture in the networks deeper in the skin. So, without enough NMFs, the natural upward flow of moisture into the upper skin layers is disrupted. The result is increasingly dry skin that’s less able to protect itself and the rest of the body.

10 CAUSES OF DRY SKIN

Environmental factors

The six main environmental triggers that can lead to dry skin are:

1. The weather: Harsh weather conditions and seasonal changes in temperature and humidity can cause dry skin, depending on what your body is sensitive to.
2. The sun: Exposure to UV light can also lead to dry skin, since it increases the rate of skin ageing. Read more about age-induced dryness.
3. Improper skin care: Skincare products that contain harsh chemicals can strip away the skin’s protective oils, as can prolonged exposure to hot water, and over exfoliation. Read more about gentle cleansing and safe skincare routines.
4. Medication: Certain medical treatments such as dialysis, radiation therapy and chemotherapy are known to cause dry skin, as do many acne treatments and any medications that have a diuretic effect (including blood pressure medications). Always check with a doctor or pharmacist if you are concerned that a medication might contribute to dry skin.
5. Diet: A lack of nutrients, unsaturated fatty acids, and vitamins can contribute to dry skin. Vitamin C and E are also involved in maintaining healthy skin.
6. Not drinking enough water: Our skin draws and uses about half a litre of water a day from the deeper skin layers in a process called trans-epidermal water loss (TEWL). We also lose water every day in the form of perspiration.

Internal factors

The four main internal factors that cause dryness are:

1. Genetics: Moisture levels in the skin are partly determined by genetics. Under identical conditions, different people will display different skin types, so some people are just more susceptible to dry skin.
2. Skin conditions: Eczema (atopic dermatitis), diabetes, ichthyosis, and psoriasis all have a genetic component and involve dry skin symptoms. Read more about the causes, signs and treatment of diseases like psoriasis and eczema.
3. Hormones: Hormonal changes during puberty, pregnancy or menopause can lead to dry skin.
4. Age: As we age, our skin’s glands naturally become less productive. Fewer lipids are available, the skin loses its elasticity, density decreases, and the skin slowly loses its youthful look. Read more about age-induced dryness.

Psoriasis

Psoriasis is a common chronic inflammatory skin disease caused by an autoimmune response cycle with genetic roots. During flare-ups of psoriasis, the body replaces skin cells (keratinocytes) more rapidly than normal, and immature skin cells arrive at the surface of the skin within days instead of weeks, leading to build-up on the surface in rough, inflamed patches called plaques or psoriatic lesions.

Signs & symptoms

Skin with psoriasis will often form raised, inflamed areas like rashes or welts (these are red on paler skin and purplish on darker skin) covered by a build-up of tough, silvery or grey, scaly dry, dead skin cells (keratin) on the surface. These plaques can also lead to darkened patches of skin. Besides causing embarrassment and self-consciousness, the condition can become painful and interfere with sleep and concentration.

Causes

Along with commonly being caused by a genetic mutation, psoriasis can also be triggered by bacterial infections, injury, stress, alcohol and tobacco use, and some medications like antimalarials and lithium. These same triggers can also lead to flare-ups once a person has psoriasis.

The psoriasis cycle

• The immune system’s T-cells mistakenly (due to a glitch in the genetic makeup) attack healthy skin cells.

• This pushes the body’s skin cell manufacturing into overdrive.

• These immature skin cells are pushed to the skin surface too rapidly, forming raised, inflamed patches

• That unusual activity prompts the body to produce more T-cells.

Topical treatment

While there is no cure, treatments applied directly to the skin surface (topical treatments) are an essential part of managing psoriasis, along with medication. Topical treatments include skin softeners (emollients) and moisturisers, along with compounds that break down the outer layers of the skin (keratolytic agents), and corticosteroids. During the initial phase (in which the skin overproduces areas of excessive, rough growth), keratolytic agents are most beneficial, and can be used in conjunction with moisturisers and emollients.

Regular use of emollients and moisturisers are helpful during both the flare-up and remission phases of psoriasis. Here are four essential skin tools for managing psoriasis:

1. Emollients work by generating a film that reduces the amount of water-loss from the skin due to evaporation, locking in essential moisture. They make the outermost layer of the skin more supple and reduce superficial scales.
2. Moisturisers are emollients that are enriched with natural moisturising factors (NMFs), which attract and bind water. More advanced moisturisers also contain active components such as glyceryl glucoside, which activates the skin’s own moisture network to draw moisture from the deeper layers of the skin, to supply moisture to the upper skin layers.
3. Keratolytic agents reduce the psoriatic plaque scales by breaking the keratotic material that has built up in deposits of dead skin cells. Salicylic acid is the most effective of the known keratolytic compounds. Urea is another commonly used keratolytic agent. As an NMF, urea also helps to bind water in the skin.
4. Topical corticosteroids have anti-inflammatory properties, and reduce the rate of plaque formation and the irritation that comes with it. Moderate strength topical corticosteroids are often prescribed for psoriasis on the face, genitals, or areas that require stretching or flexing, in combination with emollients and moisturisers.

Eczema

Eczema (also called atopic dermatitis – ‘atopic’ means unusual in Greek, while ‘derma’ refers to skin, and ‘-itis' indicates inflammation) is a chronic skin condition linked to both the skin’s barrier cells and its immune cells. Eczema causes flare-ups of excessively dry, severely itchy and inflamed skin, with scabbing and oozing. The intensity of itching is one of the key differences between eczema and psoriasis, and eczema will show up more in the insides of the elbows and backs of the knees and at the hip. 

Signs & symptoms

Eczema flare-ups can lead to cracked, dry skin, itchiness and rashes on swollen skin, along with darkening of the skin around the eyes. The rash presents as reddened patches on pale skin and as darker brown, purple or ashy grey patches on darker skin. On darker skin the condition can also present as bumps on the arms, legs and torso (papular eczema), as well as raised skin like goosebumps around the hair follicles (follicular accentuation). When these flare-ups become irritated by scratching, it can lead to skin thickening and firm, raised skin bumps called prurigo nodules. Patients with darker skin may show darker coloured skin patches (hyperpigmentation) or lighter coloured patches (hypopigmentation), which will fade once the condition is under control. In severely irritated skin during intense flare ups, eczema can lead to a further trio of symptoms – skin thickening, hyperpigmentation or hypopigmentation, and exaggerated skin lines – called lichenification (like patches of lichen on a rock).

Causes

Eczema affects the protective top layer of skin, leaving it prone to infection and irritation. Certain genes are linked to the development of the condition, and people with a family history of eczema, as well as those whose families show allergic responses including asthma and hay fever, are at risk for developing eczema.

Eczema flare-ups can be triggered by chemical skin irritants like harsh soaps and detergents. Environmental triggers can include everything from cold or dry weather, to damp, dust mites, mould exposure, pollen, pet fur and dander, and food allergies and sensitivities. Hormones and stress can also trigger flare-ups.

Dry to very dry skin, including dry skin due to diabetes or psoriasis, benefits from regular and consistent skincare, using products specially formulated to both tackle the causes of the dryness and give instant and long-lasting relief for the symptoms.

Treating dry skin takes a specialised, gentle skincare routine that does three things:

1. Cleans the skin without harming the skin barrier.
2. Restores moisture, targeting areas of concern.
3. Protects the skin from further harm.

Skincare for dry skin needs the following six steps:

1. Gently cleanse your scalp, face and body with suitable products and lukewarm water. Find important cleansing tips here.
2. Lightly rub a product containing Urea into slightly damp skin.
3. Lock in moisture by applying moisturiser all over the body and gently rubbing it in. Read more about caring for dry body skin here.
4. Use products suitable to specific areas like your feet and hands. Learn how to care for your dry hands and feet here.
5. At the start of your day, apply sunscreen with an SPF of at least 15, and remember to reapply throughout the day.
6. Moisturise your lips. Find useful lip care tips here.

Make your six-step routine even more effective by keeping the following skin care tips in mind:

• When cleansing, rinse off your body wash thoroughly but do not rub at the skin.
• Pat dry with a clean towel until just damp.
• Be patient with your routine. This might be a good time for podcasts or audiobooks.
• Exfoliate once per week only, or as your dermatologist recommends.

NB! Babies and young children with eczema (atopic dermatitis) need specific daily skincare products. When choosing any skincare product, always check the age recommendation.

All about feet

Daily life keeps us on our toes, but our poor feet often come last in our body care routine. If the skin on your feet is so dry that you could start fires when you rub them together under the covers, it’s time for a little TLC. The good news is that you can treat it all, from rough, dry skin, to callouses and thickened heels. You’ll soon be ready to put your best foot forward in your prettiest stilettos and sandals.

Understand your foot skin

The skin on the soles of our feet has developed to be naturally thicker and harder than skin elsewhere on the body, as cells have to divide more quickly in response to intense pressure and friction. It is also susceptible to dryness as it has fewer oil glands. And the daily stressors – like restrictive footwear – that we place on it can dry it out even further, especially at the heel pads.

Hands Up

Your hands do it all. Your skin has to withstand everything from an enormous range of temperatures, to the harsh chemicals in hand sanitisers, dish detergents, paint and building materials, and repeated washing. They also need to withstand friction from things tugging at them including your over-eager dog on a leash.

Understanding your hand skin

On the back of our hands the skin is thin, fine and flexible, but quick to show dryness and ageing. Over our knuckles it needs to stay elastic, as we use our hands for everything, yet tough, as this is often a body part we scrape and knock against things. The thicker, more stable skin on our palms, inner fingers and fingertips needs to be tough enough to pull a rope and push a sewing needle, but sensitive enough at the tips to pick up details half the width of a piece of hair. Dryness is problematic for all of these functions.

Aside from your products and skincare routine, here are five more things that you can do every day to care for your dry skin (and why they’ll help):

1 Protect against sun-exposure: After cleansing and moisturising, our next concern is sun protection. A small dose of sunlight can have a positive influence on our mood, and limited sun exposure is essential for our bodies’ production of vitamin D, which is essential for bone remineralisation, muscle and nerve function, and supports the immune system. But over-exposure is deeply harmful to the skin, and especially damaging to dry skin. UV light increases the rate of skin ageing, and skin ageing can increase the risk of dryness. Here are some quick tips for having fun in the sun:

• Apply sun protection every morning after your normal moisturiser.
• Reapply your sun care regularly to maintain the level of protection and to avoid sunburn.
• Reduce sun-exposure by wearing protective clothing.
• Use sun protection products especially developed for dry skin’s needs, such as sunscreens that do not contain irritating perfumes and colourants, as dry skin is prone to irritation. The Eucerin Sun Protection range includes products suitable for everyone, from babies and children, to those with allergy-prone skins, sensitive skin, dry, ageing skin, and even those who need oil control products.

2 Avoid scratching: The instant relief is not worth the agony! Scratching further damages the stressed skin surface and can even lead to bleeding, vulnerability, infection and scarring. Instead of scratching, try holding cold packs wrapped in cloth against the skin to numb the area, try acupressure points, or apply a thick moisturiser that contains ceramides. Speak to your doctor for more tips, including how to avoid scratching in your sleep.

3 Avoid fragrances: Along with ditching fragranced bath and body care products, replace your laundry detergents, dish soaps and household cleaning products with products suited to sensitive skin. And wear gloves while tackling household tasks involving any harsh chemicals.

4 Use a humidifier: This is especially helpful in drier climates, especially during winter. Set up the humidifier in places you spend the most time in, including your bedroom and office.

5 Choose natural fabrics: Wear clothes made of natural materials, like cotton and silk, that do not irritate the skin. Even though wool is natural, it can irritate the skin and should be avoided.