Dry Skin & Sensitive Skin

Causes of dry skin

Dry skin is due to disruption in the integrity of the barrier function of the outer skin (epidermal stratum corneum), whereby there is an overall reduction in the lipids in the stratum corneum, resulting in increased transepidermal water loss.

Dry Environment Causes

Low humidity, cold and windy climate
Excessive air conditioning
Excessive bathing and hand washing
Bathing with hot water
Excessive cleansing, scrubbing or towel-drying of the skin
Contact with soap, detergents and solvents and topical alcohol
Extended sun exposure

Medical Causes

Postmenopausal females
Medical skin conditions eg eczema or atopic dermatitis, ichthyosis vulgaris
Medical conditions eg, hypothyroidism
Topical creams containing retinoids, salicyclic acid, etc
Certain drugs such as oral retinoids

Treatment with Medical Skincare

The cornerstone of treatment of dry skin is to adopt a sound medical skincare regimen that has moisturisers/emollients which should be applied liberally and often enough (particularly shortly after bathing, and when itchy) to restore the skin barrier function, thus reducing transepidermal water loss and symptoms like itch. Topical steroids may be applied if there are signs of dermatitis.

In addition, you can modify your daily routine and lifestyle to reduce the symptoms of dry skin by avoiding the aggravating factors.

Avoid Aggravating Factors

Engage in a shorter shower rather than a prolonged soak in a bath.
Use lukewarm water instead of hot water during bathing.
Replace standard soap with shower foams that have emollients or bath oil.
Use gentle cleansers without any dyes, fragrances, or alcohol.
Avoid excessive water exposure; limit the amount of time spent in a hot tub or pool.
Pat the skin dry after a shower with a towel instead of rubbing the towel on your body.
Minimise contacts with detergents or solvents that aggravate dryness.
Use a humidifier to increase the moisture of the air in your home.
Avoided extended sun exposure.

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Sensitive Skin
What is sensitive skin?

Sensitive skin is a general layman term used to describe a condition where the skin has reduced tolerance to cosmetic and personal care products when applied, often on the face. Medically, it often refers to a form of irritant contact dermatitis, an inflammatory response of the skin to externally applied agent/factor(s) which is not due to allergy.

Examples of such external applied agents/factors include:

Skin irritants,usually a combination of several mild irritant agents/factors (eg acids, alkali, detergents, thinners and oils), of which wet work is one of the significant factors.

However, patient’s inherent factors also influence susceptibility eg age, sex, skin site and history of eczema. Eczema of any type is a well-recognised predisposing factor for the development of irritant contact dermatitis.

Clinical Features

Sensitive skin is usually present with:

symptoms eg burning, stinging, itching,
visible skin changes eg redness, dryness, scaling, peeling, bumps, hives.

Spectrum of Sensitive Skin

Contact dermatitis
Eczema (endogenous type)
Urticaria/hives (physical and contact type)
Dry skin
Rosacea
Photodermatoses (skin sensitivity to sunlight)

How is Sensitive Skin Treated?

Treatment is usually targeted at the underlying medical condition. For instance, topical steroids may be indicated for associated dermatitis. Another key defense in controlling it is avoidance of the triggering agent/factor(s), if possible.

Management may also include an appropriate range of medical skincare products (cleanser, moisturizer, sunscreen, etc) that are generally mild and suitable for sensitive skin.