Top 5 tips to manage dry skin

There really isn’t an obvious answer to this question, which makes deciding on which moisturizer to purchase extremely difficult. Unfortunately, the research in moisturizers to help relieve dry skin is extremely poor.

Dry skin (or xerosis) is not uncommon as it has been estimated that over 50 per cent of seniors aged 65 or older experience it. A primary reason why xerosis is more prevalent in the elderly is due to a decrease in natural moisturizing factors and lipids resulting in a loss of hydration. Common risk factors for xerosis include: friction, UV light from sun, low humidity and the use of soaps.

Topical moisturizers are an effective treatment in managing itch (or pruritus) from dry skin. Unfortunately, itch is often multifactorial with common causes such as: chronic kidney disease, liver dysfunction, psoriasis, stroke, incontinence and medications.

Medications such as statins, calcium channel blockers and diuretics may exacerbate dry skin and itch. It is important to not stop any medications without first consulting your local pharmacist or physician. All elderly patients should have their drug regimen reviewed by a pharmacist to identify potential adverse effects.

There are four main classes of moisturizers: occlusives, humectants, emollients and rejuvenators.

• Occlusives have a greasy feel and are not aesthetically pleasing, making compliance a concern. Occlusives form a barrier over the skin to prevent water loss, and are typically recommended for dry and damaged skin as they promote moisture retention and allow barrier repair. Common occlusives include lanolin and petrolatum.

• Humectants are another big class of moisturizers known for their ability to hydrate the skin through enhancing water transfer upward from deeper skin tissue and inwards from external environment. Popular examples of humectants are glycerin, urea, honey and hyaluronic acid, with urea being the most popular.

• Emollients improve skin texture by filling gaps and fissures, leading to increased softness and smoothness of the skin. Examples of emollients include petrolatum, dimethicone and propylene glycol.

• Rejuvenators such as keratin and collagen are reported to replenish essential skin proteins.

Currently, there is no ingredient or formulation in literature that is deemed the best. The ideal moisturizer should at minimum include an occlusive and humectant to achieve hydration.

For example, an emollient-dominant moisturizer would not be designed to repair damaged skin, but more for providing fragrance and temporarily moisturizing the skin.

The best moisturizers are those with a healthy composition of multi-functional ingredients from all the classes to repair, protect and hydrate the skin. Popular brands of multi-functional moisturizers include: CeraVe, Eucerin, Cetaphil, Curel and Thentix, which uniquely uses honey as a natural humectant.

Top five tips to manage dry skin:

1) At least twice daily application of moisturizer especially after showers or baths.

2) Avoid taking long and frequent showers or baths.

3) Use lukewarm water to shower or bathe.

4) Avoid alkaline (high pH) soaps and use soaps that are slightly acidic such as Dove and Cetaphil, as soaps that are too alkaline can damage the skin barrier.

5) Avoid fragrances, preservatives and extracts in skin products.

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