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Xerosis

Overview

Xerosis is the medical term for the condition commonly known as dry skin. In most cases, it affects the outermost layer of your body, that is, skin, but may involve other outer membranes, such as the conjunctiva of your eyes. It often occurs during cold and dry weather. The low temperature and humidity in the atmosphere lead to excessive dryness and cracking of your skin. It can be associated with other medical factors as well. Xerosis occurs as an expected outcome of aging as well. As the skin cells grow older and lose their capability to retain moisture or produce oils, dry and cracked skin occurs along with fine lines and wrinkles. If necessary, aging-related xerosis can only be managed with long-term care and supportive treatment.

Causes

The most common cause of xerosis is cold weather. Extremely cold temperature prevents the blood circulation from adequately nourishing the skin and conserving body heat. This, along with less humidity in the external atmosphere, leads to dry skin. Taking body showers with hot water frequently or for an extended period can also cause xerosis. Frequently washing hands, overuse of sanitizers, or excessive scrubbing are other factors. It can also be caused by prolonged exposure to harsh sunlight or high radiation. Dehydration and nutritional deficiency, such as lack of vitamin C, vitamin E, zinc, etc., also contribute to xerosis. Other causative factors may include anemia, diabetes, chronic kidney disease, liver disease, hypothyroidism, hyperthyroidism, etc.

Risk Factors And Epidemiology

Age is the most potent risk factor for xerosis. It is common to develop dry skin as you grow past the age of 60. Environmental factors such as cold weather, low humidity, sunlight exposure, etc., make you more prone to developing this condition. People in professions needing to wash hands frequently, such as healthcare staff, kitchen staff, or laundry workers, are at high risk. Few individuals with OCD have also been observed to have a habit of washing hands frequently with excessive scrubbing. This is related to the psychological thought that their hands are always dirty or have germs. Ill maintenance or personal hygiene, severe dehydration, lack of proper nutrition, and diabetes can also increase the risk for xerosis. Patients with certain genetic or autoimmune skin diseases are also at risk.
Xerosis is a very common condition that occurs worldwide and can affect people of any age. It is seen more frequently among the elder, especially those over the age of 60. Males and females are equally affected by this condition.

Signs And Symptoms

The frequent signs and symptoms of xerosis are associated with aging and other environmental factors. The most common symptom is scaling of the skin, especially that of the scalp, arms, lower legs, soles of the foot, elbows, knees, and knuckles of fingers. Skin becomes flaky and sheds off white scales, especially during harsh, cold weather. The skin may also form cracks or wrinkles if it is too dry. Dry skin may also be accompanied by severe itching, redness, or rashes, depending on the severity of this condition.

Diagnosis

The diagnosis of xerosis is usually made by its clinical presentation. Your doctor may ask questions about your hand washing or bathing habits, the presence of diabetes, or any other risk factors that lead to the development of dry skin. Examination of eyes may also be performed to check the presence of eye-related symptoms. If your doctor suspects a thyroid disease, inspection and palpation of the neck are done along with other suitable tests to confirm the diagnosis. Genetic or autoimmune diseases require particular diagnostic and imaging tests to identify the primary cause.

Differential Diagnosis

 Xerosis needs to be differentiated from other skin conditions with similar symptoms. Other such conditions include atopic eczema, ichthyosis Vulgaris, allergic dermatitis, psoriasis, scabies, atopic dermatitis, T-cell lymphoma, stasis dermatitis, etc.

Treatment

Treatment of xerosis includes frequent application of lotions, moisturizers, oils, or wax-based products on the affected skin, especially on the face, hands, and feet, since they’re more exposed to the external environment. The products replenish the dehydrated skin cells and form a protective layer to prevent more water loss. The use of petroleum jelly or other greasy products is also effective in creating a protective barrier for dry skin. Before applying any skin products, it is necessary to check their active ingredients beforehand to avoid the risk of any known allergies. Adequate water consumption (at least eight glasses a day) should be maintained as prescribed by your doctor. Nutritional deficiencies are fulfilled with a proper diet and dietary supplements if necessary. It is also advised to apply sunscreen before going out in sunlight for long hours.

Medication

Topical corticosteroid ointments or creams such as those containing hydrocortisone are suggested in case of severe itching or rashes. If any other underlying systemic, genetic or autoimmune disease is present which is suspected of causing xerosis, it needs to be diagnosed and treated accordingly with the use of medications as prescribed by your doctor.

Prognosis

The overall prognosis or xerosis is good if certain habits are modified with prescribed home treatment.  It does not require any specialist care unless there are any other skin abnormalities such as pus discharge, frequent rashes, ulcers, or tumors.

Prevention

Aging-related xerosis cannot be prevented, but it can be managed well. However, xerosis occurring due to environmental factors can be controlled by frequently using oil-based lotions or moisturizers for your skin, using petroleum jelly, and drinking water to prevent skin from getting dehydrated. Hot showers should be limited to a short time. Rather it is preferred to shower with lukewarm water in winters. If you have a habit of frequently washing your hands or it is a professional demand, it is better to wear protective gloves for the required time. Psychological habits of over cleanliness may require professional intervention. It is recommended to wear sunscreen or protective dressing if you’re planning to stay out in sunlight for a long duration. Preventive methods can delay aging-related eczema development if they’re adopted from a younger age.