Dry Skin Pain - Who Suffers from Dry Skin Pain?

What is dry skin?

Dry skin is skin that is lacking water, humectants and fats. Humectants absorb and hold water, while fats coat the skin and seal in moisture. When there is not enough water, humectants or fats, skin barrier disruption can occur, further worsening symptoms of dry skin.

Dry skin symptoms include:

• lack of water in skin
• lack of water-holding substances called humectants (glycerin, hyaluronic acid, natural moisturizing factors)
• lack of epidermal lipids (ceramides, fatty acids, cholesterol)
• lack of sebum (triglycerides, wax esters, squalene)

Sebum is an oily, waxy substance produced by your body’s sebaceous glands.

Sebum coats the skin, seals in moisture, and protects your skin from getting too dry. When there is not enough sebum, skin appears dull, rough and flaky, and skin feels overly tight, itchy and uncomfortable.

Dry skin is very common, and can occur for a variety of reasons. You may have naturally dry skin. But even if your skin type is normal or oily, you can still develop dry skin from time to time. Dry skin can affect any part of your body.

Read more: What is Dry Skin?

Dry skin is often relieved with the use of moisturizers, a good face oil, and some lifestyle modifications, such as using a humidifier, avoiding harsh cleansers, and supplementing the diet with essential fatty acids. 

What is very dry skin?

Very dry skin is a more severe type of dry skin, and is characterized by skin barrier damage, microbe imbalances and inflammation, leading to red, irritated, itchy skin.

Symptoms of very dry skin include:

• skin feels tight and dehydrated, especially after showering, bathing or swimming
• skin appears dull, rough and blotchy
• slight to severe flaking, scaling or peeling
• fine lines and wrinkles are more pronounced
• irritation and itching (pruritus)
• inflammation and redness
• deep cracks on hands and feet that may bleed
• associated with skin conditions such as eczema and psoriasis
• dry skin pain

Very dry skin usually has underlying genetic components as well as environmental factors that play a role.

Very dry skin does not typically respond to just moisturizers.

Nutrient-rich oils, balms and barrier creams are required to improve very dry skin and protect against further damage.

Active ingredients, including vitamins, humectants, ceramides, fatty acids and cholesterol can help repair the skin barrier, calm redness, and sooth irritation and itch.

Some people with very dry skin may also require medications to control symptoms, including antimicrobial agents, antihistamines, anti-inflammatory agents, immunotherapy, biologicals, phototherapy, and others.

Read more: What is Very Dry Skin?

What is the skin barrier?

Dry skin can damage your skin barrier.

Your skin barrier protects you from physical, chemical, and microbial insults, and prevents the loss of water from your body.

The skin barrier includes the outermost layers of skin, called the stratum corneum.

Your skin barrier is essentially what you can see and touch on the surface of your body.

When your skin barrier is healthy, it feels and appears smooth, soft, and plump.

In contrast, a damaged skin barrier looks dry, rough, dull, and dehydrated, and may become irritated and inflamed.

The stratum corneum can be thought of as a brick wall that protects you.

The "bricks" are the skin cells, called corneocytes, and the "mortar" that holds the bricks together is the lipids or fats, that together create the outer barrier.

Learn More: What is The Skin Barrier?

What is dry skin pain?

Dry skin can be painful.

Dry skin can damage your skin barrier, leading to irritation, inflammation, wounds and pain.

Dry skin pain can include:

• over-tight skin
• irritation and/or burning sensation
• itching (pruritus)
• inflammation and redness
• deep cracks on hands and feet that may bleed
• skin damage, including wounds

Dry skin pain is common in:

• Aging Skin 
• Atopic Dermatitis / Eczema
• Diabetes
• Hypothyroidism

Aging can cause dry skin pain 

 (Choi et al, 2019)

Dry skin is a common skin condition in older adults, but it is not a normal part of aging. Dry skin in older adults is multifactorial: intrinsic changes in keratinization and lipid content, use of diuretics and similar medications, and overuse of heaters or air conditioners all contribute (White-Chu et al, 2011).

Dry skin can be minimized by increasing the ambient humidity, modifying bathing technique and skincare products, and using emollients to replace the lipid components of the skin (White-Chu et al, 2011).

Dermatoses such as xerosis (dry skin), pruritus, and eczema are also widespread in the elderly, create substantial suffering in those afflicted, and are often resistant to treatment (Farage et al, 2009).

Eczema can cause dry skin pain

Atopic dermatitis, also known as eczema, is a chronic relapsing inflammatory skin condition. 

Although the pathophysiology of atopic dermatitis is not completely understood, numerous studies demonstrated that skin barrier dysfunction and immune dysregulation contribute to the pathobiology of atopic dermatitis (Kim et al, 2019).

Dry skin is a common finding in patients with atopic dermatitis (Linde et al, 1992).

Population-based studies in the United States suggest that prevalence is about 10% for children and 7% for adults (Avena-Woods, et al, 2017).

The onset of atopic dermatitis can occur at any age.

In infancy, atopic dermatitis is generally recognized soon after birth, as dry skin occurs early and can involve the entire body, usually excluding the diaper area. 

In childhood, dry skin is often generalized, causing rough, flaky, or cracked skin.

In adulthood, dry skin is prominent, and lesions are more diffuse with underlying erythema. The face is commonly involved, presenting as dry and scaly (Avena-Woods et al, 2017).

Hypothyroidism can cause dry skin pain

People with hypothyroidism often have dry skin.

It has been shown that in over 80% of individuals with primary hypothyroidism, the epidermis is thin, rough, and hyperkeratotic giving a scaly appearance. Furthermore, patients with hypothyroidism often demonstrate a fine wrinkling of the skin that imparts a parchment-like quality (Lause et al, 2017).

Diabetes can cause dry skin pain

Dry skin is common in diabetes.

Clinical observations show reduced hydration of the skin barrier and decreased sebaceous gland activity in patients with diabetes. Even in the absence of dry skin, patients with diabetes have an impaired desquamation (cell shedding) process (Piérard et al, 2013; de Macedo et al, 2016).

Dry, scaly skin is also often observed in diabetic patients. 

In the skin, diabetes is reported to induce advanced glycosylation end products in the collagen of the dermis, which are thought to produce the characteristic stiff and thick skin (Sakai et al, 2016).

Summary

Dry skin is a seemingly simple condition that has a wide spectrum of symptoms - from mild dryness and flaking to severe itching, redness and pain.

Anyone can develop dry skin, but you're more likely to suffer from dry skin pain if you are older or have certain diseases or conditions, including atopic dermatitis (eczema), diabetes and/or hypothyroidism. 

References

Avena-Woods C. Overview of atopic dermatitis. Am J Manag Care. 2017 Jun;23(8 Suppl):S115-S123.

Balin A. K., Pratt L. A. (1989). Physiological consequences of human skin aging. Cutis 43 (5), 431–436. 

Bergfeld WF. A lifetime of healthy skin: implications for women. Int J Fertil Womens Med. 1999 Mar-Apr;44(2):83-95. 

Choi EH. Aging of the skin barrier. Clin Dermatol. 2019 Jul-Aug;37(4):336-345.

de Macedo GM, Nunes S, Barreto T. Skin disorders in diabetes mellitus: an epidemiology and physiopathology review. Diabetol Metab Syndr. 2016 Aug 30;8(1):63.

Farage MA, Miller KW, Berardesca E, Maibach HI. Clinical implications of aging skin: cutaneous disorders in the elderly. Am J Clin Dermatol. 2009;10(2):73-86.

Fisher GJ, Kang S, Varani J, Bata-Csorgo Z, Wan Y, Datta S, Voorhees JJ. Mechanisms of photoaging and chronological skin aging. Arch Dermatol. 2002;138:1462–1470. 

Jenkins G. Molecular mechanisms of skin ageing. Mech Ageing Dev. 2002;123:801–810.

Kim J, Kim BE, Leung DYM. Pathophysiology of atopic dermatitis: Clinical implications. Allergy Asthma Proc. 2019 Mar 1;40(2):84-92.

Kim EJ, Kim MK, Jin XJ, Oh JH, Kim JE, Chung JH. Skin aging and photoaging alter fatty acids composition, including 11,14,17-eicosatrienoic acid, in the epidermis of human skin. J Korean Med Sci. 2010 Jun;25(6):980-3.

Kim EJ, Jin XJ, Kim YK, Oh IK, Kim JE, Park CH, Chung JH. UV decreases the synthesis of free fatty acids and triglycerides in the epidermis of human skin in vivo, contributing to development of skin photoaging. J Dermatol Sci. 2010 Jan;57(1):19-26.

Lause M, Kamboj A, Fernandez Faith E. Dermatologic manifestations of endocrine disorders. Transl Pediatr. 2017 Oct;6(4):300-312.

Linde YW. Dry skin in atopic dermatitis. Acta Derm Venereol Suppl (Stockh). 1992;177:9-13.

Piérard GE, Seité S, Hermanns-Lê T, Delvenne P, Scheen A, Piérard-Franchimont C. The skin landscape in diabetes mellitus. Focus on dermocosmetic management. Clin Cosmet Investig Dermatol. 2013 May 15;6:127-35.

Sakai, S., & Tagami, H. (2016). Xerotic skin conditions and SC properties: diabetic dry skin. In Skin Moisturization (pp. 215-228). CRC Press.

White-Chu EF, Reddy M. Dry skin in the elderly: complexities of a common problem. Clin Dermatol. 2011 Jan-Feb;29(1):37-42.

Author Information

Dr. Natasha Ryz is a scientist, skin care expert and an entrepreneur. She is the founder of Dry Skin Love Skincare, and she creates skincare products for beauty, dry skin and pain relief.

Dr. Ryz has a PhD in Experimental Medicine from the University of British Columbia in Vancouver, and she is a Vanier scholar. She also holds a Master of Science degree and a Bachelor of Science degree from the University of Manitoba in Winnipeg.

Natasha is the former Chief Science Officer of Zenabis Global, and she oversaw cannabis extraction, analytics, and product development. Her team brought 20 products to market including oils, sprays, vapes and softgels.

Why I Started A Skincare Company