What Causes Dry Skin? 12 Causes of Dry Skin from Aging to Disease

Posted by Dr. Natasha Ryz on

 

What Causes Dry Skin? 12 Causes of Dry Skin from Aging to Disease

Dry skin is common during the cold, dry, winter months. 

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.

Dry skin can be caused by environmental factors including cold weather, low humidity, UV radiation, harsh soaps, chlorine exposure, hot water, aging and menopause.

Dry skin can also be caused by genetic factors such as filaggrin mutations, and disease states including malnutrition, eczema, diabetes and hypothyroidism.

This article will cover:

    • What is dry skin?
    • What causes dry skin?
    • Cold weather can cause dry skin
    • Low humidity can cause dry skin
    • Sun exposure can cause dry skin
    • Chlorine exposure can cause dry skin
    • Harsh soaps can cause dry skin
    • Aging can cause dry skin
    • Menopause can cause dry skin
    • Malnutrition can cause dry skin
    • Vitamin deficiencies can cause dry skin
    • Atopic Dermatitis / Eczema can cause dry skin
    • Diabetes can cause dry skin
    • Hypothyroidism can cause dry skin
    • Summary
    • References

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.

Read more: What is Dry Skin?

Symptoms of dry skin include:

  • Loss of skin elasticity.
  • Skin feels tight, dehydrated.
  • Skin appears dull, rough and blotchy.
  • Slight to severe flaking, scaling or peeling.
  • Fine lines and wrinkles are more pronounced.
  • May have irritation and a burning sensation.
  • May have itching.

    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.

    Anyone can develop dry skin.

    What causes dry skin?

    Dry skin can be caused by various factors, including:

    • Exposure to cold weather
    • Low humidity levels
    • UV radiation and sunlight
    • Harsh soaps or detergents
    • Swimming in chlorinated pools
    • Aging
    • Menopause

    1. Cold weather can cause dry skin

    Exposure to cold weather can cause dry skin.

    It is broadly accepted that your skin barrier may be negatively affected by weather conditions (reviewed by Engebretsen et al, 2016).

    As the temperatures start to get colder, the air gets dryer. Cold air has less moisture than warm or hot air, and cold air can be intensely drying on your skin.

    Strong winds and UV damage from the sun can also strip moisture from exposed skin and disrupt the skin barrier.

    Daily insults from the environment, such as low humidity, wind, and sun exposure, can lower the skin's water content, causing improper desquamation and the appearance of dry, flaky skin (Verdier-Sévrain et al, 2007).

    2. Low humidity levels can cause dry skin

    The water content of skin is remarkably high - the epidermis (the outer skin layer) contains more than 70% water, while its outermost layer, the stratum corneum has been shown to contain ~15 - 25% water (Caspers et al, 2001; Caspers et al, 2003).

    Adequate hydration of the stratum corneum serves three major functions (Fowler, 2012):

    1. it maintains plasticity of the skin, protecting it from damage
    2. it contributes to optimum stratum corneum barrier function
    3. it allows hydrolytic enzymes to function in the process of desquamation

      When the water content of the stratum corneum falls below 10%, scaling on the skin surface becomes visible (Rycroft, 1985).

      Learn more: What is Dehydrated Skin?

      When your skin is exposed to a dry environment, it could be more susceptible to mechanical stress (Engebretsen et al, 2016). 

      Studies in humans show a reduction in transepidermal water loss (TEWL) (a measure of the integrity of the skin's barrier function) with low humidity, alterations in the water content in the stratum corneum, decreased skin elasticity and increased roughness (Goad et al, 2016).

      A study on dry facial skin found a higher dryness score with low temperatures, high wind speed and low humidity (Cooper et al, 1992) and as little as 15 min of cold and dry air has been proven to significantly decrease skin hydration (Roure et al, 2012). These data suggest that a reduction in temperature leads to a decrease in skin hydration and transepidermal water loss (TEWL), and that this effect is stronger when relative humidity is low (Cooper et al, 1992; Roure et al, 2012). 

      What is best humidity level for skin?

      It is generally thought that humidity levels within occupied spaces should not exceed 60%, and when levels of humidity fall to around 30% or below, occupants begin to feel thermal discomfort (Goad et al, 2016).

      Learn more: How Does A Humidifier Help Dry Skin?

      3. Sun exposure can cause dry skin

      Ultraviolet (UV) exposure from sunlight can cause dry skin.

      UV energy includes UVA, UVB and UVB radiation. Each component of UV can exert a variety of effects on cells, tissues and molecules (D'Orazio et al, 2013). 

      Heat from the sun can dry out areas of unprotected skin and deplete the skin's natural lubricating oils. This can cause dry skin.

      Chronic exposure to UV irradiation also leads to photoaging and increases your risk of skin cancer (Matsumura et al, 2004).

      4. Chlorine exposure can cause dry skin

      Swimmers often complain of dry skin. Sensations of itching and skin tightness are frequently reported after swimming in pool water. 

      Recreational swimming can lead to significant transient changes in skin surface properties of women with healthy skin, including an increase in skin pH, and a decrease in sebum levels (Gardinier et al, 2009).

      In adolescents, swimming has also been shown to remove superficial sebum and leave swimmers at risk for dry skin (Morss-Walton et al, 2022).

      Pools treated with chlorine have higher health problems, such as eye and skin irritation, and skin dryness, compared to swimming pools treated with other chemical treatment methods (Fernández-Luna et al, 2016).

      5. Harsh soaps can cause dry skin

      Soap is one of the most popular cleansers.

      However, high pH soap can irritate and damage your skin barrier.

      Learn more: The Problem with Soap for Cleansing Dry Skin

      Soap should be replaced with low pH syndet bars, or other gentle cleansers that can preserve your skin barrier.

      Learn more: 8 Types of Face Cleansers - Which Are Best for Cleansing Dry Skin?

      6. Aging can cause dry skin 

      As we age, several changes in our skin occur: 

      1. Skin barrier becomes more permeable.
      2. Reduction in skin hydration.
      3. Reduction in skin lipids.
      4. Increase in skin surface pH.

      (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).

      7. Menopause can cause dry skin

      During menopause, your ovaries stop producing the hormone estrogen.

      Ovaries stop producing reproductive hormones gradually, when women are in their 40's - 50's. Symptoms like hot flashes, mood changes, stress, fatigue, vaginal drying and itching are common.

      Estrogen-deficient skin becomes thin and has a decrease in barrier function.

      It can be frustrating to notice your skin aging during menopause.

      As we age, the first signs of skin aging start around 30 years of age when estrogen levels begin to decline, the skin thins, dries, wrinkles, and becomes pigmented unevenly with sunspots (reviewed by Lephart et al, 2021). 

      Specifically, the appearance of wrinkles around the eyes and mouth, and frown lines along the forehead are seen with uneven skin color and a general loss of skin tone, compared to youthful skin (Lephart et al, 2021). 

      In women, declining estrogen levels are associated with a variety of skin changes, many of which can be reversed or improved by estrogen supplementation (Hall et al, 2005).

      Learn more: Does Menopause Cause Dry Skin on Your Face? 

      What causes dry skin?Sometimes dry skin may signify an underlying health condition. These conditions include:

      • Malnutrition 
      • Vitamin deficiencies
      • Atopic Dermatitis / Eczema
      • Diabetes
      • Hypothyroidism

      8. Malnutrition can cause dry skin

      Malnutrition results from a lack of sufficient nutrients in the body. 

      Malnutrition can weaken the skin barrier, leading to dry skin and skin tears.

      Inadequate nutrition and hydration have been suggested to be risk factors for skin tears in multiple studies (White et al, 1994; Baranoski et al, 2016; Leblanc et al, 2008, Munro et al, 2017). 

      Skin tears can occur at any life stage and on any part of the body.

      Multiple risk factors for the development of skin tears have been identified, including older age, and dry skin (Munro et al, 2017).

      Aging leads to structural skin changes, including reduced dermal thickness, elasticity, loss of underlying fat, resilience, and increased dryness increasing susceptibility to injury (Fleck et al, 2007; Farage et al, 2007; Hanson et al, 2010, Koyano et al, 2016).

      Dietetic consultation is recommended as a beneficial strategy for skin tear prevention and management in order to promote and monitor adequate nutrition and hydration (Munro et al, 2017).

      9. Vitamin deficiencies can cause dry skin

      Individual nutrient deficiencies can also cause dry skin issues, including vitamin A and vitamin C.

      Vitamin A deficiency and toxicity can cause dry skin

      Vitamin A is a fat-soluble vitamin that is important for many bodily functions, including proper vision, a strong immune system, reproduction and good skin health (Alashry et al, 2021).

      Vitamin A deficiency causes night blindness and dry skin (Akram et al, 2011; Phanachet ete al, 2018).

      However, too much vitamin A can also cause problems - as dry skin, cracking of lips and painful areas of bone are examples of chronic vitamin A toxicity (Penniston et al., 2006).

      Vitamin C deficiency can cause dry skin

      Normal skin contains high concentrations of vitamin C, which supports important and well-known functions, stimulating collagen synthesis and assisting in antioxidant protection against UV-induced photodamage (Pullar et al, 2017).

      Vitamin C occurs primarily in fruits and vegetables, and scurvy develops from inadequate consumption of these sources.

      The earliest symptom of scurvy, occurring only after many weeks of deficient vitamin C intake, is fatigue. The most common cutaneous findings are follicular hyperkeratosis, perifollicular hemorrhages, ecchymoses, xerosis (dry skin), leg edema, and poor wound healing (Hirschmann et al, 1999).

      Treatment with vitamin C results in rapid, often dramatic, improvement.

      10. Atopic Dermatitis / Eczema can cause dry skin

      Eczema is a common skin condition that can affect people of all ages. Overall, it is when patches of skin become extremely dry, itchy, red, and irritated.

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

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

      There are 2 major risk factors for the development of atopic dermatitis (eczema): 1) family history of atopic disease, and 2) genetic defect in the filaggrin (FLG) gene.

      The FLG gene is responsible for the development of the profilaggrin protein, found in the granular layer of the epidermis, and brings structural proteins together to create a strong barrier matrix.

      FLG mutations or deficiencies result in an abnormality in permeability of skin barrier function.  When FLG mutations are present, atopic dermatitis is more severe and persistent, and occurs mainly in early-onset atopic dermatitis (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).

      11. Diabetes can cause dry skin

      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).

      12. Hypothyroidism can cause dry skin

      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). 

      What causes dry skin?

      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.

      What causes dry skin?

      Dry skin can be caused by environmental factors including cold weather, low humidity, UV radiation, harsh soaps, chlorine exposure, hot water, aging and menopause.

      Dry skin can also be caused by genetic factors such as filaggrin mutations, and disease states including malnutrition, nutrient-deficiencies or toxicity, eczema, diabetes and hypothyroidism.

      Dry skin appears dry, rough, and may scale and flake. It may also show premature signs of aging, like surface wrinkles and loss of elasticity.

      It is important to protect your skin.

      Dry and dehydrated skin can be relieved with the use of moisturizers, humectants, and essential fatty acids.

      References

      Akram, M., Akhtar, N., Asif, H. M., Shah, P. A., Saeed, T., Mahmood, A., & Malik, N. S. (2011). Vitamin A: a review article. J Med Plant Res5(20), 4977-4979.

      ALASHRY, A. I. A., & Morsy, T. (2021). OVERVIEW OF VITAMIN A. Journal of the Egyptian Society of Parasitology51(1), 29-42.

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

      Baranoski S, Leblanc K, Gloeckner M. Preventing, assessing, and managing skin tears: a clinical review. Am J Nurs. 2016;116(11):24-30.

      Caspers PJ, Lucassen GW, Carter EA et al. In vivo confocal Raman microspectroscopy of the skin: noninvasive determination of molecular concentration profiles. J Invest Dermatol 2001; 116:434– 42.

      Caspers PJ, Lucassen GW, Puppels GJ. Combined in vivo confocal Raman spectroscopy and confocal microscopy of human skin. Biophys J 2003 July; 85: 572-80.

      Cooper MD, Jardine H, Ferguson J. Seasonal influence on the occurrence of dry flaking facial skin. In Marks R and Plewig G, eds. The Environmental Threat to the Skin, Vol. 159. Martin Dunitz, London, 1992; 159–164.

      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.

      D'Orazio J, Jarrett S, Amaro-Ortiz A, Scott T. UV radiation and the skin. Int J Mol Sci. 2013 Jun 7;14(6):12222-48. 

      Engebretsen KA, Johansen JD, Kezic S, Linneberg A, Thyssen JP. The effect of environmental humidity and temperature on skin barrier function and dermatitis. J Eur Acad Dermatol Venereol. 2016 Feb;30(2):223-49.

      Farage MA, Miller KW, Elsner P, Maibach HI. Structural characteristics of the aging skin: a review. Cutan Ocul Toxicol. 2007;26(4):343-357.

      Fernández-Luna, Á., Burillo, P., Felipe, J. L., Del Corral, J., García-Unanue, J., & Gallardo, L. (2016). Perceived health problems in swimmers according to the chemical treatment of water in swimming pools. European Journal of Sport Science16(2), 256-265.

      Fleck CA. Preventing and treating skin tears. Adv Skin Wound Care. 2007; 20(6):315-320.

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      Gardinier, S., Guéhenneux, S., Latreille, J., Guinot, C., & Tschachler, E. (2009). Variations of skin biophysical properties after recreational swimming. Skin Research and Technology15(4), 427-432.

      Goad N, Gawkrodger DJ. Ambient humidity and the skin: the impact of air humidity in healthy and diseased states. J Eur Acad Dermatol Venereol. 2016 Aug;30(8):1285-94.

      Hall G, Phillips TJ. Estrogen and skin: the effects of estrogen, menopause, and hormone replacement therapy on the skin. J Am Acad Dermatol. 2005 Oct;53(4):555-68; quiz 569-72. 

      Hanson D, Langemo D, Anderson J, Thompson P, Hunter S. Friction and shear considerations in pressure ulcer development. Adv Skin Wound Care. 2010;23(1):21-24.

      Hirschmann JV, Raugi GJ. Adult scurvy. J Am Acad Dermatol. 1999 Dec;41(6):895-906.

      Koyano Y, Nakagami G, Iizaka S, Sugama J, Sanada H. Skin property can predict the development of skin tears among elderly patients: a prospective cohort study. Int Wound J. 2016;14(4):691-697.

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

      Leblanc K, Christensen D, Orsted H, Keast D. Best practice recommendations for the prevention and treatment of skin tears. Wound Care Canada. 2008;6(1):14-31.

      Lephart, E. D., & Naftolin, F. (2021). Menopause and the skin: old favorites and new innovations in cosmeceuticals for estrogen-deficient skin. Dermatology and Therapy11(1), 53-69.

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

      Matsumura Y, Ananthaswamy HN. Toxic effects of ultraviolet radiation on the skin. Toxicol Appl Pharmacol. 2004 Mar 15;195(3):298-308.

      Morss‐Walton, P. C., Kimball, R., Rosales Santillan, M., McGee, J. S., Cukras, A., Patwardhan, S. V., & Kimball, A. B. (2022). Effects of swimming on facial sebum in adolescents. Pediatric Dermatology39(3), 376-378.

      Munro EL, Hickling DF, Williams DM, Bell JJ. Malnutrition is independently associated with skin tears in hospital inpatient setting-Findings of a 6-year point prevalence audit. Int Wound J. 2018 Aug;15(4):527-533. 

      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.

      Penniston, Kristina L, Tanumihardjo, Sherry A (2006). The acute and chronic toxic effects of vitamin A. Am. J. Clin. Nutr., 83(2): 191-201.

      Phanachet P, Shantavasinkul PC, Chantrathammachart P, Rattanakaemakorn P, Jayanama K, Komindr S, Warodomwichit D. Unusual manifestation of vitamin A deficiency presenting with generalized xerosis without night blindness. Clin Case Rep. 2018 Mar 13;6(5):878-882. 

      Pullar JM, Carr AC, Vissers MCM. The Roles of Vitamin C in Skin Health. Nutrients. 2017 Aug 12;9(8):866.

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