What Is Very Dry Skin?

Posted by Dr. Natasha Ryz on

You have most likely experienced dry skin 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.

Very dry skin is a more severe type of dry skin, and is characterized by skin barrier dysfunction, inflammation and damage.

Very dry skin is painful and frustrating.

To better understand very dry skin, it is helpful to compare it to dehydrated skin and dry skin.

What is Dehydrated Skin?

Dehydrated skin is skin that is missing water and water-holding substances, called humectants.

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

Dehydrated skin can happen to anyone, regardless of skin type — if you have dry, oily or combination skin, you can still experience dehydration.

Read more: What is Dehydrated Skin?

Dehydrated skin can be relieved with the use of moisturizers and humectants, including glycerin, hyaluronic acid and natural moisturizing factors.

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.
The following contribute to dry skin:
  • 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, 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.

  • 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

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 (reviewed by Armstrong et al, 2020, and Kulthanan et al, 2021).

Dry Skin Type vs. Very Dry Skin Type

Summary

Very dry skin is a severe type of dry skin, with skin barrier damage and inflammation, leading to red, irritated, itchy skin. 

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

Treatment of very dry skin can include nutrient-rich oils, balms and barrier creams, with active ingredients to help repair the skin barrier, calm redness, and soothe irritation and itch.

In addition, some people with very dry skin require various medications to control and manage their symptoms.

References

Armstrong AW, Read C. Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review. JAMA. 2020 May 19;323(19):1945-1960. doi: 10.1001/jama.2020.4006. PMID: 32427307.

Kulthanan K, Tuchinda P, Nitiyarom R, Chunharas A, Chantaphakul H, Aunhachoke K, Chularojanamontri L, Rajatanavin N, Jirapongsananuruk O, Vichyanond P, Chatchatee P, Sangsupawanich P, Wananukul S, Singalavanija S, Trakanwittayarak S, Rerkpattanapipat T, Thongngarm T, Wisuthsarewong W, Limpongsanurak W, Kamchaisatian W, Noppakun N. Clinical practice guidelines for the diagnosis and management of atopic dermatitis. Asian Pac J Allergy Immunol. 2021 Sep;39(3):145-155. doi: 10.12932/AP-010221-1050. PMID: 34246205.

Dehydrated Skin Dry Skin Skin Science Skin Type Skincare

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