Who Suffers From Dry Skin?

Posted by Dr. Natasha Ryz on

Dry skin is painful and frustrating.

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.

Learn more: What is Dry Skin?

Anyone can develop dry skin.

But you're more likely to develop dry skin if you are older or have certain diseases or conditions.

Dry skin is common in:

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

Atopic Dermatitis (Eczema) can cause dry skin

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

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

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 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 agingCutis 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.

Aging Skin Dry Skin Skin Barrier

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