“Gods of snow send forth chilly winds,
as falling leaves herald the coming of icy days, Landscapes are frozen in time, and the Winter Itch is back again.”
Dry skin is when the skin appears flaky. It’s classified as a kind of ‘skin type‘ that most probably you will have to manage on a long term basis. It can occur in males and females and in any age group, but mostly everyone after the age of 55 will suffer from dry skin. It is widely distributed all over the body but scalp and limbs are more prone to flakiness.
Changes in the composition and amount of epidermal lipids that occurs with age, genetics, systemic diseases or a prolonged illness, fat loss, certain drugs, bathing habits, and faster transepidermal water loss (TEWL) are some of the main pathogenic factors that can result in dry skin.
There is a strong genetic component as well, where either dry skin runs in the family, or rarer more serious inherited dry skin disorders are present at birth. Medically, dry skin is known as Xerosis and in severe cases medical treatment should be sought.
‘Dry skin’ is not the same as ‘dehydrated skin’ where there is an actual water deficit and cells lack water content and no lipid abnormalities are noticed. Although both dry skin and dehydrated skin can co-exist, making the skin appear even more sullen, aged and flaky.
In our monthly Original Scientific Paper Series we will discuss the role of lipid plant therapy in controlling this life-long skin issue along with a few practical tips that offer an evidence based approach into management and prevention.
Barrier function abnormalities of the stratum corneum is the main factor in the evolution of dry skin.
- Ceramide to lipid ratios may be altered.
- Lipid synthesis is altered or reduced.
- There is a build up of dead surface cells due to slowed cell cycles, resulting in flaky dead cells that have limited water holding capacities.
- There is abnormal expression of keratin genes (K10, K5, K1, K14).
Clinical features of dry skin
thin and rough
- Matt appearance
- Cracked skin surface
- Light pink color
- Redness and itching
- Prone to wrinkles
- Greater sensitivity to external factors
- Prone to skin allergies also known as ‘atopy-prone’ skin
- Prone to infections
- Might progress to severe scaly patches
- More prone to chemical induced sensitivity
- Cosmetic intolerances
Dryness of the skin is associated with damage to the barrier functions of the first layer of the skin that results from disturbances in the protein components and lipid structure in the stratum corneum. Dry skin can result from both internal (endogenous) and external (exogenous) causes. Inadequate or improper skincare, stress, environmental factors, pollution, progressing age, insufficient water intake and poor diets all contribute to the deterioration of dry skin where dry skin and dehydrated skin start to mingle and result in oil and water deficient skin. Dry skin is common in healthy people who genetically have a ‘dry skin type’ but it can emerge or worsen due to a variety of other reasons (Fig.1).
Fig. 1 . The main causes of dry skin
Managing dry skin will require a 3-step approach that involves preventative measures, immediate and long term care. We want to prevent infections, decrease sensitivity and itching, alter bathing, swimming and cosmetic habits that may be worsening the issue.
Avoiding factors that increase dryness by carefully selecting appropriate cosmetic products is an important part of our 3-step strategy.
Correct use of cosmetic ingredients (gentle cleansing preparations, non-alcoholic tonics, creams, moisturizing and oiling masks) will greatly reduce flakiness and itching.
The aim of cosmetic preparations is to minimize the destructive processes occurring in the stratum corneum of dry skin. One method by which we can tackle dryness is by externally supplying water from moisturizing agents and slowing down water loss from the skin by forming a lipid occlusive film.
Active ingredients supporting dry skin care can be divided into:
- Moisturizing ingredients (hydrophilic water retaining substances; e.g. hyaluronic acid, urea, sorbitol, collagen, lactic acid, panthenol)
- Occlusive ingredients (hydrophobic substances, protecting against water evaporation from the epidermis; e.g. petroleum, waxes, silicones, lanolin, plant oils)
- Ingredients that modify the stratum corneum and the epidermal protective barrier (i.e. fatty acids, cholesterol, ceramides).
Botanicals that support the health, texture, and integrity of the skin are widely used in cosmetic formulations for dry skin. Plant extracts and plant oils are recommended for the care of dry skin, because they replenish lipids and are skin-identical, reduce transepidermal water loss, display skin-barrier-reinforcing properties or promote keratinocyte differentiation. Plant extracts include, for example: aloe vera (Aloe barbadensis), St. John’s wort (Hypericum perforatum), rose hip (Rosa canina), birch (Betula alba), fenugreek (Trigonella foenum-graecum), flax (Linum usitatissimum), marigold (Calendula officinalis), comfrey (Symphytum officinale), marshmallow (Althaea officinalis). Plant oils can be used as bases of cosmetic preparations, but they can also act as active ingredients (Tab.1).
Table 1. Selected vegetable oils used for dry skin care
Dry skin can be a highly bothersome issue and using plant lipid therapy can form an intensive evidence based solution in battling this chronic problem. Avoiding factors that make it worse is another way of keeping it in check. Using the 3-step approach will make a huge difference and avoid more serious complications like infections and increased skin reactivity. If you have a combination of dry and dehydrated skin (oil and water deficits), then select both lipid based and water loving loving cosmetics that can tackle the issue with a multi-prong approach. Try various formulations and see which one suits you best as everyone’s skin is different and what suits you may not be ideal for someone else. Ideally you should apply lipids right after bathing so that the film locks in moisture and your skin stays supple throughout the day.
Daily applications of plant oils will ensure a healthy barrier with reduced flakiness and prevent redness and itching.
As winter draws near, remember that dry skin will tend to worsen, so try to use plant lipid therapy to combat winter dryness so that you can enjoy the holiday season with a smile on your face without dry flaky itchy skin coming in the way of your Halloween and Yuletide celebrations!