Dry skin - Actors Forum is the Community to Talk, Learn and Study Acting.

raasm007 · 09-23-2005, 10:44 AM

Overview

Few things are more beautiful than healthy human skin.
And few things are more burdened by symbolism or more
wrapped up with people's identities. Qualities people
attribute to skin — sensuality, youthfulness,
vitality, beauty, even goodness — are also qualities
they see in themselves. That skin often seems the
outer reflection of the inner being may explain, at
least in part, why problem skin is so distressing and
why Americans spend billions of dollars a year on
moisturizers and other cosmetics.

Ordinary dry skin (xerosis) usually isn't serious, but
it can be uncomfortable and unsightly, turning plump
cells into shriveled ones and creating fine lines and
wrinkles long before you're due. More serious dry skin
conditions, such as the inherited group of disorders
called ichthyosis, can sometimes be disfiguring and
may cause psychological distress to people living with
them.

Fortunately, most dry skin results from environmental
factors that can be wholly or partially controlled.
These include exposure to hot or cold weather with low
humidity levels and to wind, long-term use of air
conditioning or central heating, excessive bathing,
especially tub baths, and the use of strong soaps or
detergents. Metabolic changes that occur with normal
aging or with certain medical conditions also can
affect the moisture content of your skin.

Chronic or severe dry skin problems may require a
dermatologist's advice. But you can do a lot on your
own to improve your skin, including drinking more
water, showering less, and above all, moisturizing,
moisturizing, moisturizing.

Signs and symptoms

Dry skin can be a temporary problem — one you
experience only in winter, for example — or a lifelong
concern. And although skin is often driest on your
arms, lower legs and the sides of your abdomen, this
pattern can vary considerably from person to person.
What's more, signs and symptoms of dry skin depend on
your age, your health status, your locale, the amount
of time you spend outdoors, and the cause of the
problem.

If you have dry skin due to environmental factors or
normal aging, you're likely to experience one or more
of the following:

A feeling of tightness or tautness, especially after
showering, bathing or swimming
A loss of plumpness — your skin appears shrunken or
dehydrated
Skin that feels and looks rough rather than smooth
Itching (pruritus) that sometimes may be intense
Slight to severe flaking or scaling
Fine lines or cracks
Severe redness
Deep fissures that may bleed
Specific dry skin conditions
Certain medical or age-related conditions can lead to
dry skin problems that have unique signs and symptoms.
These include:

Ichthyosis vulgaris. Sometimes called fishscale
disease or fish skin disease, ichthyosis vulgaris
develops when skin cells fail to shed normally and
instead accumulate in thick, dry scales. The scales
are small, polygonal in shape and range in color from
white to brown. They're most common on the lower legs
and may be especially thick and dark over your shins.
Ichthyosis vulgaris may also cause scalp flaking and
deep, painful fissures on your palms and soles.
Children with the inherited form of the disorder
usually have normal skin at birth but develop scaling
and roughness in the first few years of life. At
times, ichthyosis vulgaris may disappear during the
adult years, only to return as you age.
Lamellar ichthyosis. This severe form of the disease
is present at birth and lasts throughout life. Infants
with lamellar ichthyosis are born encased in a filmy
membrane that's shed after 10 to 14 days, revealing
skin that's covered in scales. The scales can range
from fine and white to thick and dark and generally
occur over the entire body, although they may be
larger on the legs. Lamellar ichthyosis can be
extremely disfiguring and may cause great
psychological suffering for children and adults with
the disease.
Asteatotic eczema (eczema craquele). This condition
causes dry, scaly, deeply fissured skin that some
doctors have described as resembling cracked porcelain
or a dry riverbed. The affected skin may become
inflamed, itchy and may bleed. Although asteatotic
eczema can affect anyone, it's especially common in
older adults, occurring primarily on the shins and
sometimes on the thighs, hands and trunk.
Psoriasis. A frustrating and sometimes disfiguring
skin condition, psoriasis is marked by reddened skin
with dry, silvery scales that sometimes resemble
dandruff. In severe cases, your skin may crack, bleed
and form pus-filled blisters. Psoriasis is a
persistent, chronic disease that tends to flare
periodically, and although it may go into remission,
it usually remains active for years. It can occur at
any age, but the onset is usually gradual and the
diagnosis is commonly made between the ages of 15 and
35.

raasm007 · 09-23-2005, 10:45 AM

Causes

Because skin is so closely associated with beauty and
sensuality, it's easy to forget the crucial role it
plays in maintaining health. Although only about a
tenth of an inch thick, your skin performs a number of
essential functions, including protecting you from
viruses, bacteria and environmental assaults,
maintaining adequate hydration, and helping regulate
body temperature.

Your skin consists of three layers:

Epidermis. This outer layer, no thicker than a sheet
of paper, both shields you from the world and presents
you to it.
Dermis. This thick middle layer makes up most of your
skin. It contains collagen and elastin — fibers that
give your skin strength, structure and elasticity.
Subcutaneous layer. This layer, which is mainly fat,
is the source of your skin's nerves and blood vessels
as well as the roots of your hair follicles, oil
glands and sweat glands.
Basal cells make up the base of the epidermis. They
divide to form squamous cells that produce keratin, a
hard protein that protects your skin from harmful
substances and infection. As the basal cells divide,
they push new squamous cells toward the surface of the
epidermis, where they eventually shrink, flatten and
die. These dead cells make up the stratum corneum, the
outermost portion of the epidermis. Stratum corneum
cells flake off every day and are continuously
replaced by more cells. It usually takes about a month
for skin cells to move from the basal layer to the
stratum corneum.

But the stratum corneum is far more than a place where
cells go to die. Instead, it's a dynamic structure
that affects not only your skin's appearance but also
its health. That's because the part of the stratum
corneum between the cells is composed mainly of fats
(lipids) such as ceramides, cholesterol and fatty
acids. These fats form a strong, protective barrier
that preserves the moisture in your body. Strip away
the barrier and your skin cells lose the water they
need to stay healthy and supple. Although many of the
characteristics of dry skin are subjective —
roughness, lack of radiance, tightness — scientists
define dry skin based on specific, measurable changes
in water and lipids in the stratum corneum.

A healthy stratum corneum is about 30 percent water,
giving your skin resilience and elasticity. Most of
the water is in the interior of the stratum corneum —
in the outer layers, the water level depends on the
amount of humidity in the air. The drier the air, the
drier the outermost layer of skin.
Environmental factors
Most cases of ordinary dry skin are due to
environmental causes, such as:

Weather. In general, your skin is driest in winter
when temperatures and humidity levels plummet. Winter
conditions also tend to make existing skin conditions
worse. But the reverse may be true if you live in
desert regions, where summer temperatures can top 110
F and humidity levels sink to 10 percent or less.
Central heating and air conditioning. These may be
technological marvels, but they're dermatological
disasters. Central air and heating, wood burning
stoves, space heaters and fireplaces all draw moisture
out of the air and out of your skin.
Too much 'cleanliness is next to godliness.' When it
comes to your skin, water is a double-edged sword.
Inside your skin, it keeps the cells plump and moist,
but it has the opposite effect when you're immersed in
it. Frequent showering or bathing, especially if you
like your showers hot and your baths long, breaks down
the lipid barriers in your skin. So does frequent
swimming, particularly in heavily chlorinated pools.
Harsh soaps and detergents. Many popular soaps and
detergents strip lipids and water from your skin.
Products containing fragrances and lauryl sulfates are
harsher and more irritating than unscented products
with sarcosinates, sulfosuccinates and
cocoamphodiacetates. Deodorant and antibacterial soaps
are usually the most damaging, as are many shampoos,
which can dry out your scalp.
Other factors
Certain diseases, metabolic problems and nutritional
deficiencies can significantly alter the function and
appearance of your skin:

Ichthyosis. This group of inherited disorders occurs
either because skin cells don't shed quickly enough or
because they shed too quickly. Although the different
forms of ichthyosis vary in their pattern of
inheritance, the genes in which mutations occur, the
age when they first appear and their physical
manifestations, all cause dry, rough, scaly skin. In
rare cases, ichthyosis may be acquired in adulthood
rather than inherited, usually as a result of a
systemic disease such as cancer or HIV infection.
Certain drugs also may cause acquired ichthyosis.
Asteatotic eczema. Several factors can contribute to
asteatotic eczema, including certain neurologic
disorders and exposure to harsh soaps, to chemicals or
to cold, dry air. Older adults are especially prone to
the condition because their skin may be compromised by
dehydration, malnutrition or aging.
Psoriasis. This skin condition is marked by a rapid
buildup of rough, dry, dead skin cells that form thick
scales. Normally, it takes about a month for new skin
cells to move from the lowest layer of your skin,
where they first form, to the stratum corneum, but in
psoriasis the life cycle of skin cells speeds up.
Although a defective gene for the disorder hasn't been
discovered, most scientists believe psoriasis is an
inherited condition that may be triggered or
exacerbated by infections, skin injuries, a reaction
to a vaccine or medication, stress, alcohol or
long-time exposure to the sun or chemicals.
Thyroid disorders. Hypothyroidism, a condition that
occurs when your thyroid produces too few hormones,
reduces the activity of your sweat and oil glands,
leading to rough, dry skin.
Alcohol and drugs. Alcohol and caffeine can visibly
dry your skin. Prescription drugs such as diuretics,
antihistamines and isotretinoin (Accutane) also have a
drying effect.
Nutritional deficiencies. A long-term lack of
essential lipids, especially omega-3 fatty acids, can
affect the integrity of your skin. So can a deficiency
of the mineral zinc, which plays a key role in wound
healing and in the metabolism of fatty acids and
vitamin A.
Dehydration. Severe diarrhea and vomiting, a high
fever, profuse sweating during exercise or simply not
drinking enough liquids can cause your body to lose
more fluid than you take in. One of the first signs of
dehydration is skin that has lost its elasticity.

raasm007 · 09-23-2005, 10:47 AM

Risk factors

Dry skin is a nearly universal problem, but certain
factors make you more likely to develop tightness,
flakiness and fine lines. These factors include:

Your age. A healthy diet, consistent exercise and
stress reduction can help you stay younger longer. Yet
in spite of your best efforts, your skin is likely to
change over time. As you age, your skin tends to
become drier because your oil-producing glands are
less active. And because cells move more slowly from
the basal layer of the epidermis to the stratum
corneum, your complexion can appear rough and dull.
The slowed sloughing also causes cells to clump
together in flakes or scales. Eventually, as the
epidermis becomes thinner and more fragile and the
subcutaneous layer of fat diminishes, your skin loses
its strong protective function along with its youthful
contours.
Sun exposure. Like all types of heat, the sun dries
your skin. Yet damage from ultraviolet (UV) radiation
penetrates far beyond the epidermis. The most
significant damage occurs deep in the dermis, where
collagen and elastin fibers break down much more
quickly than they should, leading to deep wrinkles and
loose, sagging skin (solar elastosis).
Your sex. Although everyone's skin changes with age, a
man's skin tends to stay moist longer than a woman's
does. Men experience a relatively small decrease in
oil production until well into their 80s, whereas
women's skin tends to become much drier after
menopause.
Diabetes. Diabetes can damage small blood vessels and
nerves, increasing the likelihood of dry skin and of
serious complications such as infection, cellulitis
and gangrene.
Winter weather. The combination of cold outdoor
temperatures and dry indoor air takes a tremendous
toll on your skin. Windy conditions and high altitudes
only add to the problem.
Hot baths and showers. Many people find long, hot
showers and baths luxurious, but there's nothing
glamorous about what they do to your skin. Strong
soaps or soap-based cleansers, no matter how expensive
or beautifully packaged, strip away even more oil and
moisture.
Smoking. Tobacco use doesn't cause dry skin per se,
but it does accelerate wrinkling, especially around
your eyes and upper lip. People who smoke tend to have
more wrinkles than do nonsmokers who are the same age
and have similar histories of sun exposure. The amount
of skin damage increases with the number of years and
cigarettes smoked.

When to seek medical advice

Most cases of dry skin respond well to self-care
measures. See your doctor if:

Your skin doesn't improve in spite of your best
efforts
Dryness and itching keep you from sleeping
You have open sores or an infection from scratching
You have large areas of scaling or peeling skin

Screening and diagnosis

Your doctor is likely to conduct a thorough physical
exam and to question you about your medical history,
including when your dry skin started, what factors
make it better or worse, your bathing habits, your
diet and how you care for your skin.

You may have certain diagnostic tests if your doctor
suspects that your dry skin is the result of an
underlying medical condition such as hypothyroidism or
diabetes. In addition, genetic tests can help identify
some, but not all, of the more than 20 types of
ichthyosis. If tests reveal a more serious condition,
you may be referred to other doctors, including a
dermatologist, who specializes in skin disorders

raasm007 · 09-23-2005, 10:49 AM

Complications

Dry skin that's not cared for can lead to:

Eczema. This condition causes redness, cracking and
inflammation.
Folliculitis. This is an inflammation of your hair
follicles.
Cellulitis. This is a potentially serious bacterial
infection of the skin's underlying tissues.
These complications are most likely to occur when your
skin's normal protective mechanisms are severely
compromised. For example, you might scratch an itchy
patch of skin until it cracks and bleeds, opening the
way for invading bacteria. But your skin can also
crack and bleed without you ever lifting a finger.

In that case, the process might work something like
this: You take a long, hot bath every evening, but
don't apply a moisturizer afterward. As a result, the
stratum corneum loses water and the cells shrink,
losing their normal plumpness. This stretches your
skin, decreasing its elasticity and eventually causing
severe cracks or fissures. Deep fissures rupture tiny
blood vessels in your skin, which leads to bleeding.
Meanwhile, loss of tone in the top layer of skin
creates fluid buildup in the dermis, putting
additional stress on the epidermis and setting the
stage for inflammation and infection.

In most cases, dry skin problems respond well to
self-care measures. If you have more serious diseases
such as ichthyosis or psoriasis, your doctor may
prescribe prescription creams and ointments or other
treatments in addition to home care.

Although it may not be possible to achieve flawless
skin, the following measures can help keep your skin
moist and healthy:

Wash 'n' go. For most people, a once-daily bath or
shower is enough to maintain good hygiene. If your
skin is very dry, bathing every other day may be best.
Keep in mind that the longer you're in water, the more
protective oils you lose. For that reason, and because
it takes just a few minutes to wash thoroughly, limit
baths and showers to 15 minutes or less. And use warm,
rather than hot, water. Less is more when it comes to
washing your face, too. Although it may be difficult
to break the habit of cleansing your face morning and
evening, once a day should be enough to remove dirt
and oil. If your skin doesn't feel fresh on this
abbreviated schedule, try rinsing with cool water in
the morning and using a cleanser only at night.
Avoid harsh, drying soaps. If you have dry skin, it's
best to use cleansing creams or gentle skin cleansers
and bath or shower gels with added moisturizers. These
don't have to be expensive, celebrity-endorsed brands.
Many dermatologists recommend Cetaphil and Aveeno
cleansers, for instance, which are reasonably priced
and available in most drugstores. Department store
cleansers are considerably pricier, but most cosmetics
companies offer free samples that you can try. If you
just don't feel clean without soap, choose mild soaps
that have added oils and fats, such as Neutrogena,
Basis or Dove. Avoid deodorant and antibacterial
detergents, which are especially harsh. You might want
to experiment with several brands until you find one
that works particularly well for you. A good rule of
thumb is that your skin should feel soft and smooth
after cleansing, never tight or dry. Try to use soaps
and cleansers of any type only on your face,
underarms, genital area, and your hands and feet.
Don't scrub, rub or soak in the tub. You've heard that
last one before, but it bears repeating. As for the
first two, it's best to use your hands or a cleansing
sponge on your face instead of a washcloth. Although a
cloth can help remove (exfoliate) dead cells, it may
be too irritating for very dry skin. After washing,
pat or blot your skin until it's just barely dry, then
moisturize immediately to help trap water in the
surface cells.
Moisturize, moisturize, moisturize. Nearly 9,000
cosmetic, hair, and skin care products were introduced
in the United States in 2003 alone. Many of these were
moisturizers of one sort or another. And it's not only
baby boomer women with lots of disposable income who
are driving this trend — men, teens and even children
account for an increasingly large share of the skin
care market. What's more, most contemporary
moisturizers bear little resemblance to your mother's
cold cream. Instead, they're highly sophisticated
products that tread the fine line between cosmetics
and drugs. Many contain ingredients that claim to
boost your body's production of collagen and elastin,
plump up wrinkles and fill in lines, paralyze muscles,
unblock pores, and exfoliate dead skin cells.
All about moisturizers
Given the array of products, the broad audience to
which they're targeted, and the even broader price
range — moisturizers can cost from less than $10 to
more than $500 — how do you choose the right one?

The best place to start may be to understand the
different types of moisturizing agents and what they
do. On the most basic level, moisturizers hold water
in the stratum corneum. They also act as a temporary
barrier, allowing damaged surface cells time to repair
themselves. Many moisturizers contain some combination
of humectants and emollients, as well as other
ingredients:

Humectants. These are substances such as urea and
glycerin that attract water when you apply them to
your skin. But humectants need high humidity levels to
be effective, and even then, any water added to the
surface of your skin tends to evaporate quickly.
Emollients. These fill in the spaces between the cells
in the stratum corneum, helping replace lipids and
thus smoothing and lubricating rough skin. Emollients
are water-in-oil emulsions, which means that a small
amount of water is dissolved in an occlusive oil, such
as petrolatum, mineral oil or natural plant oils. If
you have mature or very dry skin, your best choice may
be a water-in-oil moisturizer, which will be tend to
be heavier and richer than other moisturizers. Most
creams labeled night creams have water-in-oil
formulations. Oil-in-water moisturizers, on the other
hand, are primarily water and have a light, nongreasy
feel. These may be a better option if you are younger,
your skin tends to break out, or you have mild or
occasional dryness.
Vitamin A. Retinol and retinyl palmitate are forms of
vitamin A that may be converted in the skin into
retinoic acid, the active ingredient in the
prescription creams Retin-A, Renova and Tazorac.
Retinoic acid helps keep pores clear and has been
shown to improve some of the damage caused by sun
exposure.
Alpha hydroxy acids. These encourage skin cells to
exfoliate properly and have proved effective in
treating some forms of ichthyosis.
Antioxidants. Vitamins such as C and E can help
protect and repair skin exposed to pollutants and UV
rays.
Keep in mind that many of these ingredients can be
drying and irritating to your skin, and you may want
to talk to your dermatologist before trying products
that contain them. Preservatives and fragrances also
can dry and irritate sensitive skin, so it's best to
look for creams that are fragrance-free and contain as
few preservatives as possible. Preservatives that seem
to cause problems for many people include
quaternium-15, imidazolidinyl urea and propylene
glycol.

Many moisturizers also contain sunscreen, hydrating
your skin and protecting it from UVA and UVB radiation
in one easy step. But combination creams may not
always moisturize or protect against sun damage as
well as individual products do. In addition, some
companies make extra-rich moisturizers that claim to
shield you from the elements better than ordinary
creams do. With names like flight cream and
high-altitude cream, they may or may not offer extra
protection against cold, dry air.

Apply any moisturizer as often as needed, especially
after bathing, showering or washing your face, before
exercising outdoors in cold weather, and every time
you wash your hands. Although often ignored, your
hands are more exposed to the elements, to soaps and
to chemicals than is any other part of your body.

Over-the-counter wrinkle creams: Miracle or marketing
myth?
Tretinoin (Topical)

raasm007 · 09-23-2005, 10:51 AM

These other measures may also help keep your skin
healthy:

Moisturize your house. With your home thermostat set
high and your central heat blasting, your home may
stay warm and cozy. But hot, dry indoor air can parch
sensitive skin and worsen itching and flaking. As a
rule of thumb, keep your house between 68 and 75 F and
use a humidifier to maintain moisture levels at 40
percent to 50 percent. Tabletop humidifiers usually
moisturize the air in a single room and require
frequent fillings, sometimes several times a day. They
also need careful cleaning to prevent the growth of
bacteria and fungi in the tank. The bedroom may be the
best place for this type of humidifier — your skin is
hydrated as you sleep. Although it's a more costly
option, you may want to consider a humidifier that's
built into your forced air heating and cooling system,
especially if you have severely dehydrated skin or
live in a climate that's dry year-round.
Choose fabrics your skin loves. Natural fibers such as
cotton and silk feel wonderful and allow your skin to
breathe. But wool, although it certainly qualifies as
natural, can irritate even normal skin. If your skin
is already sensitive and dry, you may need to forgo
cashmere sweaters and pashmina scarves and choose
other fabrics for winter. And when you wash your
clothes, try to use detergents without dyes or
perfumes, both of which can irritate your skin. Look
for these products in the grocery store or choose
fragrance-free detergents in natural foods stores.
Get your omega-3s (essential fatty acids). Low-fat
diets may help your waistline, but they do nothing for
your skin, which needs the right kinds of lipids,
especially omega-3 fatty acids, to function properly.
Your body doesn't produce omega-3s — instead you
obtain them from food or supplements. The best dietary
sources are fatty fish or fish oil capsules —
particularly salmon and salmon oil — flaxseeds and
flaxseed oil, walnuts, and soybean and canola oils.
Some dark green leafy vegetables such as spinach, kale
and broccoli contain modest amounts of omega-3s.
Incorporating these foods into your diet helps keep
skin soft and supple, but it does even more for your
overall health. Omega-3s significantly lower
triglyceride levels and reduce your risk of heart
attack and stroke. They also lower blood pressure and
may reduce the pain and inflammation of rheumatoid
arthritis.

Sorry...couldn't post in a single topic...as it was showing that "too many characters"