John R. Tkach, M.D.
300 North Willson, Suite 203B
Bozeman, MT 59715
(406) 587-5442

Dry Skin Care

Patient Information Sheet

Let's talk about taking care of dry skin problems. What is the opposite of dry? The opposite of dry is wet. So, what's wet? Wet means water. Water is what makes the skin wet, not oil or grease. Cosmetic companies want you to think the opposite of dry is oily because they want you to buy their oil.

When your skin is too dry, it is lacking water. So, you have to add water to dry skin. If you soak in the tub or shower for about 5 minutes, the outer dead layer of skin, the stratum corneum, will absorb about 3 to 5 times its weight in water. It becomes completely wet in about 5 minutes in the bath. The problem is that the air in Montana is so dry most of the year that all the water evaporates back into the air in about ten minutes after getting out of the bath. Hot water and soap wash away your own natural skin oil, sebum. Your own natural oil seals the water into your skin. Bathing can actually make you drier that before you took a bath. The heat of hot tubs and saunas empties out the oil (sebum) from oil glands. You can see the sebum floating on top of the hot tub as a thin layer of scum. The emptied skin oil glands replenish their sebum supplies in about 12 hours.

Excessive dryness causes problems in that it makes the skin itchy, scaly, cracked, and inflamed. Such dry, scaly, inflamed skin can turn into a dermatitis. In its simplest form, we call it "asteatotic dermatitis" or "xerotic dermatitis" known commonly as "winter itch." Some other forms of dermatitis are aggravated by dryness such as "ichthyosis," "nummular eczema" and "atopic dermatitis."

Dry skin becomes worse with:

  1. Dry Weather (especially winter)
  2. Too many baths, baths lasting too long, and baths too hot.
  3. Soap

Dry skin is helped by taking fewer baths, shorter baths, and bathing with water that is less hot. If one small part of the body is dirty or smelly such as the armpit, you can scrub just that one part hard. It is not necessary to wash the whole body just because one small part is dirty. In this way, you can reduce winter bathing to every other day or every three days. You skin will tolerate more frequent bathing in the summer.

Dry skin is helped by avoiding strong soaps. It is my impression that soft water helps. Often it is possible to get clean without using any soap at all. Mild soaps include Basis, Dove, Cetaphil, Oil of Olay, Neutrogena, and Aveeno (oatmeal soap substitute). Some come in milder liquid soap form. Ivory soap is pretty good and cheaper.

Increasing the humidity of the air in your house helps dry skin. A desirable setting for the humidifier is 40%. Humidity above 40% condenses on the walls in cold Montana winters and causes the paint to peel. Humidity below 40% is less effective for combating dry skin.

How dry is it in Bozeman? In the winter at -20 F outside, the humidity in your house can be as low as 10%. The driest it gets in the desert in the southwest is 18%.

Use of Dry Skin Preparations

When your skin is too dry, it is lacking water. Therefore, it is necessary to add water to the dry skin. This is to no avail unless you seal the water in with a dry skin cream, lotion, or oil. People often ask me what is the best brand to buy. There is no best brand. Sorry. The best brand is what you like the best, what works for you, and fits your budget best.

When you get out of the bath, pat the dry areas with a towel rather than rubbing them completely dry with a towel. Leave little beads of water on your skin. Quickly take the dry skin cream or lotion or oil and rub it into the wet skin to seal the water in. Always remember that you add water first and the dry skin preparation second. It is usually not sufficient to add the dry skin preparation alone. You must add water first.

If cost is a problem, you can get by with Crisco, Fluffo, or Spry like you use for cooking. They are not very elegant. You have to rub pretty hard to get them to go into the skin. But they are cheap and work well. If you away from home and cannot get anything else, you can use these.

Bath Oil

There is a trick to using bath oil. If you put bath oil into a bathtub full of water, the oil will float to the surface. When you get into the bathtub, the oil then coats your skin before the water reaches it. This may actually make the dryness worse because it seals the water out and keeps it from entering your skin.

Instead, here is the proper way to use bath oil. Put the water in the tub first and soak for 5-10 minutes. Then add the bath oil to the bath water. The bath oil floats to the top. As you exit from the bath, the oil coats your wet skin and seals the water in. The difference is subtle but important for maintaining control of dryness.

Always keep in mind that the opposite of dry is wet. You must add the water first and then the dry skin preparation second to seal the water in.

The information provided in these patient information sheets is offered for general informational and educational purposes only; it is not offered as and does not constitute medical advice. In no way are any of the materials presented meant to be a substitute for professional medical care or attention by a qualified practitioner, nor should they be construed as such.

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