What you need to know about the skin and its functions
December 12, 2025Written by Dr. Markos Michelakis
Dermatologist-Venereologist (Aesthetic Dermatology-Dermatosurgery).
Dry skin is a very common dermatological condition characterized by widespread or localized itching, hard and dry skin, and red spots resembling a rash, primarily appearing on the extremities but also on the back, abdomen, and friction-prone areas of the body. Although precise epidemiological data on its prevalence are not available, it is estimated that at least 30% of the population will experience it at some point in their lives.
Dry skin does not have a single cause but can result from external and internal factors.
- External factors are the most common underlying cause and include cold weather combined with low humidity and the use of central heating. Other external factors are frequent washing with harsh soaps (which remove skin sebum), bathing or showering with hot water, excessive use of disinfectants and cleaning agents (especially those containing alcohol), insufficient moisturizing with emollient creams, or wearing fabrics that irritate the skin (e.g., wool, linen).
Most of these factors are more common in winter, which is why many people consider dry skin a winter problem. However, it can appear in individuals with a predisposition and is not strictly seasonal. Without predisposition, the skin may become slightly drier in winter, but not enough to cause a significant problem.
Internal Factors
Predisposing (internal) factors for the development of dry skin include:
Age. It is more common in older adults because sebaceous glands shrink with age, producing less sebum to lubricate the skin, while keratinocytes are overproduced, creating the characteristic dry, dehydrated skin of older individuals.
Heredity. A classic example of a hereditary condition that can manifest mildly or severely is ichthyosis, which is characterized by dry, scaly skin.
Family history of dry skin.
Personal history of certain other skin conditions, such as atopic dermatitis, eczema, and psoriasis.
Dry skin is also more common in individuals with certain systemic diseases, such as hypothyroidism, diabetes, deficiencies of specific vitamins and trace elements (e.g., vitamin A, zinc), Sjögren’s syndrome, HIV/AIDS infection, lymphoma, and various forms of cancer or cancer treatments, as well as renal insufficiency.
It is also more frequent in menopausal women due to hormonal changes, and in patients taking certain medications, particularly for hypertension (e.g., diuretics), cholesterol, or acne (e.g., retinoids, isotretinoin). Anti-androgen therapy and chemotherapy can also make the skin drier and more sensitive.
Diagnosis
Most patients do not have the same degree of dryness across the entire body. Moist areas, such as the groin and armpits, usually do not show dry skin, while other areas can be affected. Dry skin creates a feeling of tightness or stiffness, accompanied by burning, “prickling,” or itching, and it can peel, appear erythematous, speckled, rough, and/or scaly.
Typically, patients with dry skin should be evaluated by a dermatologist for proper medical history assessment and differential diagnosis. It is more common in older adults, whose skin tends to atrophy—becoming thinner and thus more vulnerable to dryness. Individuals frequently exposed to harsh environmental conditions (e.g., cold, central heating, harsh soaps, disinfectants) can benefit from a preliminary assessment by other healthcare professionals (e.g., pharmacists) to initiate first measures (emollients, moisturizing creams).
However, if dry skin persists and is accompanied by other symptoms, dermatological examination is required. Examination is also necessary if itching occurs without a rash or if symptoms are severe enough to disturb sleep. Special attention should be given to skin that begins to develop wounds (either spontaneously or from scratching), as there is a risk of infection.
In more challenging cases, when clinical examination and medical history are insufficient for a definitive diagnosis, a skin biopsy may be recommended to determine the cause and guide treatment.
Treatment
Treatment depends on the cause of the problem. Initial self-care measures include avoiding outdoor activities in cold and windy weather, maintaining appropriate indoor temperatures year-round, and avoiding harsh bath products. Limit prolonged exposure to water and friction in the shower (no more than 10 minutes). Avoid hot water. After bathing, avoid powders and apply emollient creams to the skin. Moisturization should be repeated throughout the day. Pharmacists can also recommend mild, fragrance- and alcohol-free cleansing products to avoid harsh soaps and disinfectants. Regarding clothing, it is preferable to wear fabrics that touch the skin only made of cotton. Studies have shown that using tested soft fabrics that contact the skin reduces friction and helps prevent dry skin.
If dry skin is due to a medical condition, further treatment will be determined by a physician. If it is caused purely by external factors, the main therapeutic goal is to relieve itching, prevent water loss responsible for skin dryness, and restore hydration.
In mild cases, this is achieved using emollient and moisturizing products (lotions, creams). In more severe cases, intensive moisturizing products may be needed (characterized by the fact that they do not flow from the bottle or jar when tilted).
If itching persists, it is evident that the patient requires medical advice, possibly including local and systemic treatment as well as laboratory testing.
***** Fujimura T, Takagi Y, Sugano I, et al. Real-life use of underwear treated with fabric softeners improved skin dryness by decreasing the friction of fabrics against the skin. Int J Cosmetic Sci. 2011;33:566-571.
SOURCES: http://www.medicinenet.com/dry_skin/page3.htm
https://www.uspharmacist.com/article/causes-and-treatment-of-dry-skin
