Remedies for severely dehydrated skin

What needs fixing?

These remedies address dry skin caused by moisture loss; dry patches caused by eczema or another condition can also need treatment for that condition. Dry skin loses too much water and oil. Its outer layer holds less moisture, and its protective barrier becomes less effective. Severe dryness can leave skin rough, scaly, inflamed and cracked. Moisturizers help by adding moisture and reducing water loss, not just by making flakes less visible.234

Which moisturizer should you choose?

Moisturizer is a category that includes gels, lotions, creams and ointments, which gives the shopping aisle several ways to repeat itself. For severe dryness, start with a cream or ointment rather than a light lotion. Choose a product intended for the area you are treating: your face and body can need different moisturizers.25

Which ingredients help?

Moisturizers combine ingredients with different jobs. Humectants attract and hold water in the outer skin layer; glycerin is one example. Occlusives reduce water evaporation by forming a protective layer; examples include petrolatum, mineral oil and dimethicone. Emollient ingredients soften and smooth the skin. Ceramides are fats that help hydrate skin, and hyaluronic acid is another moisturizing ingredient to look for. A cream can combine these functions, so treating dryness does not require a separate product for every job.27

Urea and lactic acid appear in treatments for dry skin, but they are not the best starting point for every severely dry patch. Urea and acidic preparations often sting scratched or cracked skin. Avoid adding an acid exfoliant to peeling skin; moisturizing is the priority. Choose fragrance free products rather than assuming that 'unscented' means the same thing.1237

How to wash and moisturize

1. 1Keep baths and showers to five to ten minutes, using warm rather than hot water.
2. 2Use a gentle cleanser free from dyes and perfumes. Apply only enough to remove dirt and oil, and use body cleanser where needed rather than covering every area in thick lather.
3. 3Pat dry with a towel instead of rubbing. Leave the skin slightly damp.
4. 4Apply moisturizer immediately. Smooth an emollient gently over the skin in the direction of hair growth rather than rubbing vigorously.
5. 5Reapply during the day whenever skin feels dry or tight, and after handwashing. Include moisturizing when you wake up and before bed.

Aim to apply an emollient at least three or four times daily while dryness is severe. Very dry skin can benefit from a greasy moisturizer every couple of hours. Keep a tube where you wash your hands so reapplication is easy. If ordinary soap leaves skin dry or itchy, a suitable emollient soap substitute is an alternative; it cleans without normal soap's foam.67

What should you stop using?

Stop cosmetic retinoids, fragranced products and alcohol containing skincare while addressing excessive dryness; hand sanitizer is an exception to the alcohol advice. Avoid exfoliating dry, peeling skin. Before buying an itch cream, ask a dermatologist, because some can worsen irritation. If a retinoid is prescribed, discuss the dryness with your prescriber rather than changing the treatment yourself.124

Protect skin between applications

Cold air, indoor heating, frequent bathing, detergents and rough clothing can keep dryness going. Use gloves for wet chores and protection from cold air. Wear loose cotton clothing, with a cotton or silk layer under rough fabrics. A bedroom humidifier can add moisture to dry air; clean it regularly to prevent mold. For exposed skin, use a broad spectrum, water resistant sunscreen with SPF 30 or higher, alongside shade and protective clothing. Apply petroleum jelly or a comfortable lip balm to dry lips.14

What if your skin is sensitive or oily?

For combination skin, moisturize dry areas rather than automatically applying a thick product across oily areas. Heavy, occlusive moisturizers can aggravate acne or inflame hair follicles. Choose a moisturizer labeled noncomedogenic, meaning formulated not to block pores. For sensitive skin, 'natural' or 'organic' is not a shortcut to avoiding reactions. Stop a moisturizer that causes a new rash and seek advice about persistent burning, stinging or irritation. A pharmacist can help you find a different texture or formula.267

What improvement should you expect?

Moisturizers soften skin, reduce dryness and support its protective barrier. Their therapeutic effects are greatest during the first six hours after application, which makes repeated use useful. Dryness can improve when contributing factors are controlled, but a tendency to dry skin can persist. Cost, availability and whether you tolerate the moisturizer all matter, because a bathroom shelf is not a participation trophy for skincare. Choose something you can use regularly rather than repeatedly switching products.47

When does severe dryness need medical care?

Book an appointment if dryness persists despite home care, keeps returning, or becomes painful, bleeding or very irritating. Cracks and open sores allow germs to enter. A clinician can check whether eczema, another skin condition, a medicine or a health problem is contributing. Evaluation can include your bathing habits, products, medical history and medicines. Some people need a prescription treatment for inflammation as well as moisturizer. Do not assume every scaly patch is simply short of moisture.45

If you use a steroid cream or another skin treatment, leave 20 to 30 minutes between that treatment and your emollient. Ask your doctor which to apply first. Separating them avoids diluting the treatment or spreading it onto skin that does not need it.6

Use emollients safely

Keep emollients and fabrics carrying their residue away from flames and cigarettes. This applies to products with or without paraffin, and washing does not completely remove the residue. Use a clean spoon or spatula to take moisturizer from a tub. Emollients can make baths and floors slippery, so clean spills and use a nonslip mat.6