The crux of the problem with eczema and dry skin, no matter what the cause, is that it has a damaged skin barrier. If you don’t repair the barrier, your skin won’t heal. Therefore, the dryness gets worse, the eczema gets worse and it’s a cycle until you intervene with the right skin care choices. When your skin is dry and the barrier is damaged:
- Skin moisture is constantly lost.
- Exposure to harsh soaps and skin cleansing practices, solvents, chemicals that dissolve skin lipids, and drying weather continue to worsen the barrier damage.
Whether you were born with a fragile skin barrier (such as atopic dermatitis type of eczema) or you damaged it by exposure to harsh chemicals or weather (irritant dermatitis type of eczema), or you have an allergic reaction to something you touched (allergic contact dermatitis type of eczema) – the result is that your skin has a weakened barrier.
The progression you notice on your skin is first roughness, scale and subtle itch. As the process worsens, the skin starts to itch more, then hurt. The skin also becomes inflamed. Tender cracks form, skin fluids start to leak out and the skin may even get little bubbles of fluid that rupture. Ultimately skin infection can develop and the inflammation escalates rapidly. This is an eczematous dermatitis.
To treat dry, eczema-prone skin, the trick is in the details of your choices for soap and moisturizer. I’ll give you good recommendations below. First, let’s clear up some myths and facts.
Does Drinking Water Help Treat Dry Skin?
Drinking water doesn’t help heal dry skin. Contrary to popular belief, dry skin is not due to low water intake. The water you drink does not get to the outer surface of your skin where dryness occurs. That would be like thinking that taking a bath quenches your thirst – it just does not happen. Your inner hydration level and your skin hydration level are not the same. Only in the most severe dehydration is skin affected, and that is not the dryness people refer to when they have dry skin. Dry skin is due to skin barrier damage with loss of the micro elements of skin moisture.
Why Is Hot Water Bad for Dry Eczema Prone Skin?
Hot water strips oils. Whether it’s your pots and pans or your skin, oils are removed better with hot water. Even using a gentle cleanser isn’t enough; you need to control the water temperature. Use warm to cool water, NOT hot water. You need to protect your precious skin oils from over-cleansing, and that means you should not expose your skin to hot water until skin dryness and barrier strength have healed. Hot water also increases skin blood flow and this brings in the building blocks for inflammation. Hot water makes eczema worse!
What Else Can Strip Skin Oils?
- Soap and cleanser residue left on skin will continue to dissolve oils from your skin layers. Rinsing skin well after cleansing is important. Take the time to remove all soap residue, even from gentle cleansers. This is why dry hand problems often start between the fingers where cleanser is often not rinsed well.
- Exposure to harsh solvents will also remove oils. Protect skin by wearing gloves and protective clothing. Solvents include cleaning products and other chemicals like paint thinner, nail polish remover etc.
- Harsh and windy weather extremes will pull moisture out of skin too. Protect eczema and dryness prone skin from extreme weather by wearing gloves, mufflers and other protective clothing.
How Do Moisturizers Heal Dry Skin, Improve Skin Barrier Strength and Heal Eczema?
Moisturizers trap water that your skin needs to heal. This works best when you drench your skin with water while bathing or washing, and then trap it with the immediate application of a moisturizer within the “magic 3 minutes” for optimal skin hydration. Oil and water binding ingredients prevent water from evaporating as it dries. After toweling off excess bath water, hurry and apply moisturizer. You can also apply moisturizer to dry skin that has not been recently washed, but this is not nearly as healing as applying moisturizer after water contact.
Oil in your moisturizer will also seep into your skin to help replace lost skin oils. Water binding ingredients will hold water in the outer layers of your skin. This combination heals dry skin, improves skin barrier and helps to control eczema.
How to Choose the Best Moisturizers and Lotions to Heal Dry Skin and Eczema?
Choose products that contain mostly water-binding ingredients and water trapping oils. Look for:
- Oils (My preferences include botanical oils that contain healing properties of their own: coconut, avocado, apricot, olive, sunflower oil, shea butter, and jojoba oil. Petrochemical oils such as mineral oil and petrolatum have great scientific evidence as healing moisturizing oils too).
- Hyaluronic acid
- Components of the skin’s natural moisturizing factor (NMF) such as sodium PCA
How Long Does It Take Dry Skin to Heal?
Weeks to months! Yep, you need to take good care of your skin for up to two months or more depending on the depth and extent of the damage. This is because you need to:
- Stop the damage
- Allow the inflammation of eczema to subside
- Allow the top two barrier layers to repair and to heal themselves with all the structural integrity of healthy skin
That doesn’t happen in a matter of days. Your symptoms of dryness, and even eczema may improve more quickly, but realize you need to keep up the good work for months. Then, once healed, don’t slide back into whatever caused the dryness in the first place. Keep using the good skin care routine and your healthy skin may be able to hold up to warmer water and the occasional soapy dish duty without gloves. Help your skin to provide you with the good protective barrier work that nature intended.
What Are the ‘Dermatologist Approved’ Products and Care That I Depend On For My Dry Skin And Eczema Prone Patients – And My Family Who Share This Problem?
You can combat dry facial skin by using the following products.
Facial Cleansing Products:
- Daily Facial Moisturizer for Dry to Normal Skin
- Daily Facial Moisturizer for Oily to Normal Skin
- All Natural Face and Body Lotion
- All Natural Face and Body Butter
- Suntegrity 5 in 1 BB Cream SPF 30
Help relieve hand dryness and prevent hand eczema with these products.
Help heal dry, rough and itchy skin anywhere on the body with these products.
Please note that if your skin is severely inflamed, blistery-weeping, and possibly infected, you may need topical cortisone creams and antibiotics, so please see your personal dermatologist for advice.
Verdier-Sévrain S, Bonté F. Skin hydration: a review on its molecular mechanisms. J Cosmet Dermatol. 2007 Jun;6(2):75-82.
Rawlings AV, Harding CR. Moisturization and skin barrier function. Dermatol Ther. 2004;17 Suppl 1:43-8.
Lodén M. Role of topical emollients and moisturizers in the treatment of dry skin barrier disordersm, Am J Clin Dermatol. 2003;4(11):771-88.
Imokawa G. Stratum corneum lipids serve as a bound-water modulator. J Invest Dermatol. 1991 Jun;96(6):845-51.
Cho HJ. Quantitative study of stratum corneum ceramides contents in patients with sensitive skin. J Dermatol. 2011 Oct 31.
Ivan D. Cardona, MDcorrespondenceemail, Leland Stillman, MD, Neal Jain, MD, Does bathing frequency matter in pediatric atopic dermatitis? Annals of Allergy, Asthma & Immunology, July 2016 Volume 117, Issue 1, Pages 9–13