Cracked heels, chapped lips, scaly legs, fissured hands, skin so tight and parched it practically hurts to smile. All can be brought on by dry, hot Santa Ana winds common in the fall or by the cold weather and heated rooms of winter — and Angelenos have experienced a taste of both in the last couple of weeks. Even without harsh weather conditions, just spending time in one of Southern California's desert microclimates can be hard on skin.
But there are some solutions for soothing the dryness.
First, know your enemy
It's not just the outdoors — sun, wind and desert — that can cause dry skin. So can indoor heating — including in your car. Other culprits include aging, medication (such as antihistamines, antispasmodics and acne medication), thyroid conditions, diabetes, certain cancers (such as lymphoma), chemicals, diuretics, too much hot water and soap, bubble baths and bath products with heavy fragrances.
More than dry
Sometimes, what people perceive as dry skin is something more. Redness, peeling and drying around the mouth and forehead, flaking on eyebrows or in the corner of the nose may seem like simple dryness, but could be seborrheic dermatitis, says Dr. Karyn Grossman, a cosmetic dermatologist who practices both in Santa Monica and New York City. It's "like dandruff on your scalp, but it's on your face, triggered by yeast on the skin and inflammation," she says. Antifungal medications and steroid creams are among the treatments, but it's important to see a dermatologist for an accurate diagnosis and treatment plan.
Other clinical reasons for dry skin include eczema, psoriasis and infections.
"Eczema, psoriasis and seborrhea are each specific skin conditions," says Dr. Peter Lio, assistant professor of clinical dermatology at Northwestern University and director of the Eczema Care and Education Center in Chicago. Moisturizers can help, but medical advice is necessary too.
Extremely dry skin is uncomfortable, sometimes itchy and, when there is cracking, painful. "Scratching the itch can lead to areas of open skin; these areas, as well as fissures, can become portals to infection, which can then lead to serious complications," Lio says. "In severe cases of dry, itchy skin, sleep disturbance can be significant, and I have had patients tell me that they want to end their life due to the itch."
Julie Block, president of the National Eczema Assn., says more than 30 million Americans have eczema, including up to 20% of young children.
Putting the moisture back
Adding more moisture to skin usually helps, no matter the cause of dryness. Grossman recommends adding the moisture with a humectant and then sealing it with a product that will keep the moisture in.
Humectants include hyaluronic acid, glycerin, urea, lactic acid and lanolin. Grossman adds that a camomile tea compress and colloidal oatmeal baths also hydrate skin. She suggests SkinCeuticals hydrating B5 gel ($67) underneath a regular facial moisturizer. "If you're really dry, you can then use Vaseline all over your face. We use Aquaphor — it's a little more elegant," she says.
Besides petroleum jellies such as Vaseline, other sealants include dimethicone, shea butter and certain oils.
For dry hands and feet, Grossman suggests applying a moisturizer and then Aquaphor or Vaseline before bed. They work best if you soak or shower first. Slip on white socks and gloves and settle down for the night.
"There are wonderful, inexpensive, safe and effective moisturizers that can be obtained at most drugstores," says Lio. Among his recommendations — and approximate prices we found — are Aquaphor ($16.99), Eucerin Plus ($9. 99), Vanicream ($11.99), CeraVe Cream (15.99), Cetaphil Cream ($13.49) and Aveeno lotion ($7.99). Should these fail — or if symptoms are severe or involve itching or a rash — see a physician.
In addition, Grossman recommends Vaseline Sheer Infusion ($9). "It has humectants and sealants in it. And I use Johnson's baby oil gels ($4.29) on my children a lot."
Soap alternatives include Eucerin calming body wash (7.99), CeraVe hydrating cleanser ($10.61) and Free & Clear liquid cleanser ($8.60). Grossman also recommends Dove products.
Natural oils can be an option, though most modern moisturizers contain emollients that will do a better job of humidifying the skin.
But jojoba oil, primrose oil, omega-3 and olive oil are also options, and "coconut oil beats out olive oil as an anti-microbial topical," Lio says. He's also a fan of organic sunflower seed oil for its anti-itch properties for those with extremely dry skin.
If you have sensitive, dry skin, avoid topical vitamin E. "Some people develop contact dermatitis from it," Grossman says.
Makeup artist Pati Dubroff, celebrity beauty artist for Clarins, recommends using Clarins facial oils such as the brand's Santal & Blue Orchid Face Treatment Oil ($49, Us.clarins.com), on a moist face. But don't wear it underneath makeup or out in the sun. "I religiously wear it at night," Dubroff says. "Or I wear it in the daytime when I'm inside and the heat's blasting because its winter. Even in L.A., we have the heaters on at night and you wake up and you're just parched." She also wears the oils when she travels by plane.
For extremely dry skin or eczema, Dubroff also recommends Gabriel Couzian products, which are available at Gabrielcouzian-usa.com.
Tender, loving care
"Your body has a natural layer of lipids on your skin that kind of keep the outside world out and the inside world in," Grossman says. "Anything that disrupts that can aggravate dry skin or sensitive skin." For protection, wear rubber gloves when washing dishes, don protective outerwear in cold weather, take shorter showers in cooler water, use mostly nonsoap-based gentle cleansers that don't foam a lot and have little to no fragrance. "I tell people to limit soap to the areas that build up bacteria — the armpits, under the breasts, in the groin area," although soap can irritate mucous membranes, so be cautious. Reapply moisturizer to dry areas, including elbows and knees, two or three times a day. For the most part, dry skin sufferers should avoid microdermabrasion and peels.