Dry skin is common and has various causes. Anyone can have dry skin; in the Western world, the main cause is the luxury of a daily hot shower . Warm water, especially hot water or soap and water , washes away the skin's natural oils. The body replenishes this oil through sebum production, but sebum production varies from person to person and decreases with age . With frequent or hot showers, the sebaceous glands can no longer keep up, resulting in dry skin.
High room temperatures and low humidity exacerbate dry skin. These conditions are common in winter when heaters are turned up, but also in overheated hospitals and nursing homes. Atopic eczema
patients
also have dry skin. This is a characteristic of this condition. Dry skin also occurs in hereditary forms of extremely dry skin called ichthyosis (fish skin) (because the flaky skin can sometimes resemble fish scales). Medicines can also cause dry skin (isotretinoin and Neotigason, hormones, cell growth inhibitors).Causes of dry skin:- showering too often or too hot
- using too much soap
- air that is too dry
- predisposition
- older age
- atopy (filaggrin deficiency)
- ichthyosis syndromes
- medications (including retinoids)
In recent years, it has become clear why atopic eczema patients so often have dry skin. Skin cells have a rounded shape at the bottom of the skin, but as they move towards the surface, they become more flattened. These flattened skin cells are stacked on top of each other in layers. It is precisely these closely packed layers of skin cells that create the barrier. They prevent the skin from drying out and protect it from the effects of water, soap, and chemicals. A protein called filaggrin plays a role in the process in which the round cells transform into flat cells . Some atopic eczema patients have too little filaggrin in their skin, and this is hereditary. This filaggrin deficiency causes dry skin and a poor skin barrier. Tar ointments can restore the skin barrier, according to recent research at the University of Nijmegen. That might explain why tar ointments help with atopic eczema and chronic hand eczema.WHAT ARE THE SYMPTOMS OF DRY SKIN?This hardly needs explaining. Dry skin doesn't look smooth, but rather flakes of small or large scale. Sometimes, a fine snow of flakes is released when you rub it. Cracks can develop. Sometimes, a pattern of cracks appears, resembling old leather. This is also called a cracked appearance. Eczema can easily develop in such an area of dry, cracked skin, called cracked eczema or asteatotic eczema (asteatotic doesn't mean oily, but dehydrated). Dry skin can occur anywhere on the body but is most common on the flanks, upper arms, and lower legs. The face, scalp, and creases are better protected from dehydration because they contain many sebaceous glands.
Dry skin with atopic eczema
Dryness eczema (crackle eczema)
HOW CAN YOU BEST TREAT DRY SKIN?Advice for patients with dry skinDo not bathe or shower excessively (more than once a day) or too hot. Atopic eczema patients used to be told not to shower at all, but that's going too far. It is responsible to shower, but not too hot, not too long, and not to use too much soap (soap really only needs to be on your hair, armpits, groin, and genitals). For atopic eczema patients, apply a light, moisturizing cream or lotion to their skin immediately after showering. You can also use bath oil in your bathwater or shower; this leaves a film of oil on the skin. Atopic eczema patients should also keep their skin in good condition for the rest of the day and apply another moisturizing product as needed. Keep the room temperature low and the relative humidity not too low.Ointments, creams, lotions and other products for dry skinAnyone with dry skin will need to apply an ointment, cream, or lotion that contains fat. Hundreds of different products are available for the care of dry skin. These don't necessarily have to be prescription creams or ointments from the pharmacy. The cosmetics industry sells complete skincare lines that are all better made, spread better, smell better, absorb much faster, and are often cheaper than prescription ointments and creams.
The only disadvantage of these cosmetic products is that they may contain substances to which patients can be allergic, such as lanolin , perfumes , and other substances that can cause allergies. Patients with atopic eczema are particularly at risk of developing allergies (because they use many skincare products and because their skin barrier is disrupted). Approximately 6% of patients with atopic eczema appear to have an allergy to fragrances, which is quite a lot. Allergies to wool alcohols, a component found in many creams and cosmetics, are fortunately much less common (affecting approximately 0.6% of eczema patients).
However, those without a contact allergy can easily find what they're looking for in the wide range of cosmetics available. It is advisable to buy a product from a reputable brand. Examples include Nivea , Zwitsal , Balneum , Neutral , Dove , Vaseline Intensive Care , Eucerin , Dermolin , Physiogel , etc. Only buy products whose packaging clearly states their ingredients. If you have been diagnosed with a contact allergy, you should know exactly what you're allergic to, including all the synonyms for these substances, and carefully read the labels of everything you buy. Manufacturers sometimes change the composition of their products, so be sure to check this regularly. Unilever, the manufacturer of several brands such as Dove, Neutral, Zwitsal, and Vaseline Intensive Care, has a website (what's in our products) where you can look up the exact ingredients of each product. If you're unsure whether a product is safe, try it on your elbow crease for a week first. The elbow crease is sensitive skin; if no eczema develops there, it's safe to apply it to the rest of your body.
Products for dry skin from the cosmetics industry:
Hundreds of different products are available. Below is a selection of some reputable and reliable products from well-known brands:
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| Nivea cream |
Nivea Soft moisturizing cream |
Nivea Body Lotion |
Nivea Shower Lotion and Milk |
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| Zwitsal cream |
Zwitsal Dry Skin cream |
Zwitsal Body Lotion |
Zwitsal Bath Oil |
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| Dove cream |
Dove Intensive cream |
Dove Body Lotion |
Dove Shower Cream |
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| Dermolin body cream |
Dermolin restorative cream |
Dermolin body lotion |
Dermolin day and night cream |
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| Neutral baby cream |
Neutral face cream |
Neutral body lotion |
Neutral baby bath oil |
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| Eucerin pH5 body cream |
Eucerin restorative cream |
Eucerin body lotion |
Eucerin bath oil |
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| Vaseline pure |
Vaseline Intensive Rescue |
Vaseline Intensive body lotion |
Vaseline Intensive Rescue |
Dermolin:Dermolin body cream, Dermolin restorative cream, Dermolin body lotion, Dermolin day and night cream.Dove:Dove Beauty Moisture Day Cream and Night Cream, Dove Body Butter Intensive Nourishment, Dove Body Cream, Dove Body Lotion, Dove Body Milk Essential Nourishment, Dove Hand Cream, Dove Visible Care Shower Cream, and others ( www.dove.com ).Eucerin:Eucerin pH5 Soothing Ointment, Eucerin pH5 Body Cream, Eucerin pH5 Body Lotion, Eucerin pH5 Bath Oil, Eucerin pH5 Shower Oil, Eucerin AtoControl Face Care Cream, Eucerin AtoControl Acute Care Cream, Eucerin AtoControl Body Lotion and Eucerin AtoControl Bath and Shower Oil, Eucerin Complete Repair Lotion, Eucerin Restoring Hand and Foot Cream, and others ( www.eucerin.nl ).Neutral:Neutral body milk (body lotion), Neutral baby cream, Neutral face cream, Neutral baby bath oil, Neutral baby skin oil ( www.neutral.nl ).Nivea:Nivea cream, Nivea Soft moisturizing cream, Nivea Nourishing Body Milk, Nivea Sensitive Body Lotion, Nivea Happy Time Body Lotion, Nivea Pure & Natural Body Lotion, Nivea Pure & Natural Firming Body Cream, Nivea Express Body Lotion, Nivea Express Hydration Hand Lotion, Nivea In-Shower Body Lotion and Milk, Nivea Pure & Natural Body Milk, Nivea Pure & Natural Hand Cream, Nivea Repair & Care Restorative Body Lotion, Nivea Repair & Care Body Cream, Nivea Repair & Care Hand Balm, Nivea Silky Body Milk, Nivea Silky Airy Body Cream, Nivea Silky Hand Cream, and others ( www.nivea.nl ).Physiogel:Physiogel cream, Physiogel body lotion, Physiogel AI lotion and cream, Physiogel shampoo ( www.physiogel.com ).Vaseline Intensive Care:VIC Intensive Rescue Body Lotion Essential Moisture, VIC Intensive Rescue Body Lotion Fragranced, VIC Intensive Rescue Protective and Repairing Lotion, VIC Intensive Rescue Repairing & Protective Lotion unscented, VIC Intensive Rescue Moisturizing Foot Cream, VIC Intensive Rescue Moisture Locking Cream, VIC Intensive Rescue Illuminating and Repairing Balm, VIC Intensive Rescue Soothing Hand Cream, Vaseline, Vaseline Body Lotion Moisturizing, Vaseline Cocoa Butter Deep Conditioning Body lotion, Vaseline Cocoa Butter Smoothing Body Butter, Vaseline Cocoa Butter Vitalizing Gel Body Oil, and others ( www.unilever.nl ).Zwitsal:Zwitsal cream, Zwitsal Dry Skin cream, Zwitsal Body Lotion, Zwitsal Bath Oil, and others ( www.zwitsal.nl ).
Products for dry skin that can be prescribed by prescription (via the pharmacy):
Dermatologists and general practitioners can also prescribe ointments and creams for dry skin. These products are dispensed by the pharmacy. Sometimes the pharmacy does not have them in stock and they have to be ordered from a wholesaler or made. Most of these prescription ointments and creams are covered by health insurance. If in doubt, ask your pharmacist or health insurer if they are covered. Prescription ointments and creams are simpler in composition than products from the cosmetics industry. They do not contain all the ingredients that make them spread easily, absorb quickly, do not spoil quickly, and smell pleasant. This is intentionally not the case, as these products are also intended for patients with allergies to fragrances, wool alcohols, or preservatives.CreamsLanette cream I FNA (cremor lanette I FNA)
Lanette cream II FNA (cremor lanette II FNA)
Cetomacrogol cream FNA (cremor cetomacrogolis FNA)Very light greasy creamsCetaceum 5% in cetomacrogol cream
Cetomacrogol cream with 10% liquid paraffin (25-80 mPa.s)
Vaseline 10% in cetomacrogol cream FNA
Vaseline 10% in lanette cream I FNALightly greasy creamsVaseline 20% in cetomacrogol cream FNA
Vaseline 20% in lanette cream I FNAFat creamsVaseline cetomacrogol cream FNA (cremor vaselini cetomacrogolis)
Vaseline carbomer cream (vaseline 20%, paraffin 10%, lanette SX, water)
Vaseline lanette cream FNA (cremor vaselini lanette FNA)Fat creams with 50% fatVaseline 25%, paraffin 25% in lanette cream
Vaseline 50% in cetomacrogol cream FNA
Vaseline 50% in lanette cream FNAOintmentsLanette ointment FNA (unguentum lanette FNA)
Cetomacrogol ointment FNA (unguentum cetomacrogolis FNA)
Paraffin - vaseline aa (paraffin liquidum 110-230 mPa.s - vaseline aa)
Paraffin perliquidum - vaseline aa (paraffin perliquidum 60-80 mPa.s - vaseline aa)
Cooling ointment FNA (unguentum leniens)
Cooling ointment without rose oilFNA
Cooling ointment with 20% VaselineBath oilsSoya Oleum Emulgatum (soy bath oil)
Balneum Hermal bath oil (slightly greasy bath oil)
Oilatum Neutral bath oil (mineral bath oil)
Arachidis Oleum Emulgatum (peanut bath oil)
Zwitsal caring bath oil (soy oil and canola oil)
Zwitsal medicinal baby bath oil (soy oil)Bath oils, extra greasyBalneum Hermal extra oily (bath oil extra oily)Anti-itch bath oilBalneum Hermal antipruritic (antipruritic bath oil (with polidocanol))Other products (gels, creams, lotions)Bath and shower cream 'dr. de Swaan' (bath cream, slightly greasy)
Shower cream 'dr Schulten' (greasy shower cream)
Bath and shower lotion UMCG
Balneum Hermal baby cream extra greasy (baby cream extra greasy)
Balneum Hermal cream extra greasy (cream extra greasy)
Balneum Hermal shower gel (shower gel slightly greasy)
Zwitsal baby bath milk (vernix protection)Wool grease-free productsCooling ointment (unguentum leniens FNA).
Paraffin - Vaseline AA.
Vaseline album.
Patients with a wool alcohol allergy can usually also safely use Physiogel products. In addition, there are many corticosteroids with a fatty base that are wool alcohol-free.Hypoallergenic cosmeticsThe Physiogel product line is expensive and not covered by insurance, but some patients with contact allergies will have no choice but to purchase these products. They are available at pharmacies, drugstores, and various online retailers. If a patient has confirmed contact allergies, they can submit a letter of explanation to their health insurer to claim the costs; some will then reimburse the costs.
Physiogel cream: 75 ml tube (approximately €14) and 150 ml (approximately €23).
Physiogel body lotion: 200 ml bottle (approximately €22).
Physiogel AI lotion: 200 ml (approximately €28) and 50 ml cream (approximately €24).
Physiogel shampoo: 250 ml (approximately €12).
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| Physiogel cream |
Physiogel AI cream and lotion |
Physiogel body lotion |
Physiogel shampoo |
The Dr. Leenarts product line includes several care products with minimal allergenic substances, primarily aimed at babies and toddlers. They are available online ( www.drleenarts.com ) and at several drugstore chains. The new Dr. Leenarts Mountain Ointment contains wool alcohols.
Dr. Leenarts Baby Bottom Ointment: 100 ml jar (approximately €12).
Dr. Leenarts Dry Skin Ointment: 100 ml jar (approximately €11).
Dr. Leenarts Bath Lotion: 200 ml bottle (approximately €15).
Dr. Leenarts Chickenpox Lotion: 50 ml bottle (approximately €17).
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| Baby bottom ointment |
Dry Skin Ointment |
Bath lotion |
Chickenpox Lotion |
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