Xerosis is rough skin that flakes (peels) abnormally. It is synonymous with “dry skin”. Its causes are multiple. Solutions exist to improve the situation.

HOW IS XEROSIS CHARACTERIZED?

Xerosis is characterized by rough skin, frankly rough to the touch. The skin loses its elasticity, its suppleness, it is dehydrated. The flaking that accompanies it can appear in the form of small skins with “fine flakes” but also more coarsely in the form of “scales”. Xerosis is often associated with sensations of tightness or even burning or itching. In more severe cases, the skin can take on an inflammatory appearance (red patches) or be accompanied by eczema and lesions related to scratching. Xerosis is most frequently found on the hands, legs and back.

WHAT IS THE MOST COMMON CAUSE?

Xerosis is only a symptom with multiple causes.

The most common cause is dry skin, called "fragile" and most often found in women, particularly on the face with thin skin with a tendency to rosacea.

This skin is often hyper-reactive and reacts to environmental aggressions (temperature differences, pollution, air conditioning, cold winds, etc.). This is also the case for the skin of children before puberty, poorly protected by the almost total absence of sebum on its surface, and for people over 65, due to the inevitable aging of the skin and a decrease in sebum production that accompanies it. Sebum is a protective "oily" film that covers the skin.

ARE THERE OTHER POSSIBLE CAUSES AND IN WHAT CIRCUMSTANCES?

Atopic xerosis or atopic dermatitis, or "constitutional" eczema in children, is linked to abnormalities in the structure of the epidermis due to a genetic predisposition. It manifests itself very early, mainly between the ages of 3 months and 2 years, by dry red patches, sources of itching, which predominate on the face, on the cheeks, forehead and on the body, in the folds of the elbow and neck. It tends to generally fade around 5-6 years.

Induced xerosis corresponds to skin dehydrated by irritating dermatological treatments (retinoids, fruit acids). Medications can also cause dry skin such as certain chemotherapies, targeted therapies or even drugs of the class of oral retinoids for example: this is a known and expected effect due to these treatments.

Ichthyosis are skin abnormalities of hereditary or non-hereditary origin, causing xerosis, of varying severity, manifested by dry, rough skin with visible thick flaking, giving the appearance of fish scales. Most often, the condition is generalized to the entire body.

Certain significant dietary deficiencies can cause or aggravate dry skin. These are mainly deficiencies in vitamins E, group B, vitamins PP, C or A and certain deficiencies in essential fatty acids and trace elements with Zinc or Magnesium.

Finally, xerosis can be associated with different diseases: renal failure under dialysis, thyroid insufficiency or even diabetes for example.

WHAT TREATMENTS CAN BE OFFERED TO ME?

For dry skin itself, you need to "grease the skin": the application of so-called moisturizing or emollient creams to soften your skin must be done several times a day.

There are many products available, most of which are not reimbursed, with the exception of certain magistral preparations, most often reserved for severe xerosis or secondary to a medical cause. Some creams are more suitable for the hands, feet and face. Emollients and body balms are more pleasant to apply to large areas and have a faster penetration power and a longer persistence.

When the desquamation is significant, "keratolytic" preparations, i.e. those which modify the production of epidermal cells (by "stripping" the skin), may be prescribed by your doctor.

If the application of emollient creams does not improve the symptoms, it is best to consult your doctor who will try to treat the possible cause.

Thermal cures can also be offered to you as well as psychological support in severe forms, because they affect your quality of life.

HOW CAN I TAKE CARE OF MY SKIN?

Xerosis is the cause of discomfort and an unsightly appearance that justifies appropriate care. Treating the cause, when possible, is essential.

In any case, general measures must be taken:

• Avoid cleaning your skin too frequently and aggressively.
• Prefer lukewarm water to water that is too hot for your showers and baths, showers being preferable.
• Replace your usual soap with a superfatted soap.
• Prefer gentle cleansing with cleansing milks. They should be applied with your fingertips and ideally rinsed with thermal water in a spray. Hard or mineral water should be avoided.
• Dry your skin by patting it and without rubbing.
• Regularly apply emollient creams, after your shower or toilet, to all dry skin areas. If for budgetary reasons, you have to make a choice between using non-aggressive cleansing milks and emollient creams: choose the emollient cream that will remain on the skin, while the cleaning products will be rinsed off anyway. If almost your entire body is affected, this price factor can be a hindrance.
• Keep the emollient cream!
• Avoid exposing yourself to the sun.
• Humidify the ambient air, especially in apartments that are often overheated.
• Avoid clothing containing skin irritants, such as wool for example.

From simple dry skin (simple xerosis) to disabling whole-body damage, xerosis can take varying forms and degrees. Apart from treating the cause when possible, treatment remains local and symptomatic and is based above all on prevention with regular hydration of the skin, accompanied by general measures.

Author: Andrés ARANDA