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9 ways to banish dry skin

Dry skin occurs when skin doesn’t retain sufficient moisture. This can happen as a result of frequent bathing, use of harsh soaps, aging, or certain medical conditions. And for those in colder climates, it can stem from cold, dry winter air.

At this time of year, those in the Northern Hemisphere may suffer from red, rough, raw, and itchy skin. This is because cold winter air means low humidity, both outdoors and indoors. The water content of the epidermis (the outermost layer of skin) tends to reflect the level of humidity around it. Fortunately, there are many simple and inexpensive things you can do to relieve winter dry skin, also known as winter itch or winter xerosis.

Even if you live in a part of the world where cold winter air is not currently — or ever — a concern, most people will need to manage dry skin at some point. These tips for keeping skin soft and healthy can help all who battle dry skin, from chilly New England to balmy Hawaii and beyond.

Keeping moisture in the skin

Skin moisturizers, which rehydrate the top layer of skin cells and seal in the moisture, are the first step in combating dry skin. They contain three main types of ingredients. Humectants, which help attract moisture, include ceramides (pronounced ser-A-mids), glycerin, sorbitol, hyaluronic acid, and lecithin. Another set of ingredients — for example, petrolatum (petroleum jelly), silicone, lanolin, and mineral oil — helps seal that moisture within the skin. Emollients, such as linoleic, linolenic, and lauric acids, smooth skin by filling in the spaces between skin cells.

In general, the thicker and greasier a moisturizer, the more effective it will be. Some of the most effective (and least expensive) are petroleum jelly and moisturizing oils (such as mineral oil). Because they contain no water, they’re best used while the skin is still damp from bathing, to seal in the moisture. Other moisturizers contain water as well as oil, in varying proportions. These are less greasy and may be more cosmetically appealing than petroleum jelly or oils.

What can you do?

Here are some ways to combat dry skin that are effective if practiced consistently:

1. Use a humidifier in the winter. Set it to around 60%, a level that should be sufficient to replenish the top layer of the skin.
2. Limit yourself to one 5- to 10-minute bath or shower daily. If you bathe more than that, you may strip away much of the skin’s oily layer and cause it to lose moisture. Use lukewarm rather than hot water, which can wash away natural oils.
3. Minimize your use of soaps; if necessary, choose moisturizing preparations such as Dove, Olay, and Basis, or consider soap-free cleansers like Cetaphil, Oilatum-AD, and Aquanil. Steer clear of deodorant soaps, perfumed soaps, and alcohol products, which can strip away natural oils.
4. To avoid damaging the skin, stay away from bath sponges, scrub brushes, and washcloths. If you don’t want to give them up altogether, be sure to use a light touch. For the same reason, pat or blot (don’t rub) the skin when toweling dry.
5. Apply moisturizer immediately after bathing or washing your hands. This helps plug the spaces between your skin cells and seal in moisture while your skin is still damp.
6. To reduce the greasy feel of petroleum jelly and thick creams, rub a small amount into your hands and then rub it over the affected areas until neither your hands nor the affected areas feel greasy.
7. Never, ever scratch. Most of the time, a moisturizer can control the itch. You can also use a cold pack or compress to relieve itchy spots.
8. Use fragrance-free laundry detergents and avoid fabric softeners.
9. Avoid wearing wool and other fabrics that can irritate the skin.

Dry skin is usually not a serious health problem, but it can produce serious complications, such as chronic eczema (red patches) or bleeding from fissures that have become deep enough to disrupt capillaries in the dermis. Another possible complication is secondary bacterial infection (redness, swelling, and pus), which may require antibiotics. (Rarely, dry skin is associated with allergy.)

Consult your clinician if you notice any of these symptoms or if measures you take at home provide no relief. For severe dry skin, your clinician may prescribe a cream containing lactic acid, urea, or corticosteroids. She or he may also want to rule out medical conditions that can cause dry skin, including hypothyroidism, diabetes, lymphoma, kidney disease, liver disease, psoriasis, and atopic dermatitis. Always use sunscreen — even in the winter — to protect your skin.

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Does folic acid improve immunity?

Q. What do you know about taking extra folic acid to boost the immune system?

A. Folic acid is the synthetic form of folate, a B vitamin that occurs naturally in some foods, including vegetables, fruits, and dried beans and peas — and is essential for health. Folate is vital for the production and maintenance of our bodies’ cells, especially during rapid periods of growth, such as pregnancy and infancy. It’s needed to make DNA and RNA, the genetic material that dictates cell functions, and it helps prevent changes to DNA that may lead to cancer.

Since folate helps make and repair DNA, it makes theoretical sense that a deficiency of the vitamin could hamper immunity. In some animal experiments, severe folate deficiency has been found to impair immunity, but this hasn’t yet been shown in human studies, and even in animals, the health impact remains unclear. With regard to taking higher-than-recommended doses of folate or folic acid to prevent disease or improve overall health, the evidence from clinical trials is conflicting.

For most healthy adults, the Recommended Dietary Allowance (RDA) of folate from both natural and synthetic sources (fortified foods and vitamin supplements) is 400 micrograms (mcg) a day. Pregnant women should take more — 600 mcg a day — to reduce the risk of neural tube defects such as spina bifida in their babies. Others who may need more than the RDA include people with intestinal disorders that interfere with absorption of nutrients; people who take certain medications; and alcoholics, because alcohol reduces the absorption of folate and promotes its excretion through the kidneys.

The Tolerable Upper Intake Level for folic acid from supplements or fortified foods is 1,000 mcg a day. Folic acid is water-soluble and any excess is excreted in the urine, so the risk of toxicity is small even if you exceed that limit. However, experts are uncertain about the long-term health effects of excess folic acid supplementation. Naturally occurring folate from foods is not associated with any health risk, so get as much of your daily requirement as you can from a healthy diet. If that’s not possible, take a multivitamin that contains 400 mcg of folic acid.

— Celeste Robb-Nicholson, M.D.
Editor in Chief, Harvard Women’s Health Watch

Correction to the 1/18/11 issue of HEALTHbeat:

An eagle-eyed reader noticed an error in our calculation of steps per mile. The average person covers a mile in 2,000 steps. That means 10,000 steps will carry you about five miles. If you are just beginning a walking program, it makes sense to aim for 10,000 steps a day in increments. If you currently take 3,000 steps a day, set 5,000 a day as your first goal. Once you are used to that, add an extra 500–1,000 steps every week or two until you are up to 10,000 a day.