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Excessive drying of skin - Xeroderma

Xeroderma or xerodermia or xerosis cutis is a skin condition characterized by excessive drying of the skin leading to appearance of skin cracks, visible peeling of the outermost layer of the skin along with excessive itching. This condition typically occurs in the skin of scalp, lower abdomen, knuckles, lower legs, arms etc.
This condition can affect both men and women equally although elderly people are most commonly affected. This condition usually occurs due to insufficient amount water in the outer layer.
This condition is also more common during the winter season as the environmental humidity is relatively low. Xeroderma responds well to treatment and common treatment options include moisturization of the affected skin by using emollients and lubricants.
The severity of xeroderma symptoms varies from person to person; in some it may appear as temporary problem with minimal botheration but in some it may become life long discomfort. The appearance of skin on the affected area varies from person to person depending on general health condition, age, nutritional status, etc. but the most common presenting symptom is drying of the skin.
Other common presenting symptoms include
1. Excessive itching which, may lead to secondary infection of the affected area as bacterial infection may occur due to nail scratching
2. The affected skin looses the normal shine and turgidity; it appears rather dull and shrunken due to dehydration
3. Scaling or peeling of the superficial layer of the skin may occur
4. Due to continuous irritation following itching the affected area appears reddish to pink in color
5. Excessive dehydration of the skin may lead to the appearance of fissures or cracks; it increases the risk of secondary bacterial infection
Continuous scratching of the affected skin may lead to changes in the appearance of the skin like the affected skin may appear leathery in consistency, also scratching increases the risk of secondary bacterial skin infection.
The outermost layer of the skin, the epidermis is affected in xeroderma. Epidermis is thinnest in the eyelid area and thickest in the sole area. This epidermis serves certain important physiological function like protecting the deeper layers of the skin from environmental factors as well as from invasion by different pathogens. Another important function of the epidermis is to control the amount of water to be released from the body into the environment in the form of perspiration. Lipid (fatty substance) and protein present in the epidermis plays an important role in normal functioning of the epidermis by facilitating the water (moisture) holding capacity of the epidermis. Whenever there is a lack of lipid or protein there is increased risk of dry skin or xeroderma.
As such interplay of number factors lead to xeroderma or dry skin. Some of the factors are external and some are internal.
External factors include
1. Weather: the prevalence of xeroderma peaks during the winter season as during this period this season environmental moisture content becomes very low.
2. Prolonged exposure to the air conditioner or heater may lead to alter the moisture content of the skin
3. Use of detergent based harsh soaps may lead to loss of lipids present in the skin making it prone to dryness
4. Frequent hot showers may also alter lipid content of skin
5. Frequent and prolonged exposure to sunlight: the UV rays present in the sunlight also can damage the epidermis leading to xeroderma
Internal factors include
1. Suffering from certain skin condition like psoriasis, atopic dermatitis etc
2. Other medical conditions like thyroid problems, asthma
3. Aging
4. Family history of dry skin or xeroderma
Xeroderma can be treated successfully by maintaining the lipid content thereby moisture in the skin. Emollients and lubricants are primarily used. Commonly used products are cetaphil lotion, Lubriderm lotion etc.
Certain other measures like avoiding the sun, harsh soaps, hot baths as much as possible. Use of moisturizer especially after bath also helps to relieve the symptoms of xeroderma.

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