Treatment of Xerosis (Dry Skin)
The best treatment for xerosis is the regular application of moisturizers containing urea or glycerin, applied immediately after bathing to lock in moisture, with formulation selection based on severity and specific symptoms. 1, 2
First-Line Treatment Approach
Moisturizer Selection and Application
- Choose moisturizers with both rehydrating and lipid-replenishing components, with higher lipid content for more severe dryness (preferably water-in-oil formulations for very dry skin) 2
- Apply moisturizers immediately after a 10-15 minute lukewarm bath or shower when skin is still slightly damp 1
- Use fragrance-free emollients for daily management regardless of disease severity 1
- For moderate to severe xerosis, urea-containing products are particularly effective due to their humectant properties and ability to improve skin barrier function 3, 2
Specific Ingredient Recommendations
- Urea-based moisturizers are strongly recommended for hyperkeratotic conditions and show the best clinical evidence for treating xerosis 3, 2
- Glycerin-based moisturizers are effective alternatives for improving skin hydration 1
- For xerosis with fissures, consider products containing urea or dexpanthenol 2
- For xerosis with associated pruritus, consider products containing polidocanol 1
Bathing and Cleansing Recommendations
- Use gentle, soap-free shower gels or bath oils with pH5 neutral formulations and tepid water 1
- Limit bathing time to 10-15 minutes with lukewarm (not hot) water 1
- Pat skin dry after showering rather than rubbing, using clean and smooth towels 1
- Avoid alcohol-containing lotions or gels which can worsen dryness 1
Treatment Based on Severity
Mild Xerosis
- Daily application of moisturizers containing urea or glycerin 1
- Soap-free shower gel and/or bath oil 1
- Avoid alcoholic solutions and soaps 1
Moderate to Severe Xerosis
- Continue all treatments for mild xerosis 1
- Increase frequency of moisturizer application to twice daily 4
- For inflammatory lesions, consider short-term use of topical steroids (e.g., hydrocortisone cream) under dermatologist supervision 1
- For severe cases with significant inflammation, topical steroids of higher potency (e.g., prednicarbate, mometasone furoate) may be needed temporarily 1
Additional Recommendations
Lifestyle Modifications
- Wear fine cotton clothes instead of synthetic materials 1
- Maintain cool environmental temperature and appropriate humidity 1
- Apply daily sunscreen to exposed skin areas regardless of season (SPF30+, UVA/UVB protection) 1
- Avoid known trigger factors: excessive sweating, extreme temperature or humidity changes, exposure to irritants 1
Treatments to Avoid
- Greasy creams for basic care as they may worsen skin condition due to occlusive properties 1
- Topical acne medications which can irritate and worsen dryness 1
- Inappropriate use of topical steroids which may cause skin atrophy if used long-term 1
- Manipulation of skin which increases risk of infection 1
Special Considerations
- Mature skin (over 50 years) benefits particularly from ceramide-containing moisturizers to restore barrier function 5
- Colloidal oatmeal-containing products show significant benefits in improving skin hydration compared to vehicle controls 6
- Regular use of moisturizers has been shown to have both short and long-term benefits in maintaining skin hydration 4
- For xerosis affecting the feet, specialized foot creams may provide better hydration than general moisturizers 4