Dry skin on a macroscopic level can appear rough, uneven, flaky, and even cracked or fissured. Symptomatically the skin may feel dry, tight, uncomfortable, painful, or itchy. Individual or environmental factors may also work together to produce dryness.
One of the main functions of the epidermis is to prevent water loss and maintain hydration of the skin. Alterations in the barrier can result in increased water loss (known as trans-epidermal water loss, TEWL) and dry skin.
Cosmetically dry skin has been noted to have a weaker barrier quality than normal skin. Disrupted desquamation can lead to lower cohesivity of skin cells. Dry skin has been shown to contain lower natural moisturizing factors. Impaired barrier function will also facilitate the absorption of products being applied to the skin surface resulting in irritant contact dermatitis.
Underlying skin disorders (e.g. atopic dermatitis) and increased age as well as low humidity and temperature, exposure to solvents and some surfactants may contribute to dryness.
Prolonged use of soaps and surfactants can have a negative impact on the skin barrier. They can emulsify lipids and denature proteins found in the skin resulting in increased TEWL and affecting the permeability barrier. Anionic surfactants tend to be the most problematic (e.g. C10-C12 alkyl chains, alkyl sulphates) in contrast to amphoteric surfactants which have a better safety profile. In addition to altering the water and skin surface chemistry, irritants may also potentially alter the natural microbial flora of the skin. Certain bacteria have been linked to higher rates of growth in alkaline pH and may have the ability to displace the normal skin microbiome.
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