Description

Xerosis is pathologically dry skin resulting from impaired barrier function and reduced water-holding capacity of the stratum corneum. It is extremely common, affecting virtually all ages, and is a precursor to or comorbidity of many dermatological conditions including atopic dermatitis, ichthyosis, and asteatotic eczema.

Symptoms

Rough, scaly skin texture
Tightness and discomfort
Fine cracks and fissures
Pruritus (especially in elderly — senile pruritus)
Dull, ashy appearance
Asteatotic eczema (eczéma craquelé) in severe cases

Causes & Triggers

Low humidity and cold weather
Excessive bathing with hot water and harsh soaps
Ageing (reduced sebaceous and sweat gland function)
Underlying skin diseases (atopic dermatitis, psoriasis)
Systemic conditions (hypothyroidism, diabetes, renal disease)
Medications (retinoids, diuretics, statins)

Severity Classification

Mild Rough texture, minimal scaling, occasional tightness

Moderate Visible scaling, pruritus, fine crack lines

Severe Deep fissuring, eczéma craquelé, bleeding cracks, secondary infection risk

Treatment Ladder

1 Foundational: Switch to gentle syndets, reduce bath temperature and frequency
2 Mild–Moderate: Emollient therapy — apply within 3 min of bathing ("soak and seal")
3 Moderate: Emollients with humectants (hyaluronic acid, glycerin, urea)
4 Fissured: Barrier repair creams (ceramide-based) + occlusive layer at night
5 Eczema craquelé: Short course of topical corticosteroids + intensive emollients

Relevant Compounds

Allantoin

Skin protectant — promotes healing of fissures

Allantoin is a naturally occurring nitrogenous compound found in botanical extracts (particularly co…

Aloe Vera

Hydrating and soothing botanical

Aloe vera is derived from the inner gel of Aloe barbadensis miller leaves. It contains over 75 activ…

Ceramides

Restores intercellular lipid matrix

Ceramides are a family of waxy lipid molecules that make up approximately 50% of the lipids in the s…

Hyaluronic Acid

Humectant — draws and retains water in stratum corneum

Hyaluronic acid is a naturally occurring glycosaminoglycan found abundantly in the dermis and epider…

Niacinamide

Stimulates ceramide synthesis and improves barrier

Niacinamide is the physiologically active amide form of vitamin B3. It is a versatile, well-tolerate…

Panthenol

Provitamin B5 — hydration and barrier strengthening

Panthenol (D-panthenol or dexpanthenol) is the alcohol analogue of pantothenic acid (vitamin B5). Up…

Squalane

Emollient — mimics sebaceous lipids

Squalane is the hydrogenated (saturated) form of squalene, a naturally occurring lipid produced by h…

Vitamin E

Antioxidant emollient — protects lipid barrier

Vitamin E is a fat-soluble antioxidant vitamin and a key component of the skin's natural antioxidant…

Suggested Cosmetics

Cipla Excela Moisturiser Niacinamide-enriched lightweight moisturiser The Derma Co 5% Hyaluronic Acid Serum with Ceramides HA humectant + ceramide barrier repair for dry skin Dot & Key Ceramide & Hyaluronic Acid Moisturiser Ceramide + HA barrier restoration Physiogel AI Calming Relief Cream Intensive lipid-based moisturiser for severe dryness Re'equil Ceramide & Hyaluronic Acid Moisturiser Ceramide + hyaluronic acid barrier repair Venusia Max Intensive Moisturising Cream First-line emollient for severe dry skin

Lifestyle Tips

Bathe in lukewarm water for less than 10 minutes
Use soap-free cleansers (syndets) with physiological pH
Apply emollient immediately after bathing on damp skin
Run a humidifier indoors during winter months
Wear cotton clothing next to skin — avoid direct wool contact
Stay well hydrated and consider omega-3 supplementation

When to Refer

Suspicion of underlying systemic cause (thyroid, renal, diabetes)
Ichthyosis or inherited keratinisation disorders
Development of asteatotic eczema or recurrent secondary infections
Not responsive to appropriate emollient regimen