Senile xerosis. Causes of skin xerosis, treatment methods. Causes of skin xerosis in children and adults

14.08.2021 Readers

Greetings to all!

Xerosis is the medical term used to describe very dry skin that has symptoms that bother both adults and children, especially during the cold winter months. This happens when your skin lacks moisture in its outer layer - the epidermis.

In this article, I will try to tell you about the causes and methods of treating dehydrated skin at home. I will tell you about the means related more to traditional medicine, and I will also give some tips for prevention.

I will say right away that xerosis is a temporary problem, but it causes enough discomfort. Its symptoms are most often red, irritated, inflamed, rough, itchy, painful and flaky skin.

The main causes of xerosis are as follows:

Combination of low humidity and cold temperatures during the winter months;
Use of heaters and air ventilation in winter;
Harsh soaps or shower gels you use to wash your body;
Taking a shower or bath for too long;
Constant exposure to the sun in summer;
Use;
Frequent swimming in chlorinated water pools;
Aging of the human body;
Diabetes or certain medications.

Any of these reasons can become a real enemy for our skin, simply depriving it of life-giving moisture and dehydrating it. If left untreated, it can cause more serious problems such as bleeding, cracks, and scaly skin. It can also lead to atopic dermatitis (eczema) or infections.

Home treatment for manifestations of xerosis

In most cases, xerosis responds well to lifestyle changes and home remedies. Treatment of xerosis with folk methods is aimed at relieving symptoms and retaining moisture in the skin.

But if your skin is oozing, large areas of peeling, or a rash, then it's best not to tempt fate and see a doctor. Here are 10 effective home remedies for this ailment.

Glycerol

This component is quite effective in the fight against xerosis. An excellent moisturizer, it attracts moisture from the outside and delivers it to the deep layers of the skin. In addition, glycerin is an emollient that forms a protective layer on the epidermis. This allows it to stay hydrated for a long time.

In 2002, scientists proved that creams containing glycerin are among the best remedies for dehydrated skin. You can use this substance as follows:

Liberally lubricate dry areas of the epidermis with glycerin.
We leave for a few hours.
We wash it off with warm water.
We carry out this procedure 2 to 3 times every 7 days.

You can also buy glycerin-based body soap.

Coconut oil

It is a popular and effective remedy for xerosis. It contains ample amounts of fatty acids that can compensate for any moisture loss from the skin. Coconut oil also contains vitamin E, which helps to retain moisture in the epidermis.

Scientists have proven in 2004 that this natural product is excellent as an effective and safe moisturizer. In 2016, another study reported that the saturated fatty acids found in coconut oil enhance the protective functions of the skin.

And already in 2018, scientists confirm the information that coconut oil also has anti-inflammatory properties and gives the green light to this plant substance in caring for the skin of the body.

It is best used like this:

Warm up some coconut oil and spread it on the skin before bathing. We massage the epidermis thoroughly so that the product penetrates deeply into the skin. We wait 10 minutes, then take a bath or shower. We do the procedure once a day.
If you suffer from very dry skin, then you can apply coconut oil to the slightly damp epidermis after taking a bath.

Oatmeal

It is another natural ingredient that can help heal xerosis. Oatmeal is a natural cleansing and exfoliating ingredient that helps fight dry skin and dead skin cells.

In 2009, American scientists discovered that oatmeal contains a number of ingredients that attach to the skin to provide a protective barrier against dryness. And in 2014, scientists prove that ground oatmeal contains a moisturizer that can help reduce dehydration.

Use oatmeal as follows:

Add 1 bowl. oatmeal and a few drops of lavender oil in a bath and mix thoroughly. We leave for 15 minutes.
We take a bath and then rinse the body with clean water.
Pat dry the skin with a towel and apply a moisturizer.
We enjoy taking such a bath once or twice a week.

Apple vinegar

Apple cider vinegar can be used to treat the symptoms of xerosis by bathing and ingesting. This will help balance the pH of the skin to reduce dryness. It also helps the body get rid of toxins, which is very important for healthy skin.

You can use it like this:

Add 1 bowl. apple cider vinegar into the filled bath. We take it for 15-20 minutes. Then we rinse with clean water, pat dry the skin with a towel and apply a thick moisturizer. We do this once a day or less often, depending on how dry your skin is.
Add 2 tsp to a glass of water. apple cider vinegar and the same amount of honey. We stir and drink this drink twice a day.

Avocado

This fruit will be very useful for nourishing dried epidermis. Avocado perfectly softens and moisturizes dehydrated skin. The fatty acids in it easily penetrate the dermis to compensate for any moisture loss.

You can use avocado like this:

Knead 2-3 ripe fruits with a fork until a smooth consistency is obtained.
Add some honey to the mixture to make a mask.
Apply the composition to the skin and leave it on for 20-30 minutes.
Next, rinse the epidermis with water.
We repeat from 2 to 3 times a week.

You can also include avocados in your diet.

Cream

A milk-based product is a wonderful natural ingredient that actively fights dry skin. It is quickly absorbed by the skin pores and keeps the epidermis hydrated for a fairly long period of time.

This dairy product should be used as follows:

Apply cream generously to the skin. We keep it for 10 to 15 minutes, then wash it off with warm water. We do the procedure 2 or 3 times a week.
Add enough cream to 4 tablespoons. flour to make a thick paste. Apply it to the body and massage for 15 minutes. We get rid of it with warm water. We do this once a day for 1 week.

Aloe vera

In order to declare war on xerosis, you can use one of the valuable ingredients - aloe vera. An excellent natural moisturizer, it leaves the skin soft and elastic. Aloe also helps restore the acid-base balance in the epidermis.

In 2003, scientists proved that aloe vera gel improves the symptoms of dehydrated skin.

To take advantage of the gifts of nature, perform the procedure as follows:

Extract the gel from the aloe vera leaves.
We spread it all over the body.
We massage for 10 minutes to help the gel penetrate into the deep layers of the dermis.
We wait 30 minutes, then wash off with warm water.
We do the procedure 1 to 2 times a day.

Honey

A beekeeping product called honey is a natural moisturizer and is famous for its antioxidant and antimicrobial effects. All these qualities make it an excellent remedy for combating dry epidermis.

Honey helps to lock in moisture in the skin, thereby reducing dryness and making it very soft. In 2012, scientists discovered that honey could be useful for treating a variety of skin conditions, including dehydration.

Use this natural product like this:

Before carrying out water procedures, apply honey to the whole body and gently massage in a circle. We wait 10 minutes, then go swimming. We repeat it daily.
We mix honey and glycerin in equal proportions. We spread the mixture on the body, wait 10 minutes, and then get rid of it with warm water. We do this from 1 to 2 times a day.
Combine the same amount of honey, beeswax and olive oil. First, we heat the beeswax, then add the rest of the ingredients. We store the composition in a container in a cool place. We apply this mixture to the body and massage for 5 minutes, and then just leave it on the skin for the rest of the day. We repeat once a day.

Avoid hot baths

If you suffer from xerosis, then you need to avoid hot baths completely, no matter how relaxing and soothing they are. In fact, prolonged use of such baths can be an additional reason for the appearance of xerosis.

Hot water can harm your skin by drying it out and making it dehydrated and itchy. You can only take cool baths or showers, or slightly warm ones. At the same time, it is necessary to reduce the time of taking them so that the skin does not lose moisture.

In order to keep it, try to apply various base oils, such as olive, almond, and coconut, as described above, to wet, but not wet, skin immediately after bathing.

Get a humidifier

When humidity remains low, our skin is more prone to dryness. This problem is common during the long winter months as central heating makes the air hot and dry.

To make the air more comfortable and help your skin retain moisture, buy a moisturizer. It is advisable to set the humidity level between 45 and 55%, this will prevent drying out of the skin.

If you can't afford a ready-made humidifier yet, I advise you to put a container of water in each room in order to increase the humidity level in the room. Remember to change it before it goes bad.

In order not to provoke symptoms of xerosis and to cure this disease as soon as possible, pay attention to the following postulates:

Skin tends to react to sudden changes in temperature, so try to stress it as little as possible to deal with dryness and flaking.
Look for skin care products that contain vitamins A, B6, C, E, and A, as well as riboflavin, selenium, and zinc.
Use oil-based moisturizing lotions often, especially in winter.
Unless you're infrequently exposed to sunlight to avoid losing moisture, never go outside without applying sunscreen to your skin.
Choose fabrics that are pleasing to your skin. For example, cotton and silk will allow your epidermis to breathe.
If dry skin is itchy, apply cold compresses to these areas.
Use a gentle detergent that is free from dyes, fragrances and alcohol.
Limit the use of soaps on dry skin areas and choose mild soaps with oils.
Drink plenty of water, as the epidermis is in great need of moisture, dry skin, in turn, is a sign of dehydration.
Include foods that contain omega-3 fatty acids in your diet, as they help keep your skin healthy and firm.

That's all. Hopefully these tips will help your skin stay smooth, soft, and hydrated enough. In winter, I also have to resort to some of them. And remember that the skin, saturated with moisture both from the outside and from the inside, will delight you with youth and beauty for a long time.

Health to you! See you!

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Xerosis of the skin- this is an abnormal dryness of the skin caused by hyposecretion of the sebaceous glands, as a rule, which is the cause of a fairly severe itching, and sometimes some infectious skin diseases. In some cases, xerosis is called the initial stage of development of ichthyosis, but most often increased dry skin is a sign of certain skin diseases and a symptom of the negative influence of various external factors on the skin (typical for people with fair skin).

Xerosis has the following characteristic features: roughness and dryness of the skin, peeling, inelasticity of the affected areas that are prone to cracking. Visually, the skin looks rough, often becomes covered with red spots, the pores are practically invisible. Often, xerosis is accompanied by such an unpleasant manifestation as. In this case, the causes of the observed itching are various chemicals, viruses, bacteria that easily penetrate the inner layers of the skin through the damaged epidermis. In most cases, the localization of xerosis is observed in places of tension and / or friction: fingers, knees, elbows.

Causes skin conjunctiva

Xerosis is the main symptomatic manifestation of most dermatological diseases: it is observed in almost all patients with a diagnosis; congenital is observed in patients with irritant eczema of the hands, follicular keratosis, etc.

In addition, improper skin care, exposure to various chemical agents due to their frequent use (poor-quality shower gel, soap, dishwashing detergents, etc.) can act as a catalyst for the development of xerosis. Often, various features of the environment lead to the development of xerosis: strong wind, humidity and air temperature.

In addition, the following predisposing factors and manifestations can lead to the development of xerosis:

Long-term use of systemic and external glucocorticoid drugs

Diseases of various systems and organs: chronic renal failure, liver cirrhosis, hepatitis, hypovitaminosis, hematological and oncological diseases, intestinal malabsorption, etc.

Eating and sleep disorders, changing time zones

Various aggressive irritating environmental factors (air pollutants, tobacco smoke, etc.)

The leading mechanism for the development of xerosis is a decrease in the barrier function of the epidermis due to the insolvency of the lipids of the stratum corneum, which leads to an increased transepidermal moisture loss.

Xerosis of the skin symptoms

According to its course, this disease is divided into stages characterized by morphological and functional changes.

The first stage of the course of skin xerosis is characterized by functional disorders related directly to the protective properties of the skin. There are sensations of tightness, dryness, which, however, are not painful and constant, quite easily compensated by the application of moisturizing creams. In most cases, a feeling of tightness occurs during facial movements, while the texture of the skin is unchanged, there is no pronounced wrinkling. In some cases, itching and increased sensitivity can be observed in the form of a kind of response to aggressive external influences (wind, salt water, etc.). There are no significant morphological changes.

The second stage of xerosis is characterized by the development of hyperkeratosis against the background of exfoliation. At this stage, the feeling of tightness and dryness becomes permanent and is no longer associated with mimic activity. These manifestations do not completely disappear even after applying emollient and moisturizing creams. A slight superficial wrinkling begins to form on the skin, fine-lamellar peeling becomes visible. An increased sensitivity of the skin to previously harmless non-aggressive factors (conditioned air, water, etc.) develops, redness periodically begins to occur, etc. An increase in the sensitivity of the skin is directly related to a partial loss of barrier properties. The picture of morphological changes reflects hyperkeratosis, violation of the integrity of the stratum corneum, thinning of the malpighian layer.

The third stage of xerosis is characterized by hypotrophy of the dermis, peeling of the skin becomes pityriasis (large-lamellar). Wrinkling deepens even more, especially in areas of constant mimic activity (above the bridge of the nose, in the corners of the eyes, etc.). Deformation of the skin relief already affects the dermal layer. Dryness is no longer compensated by moisturizers. The skin looks taut, becomes inelastic, stiff, rough to the touch, cracks very easily, followed by the formation of pityriasis scales in these places. There is an increased sensitivity accompanied by itching, inflammatory reactions and diffuse. The pattern of morphological changes includes a decrease in blood flow in the papillary dermis, thinning of the dermis and epidermis, cracks in the stratum corneum,.

The fourth stage of the course of xerosis is characterized by atrophy of the dermis and epidermis. There are pronounced trophic changes in the skin, sometimes before the formation of trophic ulcers. The histological and clinical features are similar to those observed during natural aging.

Xerosis of the skin in children, in terms of its symptoms and causes of development, is no different from that in adults.

Xerosis treatment

Treatment of xerosis of the skin directly depends on the causes that caused it and is primarily aimed at eliminating them. Due to the fact that xerosis is a systemic process, the following general recommendations should be adhered to: intake of balanced food enriched with vegetables and fruits, adequate drinking regime, cessation of alcohol intake, smoking cessation, exclusion of prolonged exposure to the open sun, use of special emollients of hygiene, regular physical exercise.

In addition to following the general recommendations described above, which are relevant for almost all skin diseases that are accompanied by xerosis, external therapy is of decisive importance. However, one decisive condition must be met - all emollients and moisturizers applied to dry skin should be similar in composition to the physiological lipids of healthy skin.

In addition, moisturizing emollient remedies must fully meet the following criteria: hypoallergenicity, excellent tolerance, high degree of safety, appropriate age group. The effectiveness of moisturizing emollients is directly related to skin pH and dosage. The particular importance of the use of emollient moisturizers in combination with anti-inflammatory (local) drugs is given in case of developed xerosis against the background of atopic dermatitis. It is the complex treatment of xerosis that significantly reduces all symptomatic manifestations of this disease. Also, such treatment is more effective than the common anti-inflammatory drug monotherapy.

Each medication is selected individually by a dermatologist, therefore, in order to avoid self-medication, we will not give the names of the drugs, but below we will describe the basic rules for caring for problem skin, because the prescribed anti-inflammatory drug should be applied only after certain manipulations.

Rules for caring for atopic skin:

Thorough daily cleansing of the skin using a special cream by taking a shower (no soap)

Immediately after wetting the skin after a shower, apply a moisturizer prescribed by your doctor, depending on the current condition of the skin. In order to moisturize the skin of the face, hydrating creams are usually used. Moisturizing the areas of folds and limbs is carried out using lipid-enriched ointments. In case of atopic dermatitis in the stage of exacerbation, emulsions and / or creams are applied, and lipid-enriched ointments in the stage of remission

Xerosis prevention

For successful treatment and prevention of recurrence of xerosis, a number of preventive measures must be followed. All people who periodically show signs of dry skin should adhere to the following rules:

Quality sleep. Healthy and full sleep is excellent for the regeneration of skin cells

Compliance with an adequate water regime. To maintain skin hydration and maintain water balance, you must drink at least two liters of water per day

Active lifestyle and sports. Light superficial massage and moderate physical activity significantly improve blood circulation, as a result of which the cells of the skin are saturated with nutrients and oxygen

Quitting alcohol and smoking

Elimination of large temperature differences, hypothermia or overheating

A diet with a decrease in the use or complete elimination of caffeinated foods, sugar, fried foods. At the same time, on the contrary, there is an increase in the consumption of fruits, vegetables, nuts.

Xerosis of the skin means abnormal dryness of the skin caused by a decrease in the secretion of the sebaceous and sweat glands, a violation of the hydrolipid balance, and a lack of amino acids in the stratum corneum. All of the above is accompanied by a feeling of discomfort, itching and is the cause of inflammatory skin diseases leading to social maladjustment of the patient.

Skin xerosis is a pathognomonic manifestation of many types of dermatological pathology: atopic and seborrheic dermatitis, ichthyosis, psoriasis, irritant hand eczema and others. In addition, the occurrence of xerosis is facilitated by:

chemical effect of cosmetics and detergents on the skin;
unfavorable living conditions;
increased insolation;
exposure to air pollutants;
malnutrition;
hypovitaminosis;
regular use of hot water for washing;
non-observance of the regime of work and rest;
chronic diseases of internal organs;
long-term use of glucocorticoid drugs locally and systemically.

Persons with thin skin are prone to xerosis. Xerosis is common in the elderly, as well as in those who, by the nature of their professional activities, often wash themselves, especially with alkaline detergents. There are also congenital forms of xerosis.

Symptoms of skin xerosis

The disease undergoes a number of stages in its development, which have their own characteristics.

First stage:

the feeling of dryness and tightness of the skin is unstable;
a feeling of tightness is provoked by facial movements;
itching appears only with aggressive environmental influences;
there is no pronounced wrinkling of the skin.

Second phase:

tightness and dryness are felt constantly;
peeling of the skin appears;
there is a slight wrinkling of the skin;
from time to time, redness and itching of the skin appear;
the skin becomes sensitive to non-aggressive environmental factors.

Stage three:

peeling of the skin becomes pityrious;
wrinkles in areas of mimic activity become deeper and deformed;
the skin loses its elasticity, cracks easily;
worried about itching, redness, inflammation of the skin.

Fourth stage:

hypotrophy of the epidermis and dermis;
severe skin nutritional disorders;
trophic ulcers.

Diagnostics of the skin xerosis

It includes the collection of anamnestic data allowing to establish the root cause of dryness, the affected areas of the skin are examined, which have a characteristic appearance: dry, rough, in the form of pityriasis scales, mainly on the extensor surfaces of the limbs. If necessary, a set of laboratory and instrumental diagnostic measures is carried out, in each case determined individually.

Treatment of skin xerosis

In the treatment of skin xerosis, it is of paramount importance to limit the factors causing the condition. Against this background, it is quite important to have an adequate drinking regimen and a balanced diet, cessation of tobacco smoking and alcohol excesses, and limitation of insolation. It is extremely important that moisturizers and emollients applied to dry skin must be formulated to match the lipids of healthy skin. The use of moisturizers is also necessary during periods without xerosis symptoms. It seems justified to use moisturizers in combination with topical corticosteroids for xerosis in combination with atopic dermatitis.

Essential drugs

There are contraindications. Consultation of a specialist is required.

(vitamin A). Dosage regimen: Retinol acetate is taken orally for prophylaxis, during treatment it is prescribed orally and injected intramuscularly. Inside: therapeutic doses of retinol acetate are for adults from 10,000-30,000 to 50,000-100,000 IU per day, for children - from 1,000 IU to 20,000 IU per day, depending on age. Outwardly, an oily solution of retinol acetate is used to lubricate the affected areas of the skin. Local treatment is combined with the simultaneous use of retinol acetate orally or intramuscularly. The maximum dose is a single dose of 50,000 IU, and the daily dose is 100,000 IU.
(vitamin E). Dosage regimen: Tocopherol acetate is taken orally 1-2 capsules 2-3 times a day after meals. The course of treatment is 2 months. Most often prescribed in combination with retinol acetate.
Hydrocortisone ointment 1% (GCS, has anti-inflammatory, decongestant, antipruritic effect). Dosage regimen: topically. The ointment is applied in a thin layer to the affected skin 2-3 times a day. The duration of the course of treatment depends on the nature of the disease and the effectiveness of therapy, making up, as a rule, 6-14 days; with a persistent course of the disease, it can be extended up to 20 days.
Uryage Emolyant Extrem (restoration of the level of skin hydration). Dosage regimen: the cream is applied to the skin 2 times a day or as needed.

A recent survey of more than 4500 people over the age of 15 in 8 EU countries showed that ~ 40% of them have sensitive skin, which is most often manifested by dryness. Most of these individuals indicated the presence of atopic dermatitis (AD) in childhood. According to Japanese researchers who studied the prevalence of AD for the period 1998-2004, sensitization to inhalation allergens can be easily established even in children with clinically pronounced dry skin, in the absence of other symptoms of AD itself.

Dry skin is not only a cardinal sign of blood pressure. Sometimes practically healthy people complain about dry skin, in whom improper skin care (chemical exposure as a result of frequent use, in particular, soap and shower gel, other cosmetics, detergents) leads to dry skin. Climatic features of the environment (temperature and humidity, strong wind, prolonged exposure to sunlight, etc.), especially in combination with a congenital predisposition to increased dry skin, can also cause xeroderma. Other external causes include aggressive environmental factors (tobacco smoke, air pollutants), jet lag, improperly selected cosmetic care products, and sleep and nutritional disorders.

More than 75% of people over 70 have dry skin, which is the main cause of itchy lower limb skin in older people. Xeroderma, as a rule, accompanies hypothyroidism, intestinal malabsorption. Increased dry skin is detected in patients with cancer, hematological diseases, hypovitaminosis, hepatitis, cirrhosis and chronic renal failure.

Dry skin is the main symptom of most dermatological diseases. So, it is present in almost 100% of patients with AD. Congenital dry skin is noted in patients with psoriasis, seborrheic dermatitis, ichthyosis, follicular keratosis, irritant hand eczema, etc.

This skin condition is characterized by a feeling of discomfort, often dry skin is accompanied by itching, burning, tingling, peeling, flushing. All this leads to a decrease in the patient's quality of life and, along with the specific treatment of the underlying disease, requires proper care for dry skin with the use of various emollients and moisturizers.

Let's briefly describe the features of dry skin.

What is dry skin and how is it different from normal skin?

The skin is the first to react to environmental influences. As you know, the skin has three main layers: the outer (epidermis) and two inner (dermis and subcutaneous fatty tissue). The ducts of the sebaceous and sweat glands emerge on the surface of the skin, supplying the skin with moisture and lipids. The epidermis is divided into 5 levels, of which the uppermost is horny. The main cells found in the epidermis are keratinocytes and melanocytes. In turn, the stratum corneum is formed from corneocytes (which contain lipids) and water. Most of the lipids of the stratum corneum are ceramides (50%), fatty acids (10-20%) and cholesterol (25%). The corneocytes themselves contain the so-called natural moisturizing factor (NUF). What is its role? It is known that the stratum corneum normally contains 15-13% water. When the water content is reduced to 10% or less, visible scales form in the skin and it becomes dry. To prevent this process, the epidermis contains moisturizing substances, the main of which is EUF - a component consisting of a mixture of amino acids, their derivatives, as well as minerals formed during the hydrolysis of the filaggrin protein. These water-soluble compounds are hygroscopic, i.e. they retain water. This water acts as an intracellular adhesive in the stratum corneum, thereby keeping corneocytes elastic and preventing desquamation and cracking in damaged skin. There are three forms of water in the skin: static, or "bound", dynamic and transepidermal. Transepidermal water is formed from the circulating blood, it penetrates through the dermis into the epidermis and eventually evaporates from the skin surface. This movement of water plays a role in the nutrition of the epidermis, which, as you know, does not contain blood vessels. Static water of the stratum corneum is localized between lipid layers and inside corneocytes. The stratum corneum also contains other moisturizing ingredients (hyaluronic acid, glycerol, lactate), which mainly play a role in maintaining the physical properties of the skin's epithelial barrier.

Another important defense mechanism of the skin is an acid reaction on its surface, which protects the skin from penetration of microorganisms inside, regulates the process of hydration, maintains the natural state of the epidermis and determines the difference in biological skin types. The pH of the skin is directly related to the level of dynamic water in the stratum corneum. The pH of healthy newborn skin ranges from 6.5-7.0, which requires specially selected hygiene products in accordance with age. With dry skin, it is very difficult to maintain a normal pH level. A change in its level contributes to the deterioration of lipid metabolism in the skin, as well as its infection.

The epidermis, together with the hydrolipidic film, forms the so-called barrier function: protecting the skin from environmental factors, mechanical damage and increased water loss. From the above it follows that with dry skin, all these processes are disrupted. Moreover, in recent years, one of the main reasons for the development, in particular, of AD, scientists are considering exactly the defects in the barrier function of the skin. This is convincingly evidenced by data such as an increase in transepidermal water loss, a decrease in the threshold of skin susceptibility to external irritants and pathogens, as well as its dryness. In addition, as shown by immunohistochemical studies of atopic skin, the severity of the impaired barrier function correlates with the degree of the inflammatory process in AD and, in general, with the severity of the disease. It has also been proven that the dysfunction of the skin barrier is significantly affected by the imbalance between the level of proteases (chemotryptic, tryptase, cysteine protease) and their inhibitors, as well as staphylococcus superantigens.

Recently, deficiency of antimicrobial peptides - a kind of endogenous antibiotics - has been given an important role in impairing the barrier function of the skin. More than 20 different antimicrobial proteins have been characterized. The most studied of them are two groups - cathelicidins (in particular, LL-37) and beta-defensins, which exhibit synergistic antimicrobial activity against staphylococcus aureus and fungi. Malassezia furfur... In healthy skin, these peptides are expressed in very small amounts, but they can accumulate in the skin during inflammation.

Some authors associate dysfunction of the skin barrier with genetic features of the structure of the skin, in particular, with a mutation of the filaggrin gene, a specific gene responsible for the so-called complex of epidermal differentiation. Scientists see an increased susceptibility to skin infections in AD not only in defects in the epithelial barrier, but also in the expression of Th2-lymphocyte cytokine receptors. However, what is primary in these processes - a defect in the barrier function of the skin or inflammation - is still not clear. The restoration of the barrier function of the skin is also associated with the reconstruction of the lipid-rich intracellular substance of the stratum corneum. This process consists of two phases: an initiating fast phase and a late prolonged one, which includes, in particular, the synthesis of new lipids in corneocytes (ceramides, cholesterol, fatty acids) using a number of transcription factors and proteins.

What does dry skin affect? It was said above that in the presence of xerosis, the susceptibility of the skin to exposure to surrounding allergens, irritants, as well as bacteria and viruses increases significantly. It should also take into account the close relationship of the cycle "xerosis-itching". Accordingly, effective treatment of dry and itchy skin can improve the results of therapy for AD. However, it is impossible to influence such causes of dry skin as changes in the stratum corneum, disturbances in keratinization, the composition of the balance of intracellular lipids, metabolism of transepidermal water, changes in skin pH, etc., simply by applying moisturizers and / or emollients to the skin. These are very complex physicochemical, biochemical and pathophysiological processes that occur in different ways in skin diseases. Recently, scientists are considering dry skin with atopy from the point of view of a single pathophysiological concept of "atopy, dry skin and the environment".

The main factors affecting dry skin

So, specific mechanisms that impair skin barrier function include factors such as a deficiency in ceramide synthesis and a decrease in the level (EUF) in the stratum corneum. Perhaps, in the future, this leads to disturbances in the differentiation of the epidermis, which is manifested by defects in the barrier function of the skin, an imbalance in lipid biosynthesis, etc. Repeated exposure to damaging factors enhances the immune inflammatory process, with the involvement of even the endothelium, violation of keratinization, etc.

The main external triggers that maintain dry skin are temperature, humidity, sunlight, and chemical agents: soap, shower gel, alcohol solutions, detergents. Do not forget about pharmacotherapy using retinoids, alcohol-containing solutions, phototherapy. In addition, dry skin not only significantly increases the absorption of topical corticosteroids (hence their side effects), but their prolonged use leads to dryness and atrophy of the skin itself.

Briefly described above, the characteristics of dry skin, in fact, of course, represent more complex physico-biochemical, immunological and biological processes that scientists continue to study around the world. One of the important tasks remains to clarify the exact immunopathophysiological and etiological mechanisms of the development of such chronic skin diseases as psoriasis and blood pressure.

Dry skin treatment

Dry skin is a systemic process. Therefore, such general recommendations as an adequate drinking regime, eating a balanced diet enriched with fruits and vegetables, stopping smoking and drinking alcohol, avoiding prolonged exposure to the sun, regular exercise, and the use of special hygiene products for dry skin are very relevant in all cases of xeroderma.

On the other hand, it is understood that moisturizers and emollients applied to dry skin should be substantially similar in composition and concentration to the physiological lipids of healthy skin.

Scientific data of recent years have made it possible to substantiate the absolute importance of external therapy for all skin diseases accompanied by xerosis. First of all, this affected new therapeutic opportunities for AD, which led to the development of a new direction in medicine - the pharmaceutical and cosmetic industry. Therapeutic moisturizers / emollients had to meet criteria such as age group, efficacy for dry skin of various origins, high safety profile, excellent tolerance, hypoallergenicity, compliance with international development and production standards.

Let us consider some of the features of the modern approach to the therapy of AD, one of the main types of which scientists unanimously recognize the need for external auxiliary therapy - skin hydration and the use of emollients.

Moisturizers / Emollients: Are They Really Effective for BP?

It is known that a significant decrease in the level of ceramides - the main molecules that retain water in the stratum corneum, was found both in the affected and unaffected skin of patients with AD; in all patients with blood pressure, the pH of the skin is changed, etc. Violation of the barrier function of the skin occurs in both types of blood pressure - allergic and non-allergic, however, scientists believe that it is more pronounced in the non-allergic form. It has also been proven that with AD, the skin is dry even without exacerbation of the disease. In this regard, the use of moisturizing / emollient agents is justified in those periods of the disease when there are no symptoms. However, one should not forget about the likelihood of side effects on these funds too.

Let's conduct a small review to assess the effectiveness of moisturizers / emollients in AD.

Analysis of published reports shows that the effectiveness of moisturizers / emollients depends on the dose (they should be used regularly and in sufficient quantities), skin pH, and patient compliance. The use of moisturizers / emollients in combination with anti-inflammatory drugs (topical corticosteroids, topical calcineurin inhibitors) is especially important. This approach is superior in reducing all BP symptoms and is more effective than anti-inflammatory drugs alone. So, in children and adults suffering from mild to moderate severity of blood pressure, Hanifin et al. conducted a comparative study of the effectiveness of topical application of a moisturizing cream 3 times a day in combination with a topical corticosteroid 2 times a day (group 1) and monotherapy with a hormonal drug (group 2). After 3 weeks of treatment, a significant clinical improvement was achieved in the first group of patients compared to the second group. In addition, more than 95% of study participants expressed a desire to receive combination therapy. In another study, an emollient cream was added to 2.5% hydrocortisone cream applied once daily; this treatment regimen was compared with the effectiveness of two-fold use of only one hormonal drug. It has been shown that the addition of an emollient reduces the need for topical hormone, and its regular use helps to prevent recurrent exacerbations of blood pressure.

The efficacy of adjuvants was clinically and morphologically confirmed in a study by Chamlin et al., Who added an emollient with a predominance of ceramides to the standard therapy of a group of children with "persistent resistant blood pressure". By the end of 6-12 weeks, all patients showed a clinical improvement in the course of blood pressure. In addition, extracellular laminar membranes were found in the ultrastructure of the stratum corneum, which were almost completely absent initially.

An interesting study was conducted back in 1998 by Ainley-Walker et al., Who studied the effectiveness of various external agents in patients with AD by applying them to two symmetrical areas of the affected skin. The study included 82 patients (66 of them children) who used a topical corticosteroid of medium / high activity and emollient. When comparing the effectiveness of the topical hormone of the light class and the emollient, the hormonal drug was effective in 10 cases out of 17, in 5 cases the clinical efficacy of the drugs was the same, and in two cases the emollient was even more effective than the hormone.

Without age restrictions, the Nizhi laboratory has developed a Topikrem line for patients with AD, psoriasis, and seborrheic dermatitis.

For all age groups, the program for the treatment and care of dry atopic skin of another French company - "Dermatological Laboratories Uriage", has proven itself to be excellent. This is a whole line of therapeutic cosmetics based on thermal waters. Thermal water Uryazh differs from other mineral waters in isotonicity, that is, its osmotic pressure is close to the osmotic pressure of blood plasma and cells, therefore Uryazh water does not violate the integrity of cells and does not change their volume. Thanks to its minerals and trace elements, Uryazh water has a moisturizing, soothing and protective (in relation to lipid oxidation) effects. Currently, on the basis of Uryage thermal water, products have been developed, including for dry atopic skin: Cu-Zn cleansing liquid gel (containing no soap and fragrances), Cu-Zn cream, Uryage Emoliant Extrem (Emoliant form - "water in oil" ). Uryazh Emolyant Extrem is prescribed for severe dryness of the skin of the face and body in children and adults. It consists of raspberry seed oil, oligosaccharides, Uriazh thermal water 30%, vegetable squalanes and sterol. The drug is applied 2 times or as needed. As a result of using Emoliant Extrem, the barrier function of the skin and its level of hydration are restored.

Hydrolipidic, as an "oil in water" form, is intended primarily for daily care of very dry and sensitive skin, including senile skin. The essential fatty acids included in the emulsion make it possible to compensate for lipid deficiency and enhance the adhesion of epidermal cells. With severe dryness of the skin, accompanied by desquamation and / or hyperkeratosis, after cleansing the skin, apply Keratosan - it has the texture of milk "oil in water", it is easily applied to large areas of the body 2 times a day. The emulsion is easily absorbed without leaving a greasy residue. After the first applications, a very light and quickly passing tingling sensation may be felt.

The latest development of Uryage laboratories is the Cerasterol-2F complex, which is built into the structure of the skin barrier, restoring it. On the basis of this complex, Ksemoz Uryage cream was created for intensive moisturizing of dry skin in newborns, children and adults with all types of xerosis. Ksemoz also contains phytosqualane, glycerin, shea butter, thermal water Uriazh 30%; apply 1-2 times a day or more often, as needed.

Thus, the basic rules for caring for atopic skin include daily cleansing of the skin by taking a shower using a special cream (soap without soap) for washing (Cleansing dermatological gel Uriage; Mustela Stelatopia washing cream, etc.); almost immediately after getting the skin wet, the patient is recommended to apply a moisturizer, which the doctor prescribes to the patient depending on the condition of his skin. In particular, hydrating creams are used to moisturize the skin of the face; on the limbs and the area of the folds - lipid-rich ointments; with exacerbation of blood pressure - cream, emulsion; in remission - lipid-rich ointments; in summer - hydrating creams; in winter - lipid-rich ointments. Only after proper skin care, the doctor recommends that the patient apply an anti-inflammatory drug to the skin, depending on the severity of the skin disease, accompanied by the symptom of dry skin.

Literature

Elias P. M. Stratum corneum defensive functions: an integrated view // J Invest Dermatol. 2005; 125: 183-200.
Morar N., Cookson W. O., Harper J. I., Moffatt M. F. Filaggrin mutations in children with severe atopic dermatitis // J Invest Dermatol. 2007; 127: 1667-72.
Bieber T. Atopic Dermatitis // NEJM, 2008; 358: 1483-1494.
Barcoa D., Gimenez-Arnaub Xerosis A. A dysfunction of the epidermal barrier // Actas Dermosifiliogr. 2008; 99: 671-682
Hanifin J., Hebert A., Mays S. Effects of a low-potency corticosteroid lotion plus a moisturizing regimen in the treatment of atopic dermatitis // Curr Ther Res. 1998; 59: 227-233.
Imokawa G., Abe A., Jin K. et al. Decreased level of ceramides in strarum corneum of atopic dermatitis: an etiologic factor in atopic dry skin? // J Allergy Clin Immunol. 1999; 104: S123-S125.
Chamlin S., Kao J., Frieden L. et al. Ceramide-dominant barrier repair lipids alleviate childhood atopic dermatitis: changes in barrier function provide a sensitive indicator of disease activity // J Am Acad Dermatol. 2002; 47: 198-208.
Ainley-Walker P., Patel L., David T. Side to side comparison of topical treatment in atopic dermatitis // Arch Dis Child. 1998; 79: 149-152.

D. Sh. Macharadze, Doctor of Medical Sciences, Professor

Xerosis is a skin condition characterized by severe dryness of the epidermis, roughness, and sometimes peeling. Xerosis is congenital and acquired, its main cause is a decreased function of the sebaceous glands, which leads to extreme dryness of the skin.

With a deficiency of sebum, the skin ceases to properly perform its main functions - barrier and protective.

The main signs of xerosis:

1
feeling of tightness of the skin;
2
rough surface of the epidermis, the presence of scales;
3
invisible pores;
4
rugosity;
5
frequent itching.

Causes of skin xerosis in children and adults

The main causes of xerosis are listed by La Roche-Posay expert Alexander Prokofiev.

Thin skin.

Lack of vitamin A.

Influence of unfavorable factors (sun, solarium, wind, frost).

Prolonged exposure to hot water.

Using soap to cleanse the skin.

Wrong selection of cosmetics.

The use of certain medications (retinoids, hormonal agents).

Also, xerosis may indicate the presence of a dermatological or general disease, for example:

ichthyosis (in infants and children);

atopic dermatitis (in children);

follicular keratosis;

psoriasis;

oncological diseases;

hypothyroidism.

Varieties of xerosis

In total, there are three types of xerosis:

1
atopic (congenital) observed in children and, as a rule, is hereditary;
2
senile- This is the development of dry skin as a result of natural aging processes;
3
acquired xerosis caused by improper skin care and exposure to external or internal factors.

The first symptoms and signs of xerosis

The following information will help you catch xerosis at the initial stage and consult a doctor in time, who will identify the cause of this condition and prescribe adequate treatment. So, xerosis has three degrees of development.

First stage

The skin looks more or less well, there are no external symptoms visible to the naked eye. So far, all the changes occur at the level of sensations of dryness, burning and tightness, which disappear after applying a moisturizer.

Second stage

Peeling, redness, itching and wrinkling are added to the sensations of dryness and tightness. The moisturizer at this stage does not help much.

Third stage

There are all the signs of xeroderma: dryness of the stratum corneum is accompanied by scales, red spots, itching and even cracks (mainly in the folds - knees, elbows, fingers). The skin becomes very thin and defenseless against microorganisms and diseases such as dermatitis, eczema.

Which doctor should you contact

First, you need to contact a dermatologist, who will establish the true cause of xerosis and send for additional examination if pathological dryness is not caused by a skin disease. Eliminating the root causes will bring the function of the sebaceous glands back to normal.

How to deal with the disease

You need to deal with xerosis under the guidance of a doctor, but we will show you some general rules for care.

1
Alkaline soaps should be avoided. The best option is syndet, a significantly less aggressive cleansing product suitable for sensitive, dry skin.
3
As a care, it is important to use light nourishing creams with components that mimic sebum, that is, they form a protective fatty film to retain moisture.

Xerosis care products should contain a minimum of components, but among them are welcome:

mineral and natural vegetable oils;

soothing ingredients such as bisabolol, herbal extracts (St. John's wort, calendula);

components of a natural moisturizing factor, such as glycerin and hyaluronic acid.