Condition

Dry Skin (Xerosis)

Dry skin, or xerosis, is skin that has lost water and oil, so it feels tight, rough and flaky. It is very common, much worse in winter, and usually fixed by changing how you wash and moisturize rather than by treating a disease.
At a Glance

Dry skin is skin that cannot hold on to water, so it feels tight and looks rough, dull or flaky. Almost everyone gets it at some point, and it is far more common in winter, in older adults, and in anyone who takes long hot showers.

The fix is boring and it works: shorter, cooler showers, a gentle cleanser, and a thick moisturizer put on damp skin within a few minutes of getting out. Timing matters more than which product you buy.

If the skin is also intensely itchy, inflamed, and keeps coming back in the same places, that is more likely eczema than plain dry skin, and it needs different treatment.

Key Facts

How CommonVery common. Most people get it at some point, and it affects the majority of adults over 60.
Who Gets ItAnyone. More common with age, in cold or dry climates, and in people who wash often or use harsh soap.
Chronic or CurableNeither, exactly. It comes and goes with the seasons and your habits, and it improves within days once you change them.
Rx RequiredNo. Almost all dry skin responds to over-the-counter moisturizers.
ContagiousNo.
CostLow. Plain drugstore creams work as well as expensive ones.

Symptoms

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Dry skin is more about how it feels than how it looks. Tightness is usually the first sign, and it turns up before any visible flaking.

What it looks and feels like

Tightness — most noticeable right after a shower or after washing your hands.
Rough, sandpapery texture — you feel it more than you see it.
Fine white flaking — small, powdery scale rather than large greasy flakes.
Dull or ashy-looking skin — light reflects poorly off a rough surface.
Fine cracks — a criss-cross pattern like cracked china, most often on the shins.
Mild itch — dry skin can itch, but a fierce itch that wakes you up points to eczema instead.
Stinging on products that used to be fine — a sign the surface has been stripped.

Where it shows up

  • Lower legs and shins — the most common spot by far, and usually the first.
  • Forearms and the backs of the hands, especially in people who wash their hands a lot.
  • The sides of the torso and the lower back.
  • The face, especially the cheeks and around the nose in winter.
  • Heels and feet, where dryness turns into thick, painful cracks.
  • Whatever gets washed most, and whatever gets rubbed by clothing, dries out first.

How it looks on different skin tones

On brown and Black skin, dry skin usually looks grey or ashy rather than pink or red, and the flaking stands out more against the surrounding skin. The cracked pattern on the shins can look darker rather than lighter. Any marks left behind once the dryness settles are pigment change, not scarring, and they fade over weeks.

Light
Medium
Brown
Deep

Several itchy, scaly conditions look like plain dry skin. If yours does not fit the description above, see Lookalikes near the bottom of this page.

Causes & Risk Factors

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Your skin holds water using two things: the natural oils sitting on the surface, and water-binding molecules inside the outer layer. Anything that removes those, or pulls water out faster than it can be replaced, leaves you dry. Cold outdoor air holds very little water and heated indoor air holds even less, which is why winter is the worst season for almost everyone. Hot water and soap strip the surface oils directly, so long showers, frequent hand washing and harsh foaming cleansers do a lot of the damage.

Age matters too. Skin makes less oil and holds less water each decade, which is why dry skin is close to universal past sixty. Some people are simply built with a weaker barrier — dry skin runs in families, and it often travels with eczema, hay fever and asthma. And sometimes dryness is a symptom of something else. An underactive thyroid, kidney disease, poorly controlled diabetes, and medications including retinoids, diuretics, statins and acne treatments all dry the skin out. That is worth thinking about when dry skin is severe, is new for you, or does not budge with the usual measures.

What Hurts and What Helps

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What Makes It Worse

  • Hot showers and baths, and long ones. Heat strips oil off the skin faster than anything else in a normal day.
  • Winter, and indoor heating. Cold air holds little moisture and heated indoor air holds less.
  • Harsh soap and foaming cleansers. Anything that leaves your skin squeaky has taken the oil with it.
  • Frequent hand washing, and alcohol hand sanitizer.
  • Scrubs, washcloths, loofahs and exfoliating acids used too often.
  • Dry air from air conditioning, plane travel and wood stoves.
  • Waiting until the skin is completely dry before moisturizing. Most of the water you could have trapped has already gone.
  • Alcohol-heavy toners and astringents.
  • Age, which is the one on this list you cannot do anything about.

Daily Habits That Help

  • Shorter showers, and lukewarm rather than hot. Five to ten minutes is plenty.
  • Moisturizing within about three minutes of getting out, while the skin is still damp. This single habit does more than the choice of product.
  • Patting dry instead of rubbing, and leaving the skin slightly damp on purpose.
  • A cream or ointment rather than a lotion. Thicker products hold water in better, and as a rule the greasier something feels, the better it works.
  • A gentle, non-foaming cleanser, used only where you actually need it.
  • A humidifier through the winter, especially in the bedroom.
  • Fewer products overall. Dry skin is very often the result of doing too much rather than too little.
+1 more
  • Time. Skin that has been dried out takes a week or two of consistent care to feel normal again, not a day.

Try at Home

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Almost all dry skin is fixed at home, and the ingredient list matters less than people think. What matters is a thick enough product, used often enough, on damp skin.

Always
The whole treatment for most people. A cream or ointment with ceramides replaces the fats that hold water in and keeps the surface from drying out again. Twice a day, and always within a few minutes of a shower.
Always
The cheapest thing that works, and nothing seals water into skin better. Best on the spots that crack — heels, fingertips, knuckles and lips — put on at night, ideally under socks or cotton gloves. It is greasy, and that is the point.
Always
Changing your cleanser often does more than adding a moisturizer. Bar soap and high-foaming body wash strip the oils you are trying to keep. If your skin squeaks when clean, the cleanser is too harsh.
Always
A humectant, meaning it pulls water into the outer layer of skin and holds it there. It is in almost every decent moisturizer already, and it is one of the few ingredients with a long, boring, well-proven track record.
Strong evidence
Does two jobs: holds water in, and loosens thick scale so it sheds instead of building up. Best for rough shins, elbows and cracked heels. Higher strengths can sting on broken skin.
Strong evidence
A lactic acid lotion that hydrates and gently loosens flaking at the same time. It is one of the better options for rough, bumpy or scaly legs and arms. Expect stinging for the first few days on cracked skin.
Moderate evidence
Holds water at the surface, which helps most with dehydrated skin rather than genuinely oil-poor skin. The catch: on its own in dry air it can pull water out of the skin. Always put a cream over it.
Moderate evidence
Soothing and mildly anti-itch, in a cream or as a bath soak. Useful when dry skin has started to itch. It will not do much for thick scale.
Strong evidence
An occlusive that feels lighter than petroleum jelly and spreads more easily over large areas like the legs and back. Good in a bath or applied to damp skin. Less effective than petrolatum, but far more pleasant to use.
Moderate evidence
A silicone that forms a light seal without feeling greasy, so it suits the face and hands during the day. It is the reason many moisturizers feel silky. Not as strong a seal as an ointment.
Limited evidence
A light oil that sinks in fast and suits faces that feel dry but break out easily. It is a nice texture rather than a powerful treatment — it will not fix badly cracked skin on its own.
A humidifier
Limited evidence
Not a product for your skin, but one of the more useful things you can buy. Heated indoor air is extremely dry, and running a humidifier in the bedroom covers the eight hours a night you spend in it. Clean it regularly or it grows mould.

When to See a Dermatologist

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Most dry skin is handled at home with cheap products. It is worth booking a visit if:

  • Two to four weeks of daily moisturizer and gentler washing have changed nothing.
  • The itch is intense, keeps you awake, or you are scratching until the skin breaks.
  • The dry patches are inflamed, weeping, crusted or clearly raised rather than just rough.
  • The skin cracks deeply enough to bleed, especially on the fingertips, hands or heels.
  • The dryness came on quickly, covers most of your body, or is new for you as an adult.
  • You also have tiredness, weight change, swelling, or more thirst and urination than usual. Those point to a medical cause rather than the weather.

What the visit gets you: a check for the conditions dry skin can be a sign of, an honest answer on whether this is eczema rather than dryness, and prescription options that plain moisturizer cannot match.

What Happens at the Dermatologist?+

Dry skin itself is recognized by looking, and most people need no tests at all.

Testing is worth doing when the dryness is severe, came on suddenly, covers most of the body, or is new in an adult — because dry skin can be a symptom of something else.

  • Blood tests. Thyroid function is the most common, since an underactive thyroid dries the skin. Kidney function and blood sugar are checked for the same reason. Iron is sometimes added when there is itch without much rash.
  • A medication review. Not a lab test, but often the thing that finds the answer. Retinoids, diuretics, statins, some blood pressure drugs and acne treatments all dry the skin, and the timing usually gives it away.
  • Patch testing. Small patches of common allergens are taped to your back and read over about a week. Used when dry, irritated skin keeps returning to the same place, to check whether something you are putting on it is the cause.
  • A skin biopsy. Uncommon. Reserved for scaly skin that does not fit any usual pattern, or dryness with itch that has not responded to treatment.

Routine allergy blood tests do not diagnose dry skin and rarely change what you do.

Prescription Treatments

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Prescriptions are for dry skin that has become inflamed or cracked, not for ordinary dryness. Most people never need one.

Strong evidence
For dry skin that has become genuinely inflamed — red, itchy, cracked patches, most often on the shins. It calms the inflammation so the moisturizer can do its job. Short courses only, and it does not replace the moisturizer.
Strong evidence
A moderate-strength steroid, usually given as an ointment for cracked, inflamed dry skin on the arms and legs. Two weeks is a typical course. Not for the face, and not for everyday use.

What to Expect

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Step 1
The first few days

Tightness and stinging settle first. If your skin feels less tight after a shower, the change is already working.

Step 2
One to two weeks

Flaking and roughness improve. This is the slowest visible part, because the rough surface has to shed and be replaced.

Step 3
Deep cracks on hands and heels

Three to six weeks, and only if you keep them greased and covered overnight. These are always the last thing to close.

Step 4
When winter ends

Most people need much less once the heating goes off, and can drop back to a lighter moisturizer from spring through autumn.

Step 5
The honest long view

Dry skin is managed, not cured. It comes back when the habits stop or the weather turns. The upside is that the management is cheap and it works quickly.

Complications

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Dry skin on its own is not dangerous, and it does not scar. A few things can follow if it is left alone for a long time.

Cracks and splits
Deep fissures on the fingertips, knuckles and heels are painful, slow to heal, and they bleed.
Infection
Broken skin lets bacteria in. Spreading redness, warmth, swelling, pus or yellow crusting needs treating rather than more moisturizer.
An itch-scratch cycle
Scratching damages the barrier, and a damaged barrier itches more. Left long enough, the skin thickens into rough, leathery patches.
Asteatotic eczema
Very dry skin, most often on the shins of older adults, can tip into a genuinely inflamed rash with a cracked, crazy-paving look. It needs a steroid cream as well as moisturizer.
Marks left behind
Lighter or darker patches where the dryness and scratching were, most noticeable on brown and Black skin. They fade over weeks to months.

Lookalikes

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Plenty of things look like plain dry skin, and a few of them need different treatment.

  • Eczema (atopic dermatitis) — the difference is inflammation. Eczema is itchy first and dry second, the patches are raised and discoloured rather than just rough, and it returns to the same places: the elbow creases, the backs of the knees, the neck and the hands.
  • Dehydrated skin — a short-term state rather than a skin type. The skin is short of water, not oil, so it can feel tight and look dull while still being oily and breaking out. It responds to gentler cleansing and water-binding ingredients, not to heavier oils.
  • Psoriasis — thick, well-defined raised patches with a silvery scale, usually on the outside of the elbows and knees. Dry skin has no edge to it; psoriasis does.
  • Ichthyosis — an inherited condition that builds fish-like scale, usually from childhood and most obvious on the shins. Far more scale than ordinary dryness, and it does not clear with a normal moisturizer.
  • Contact dermatitis — dryness and irritation in the shape of whatever touched the skin. Worth suspecting when the dry patch has a border, or turned up after a new product.
  • Fungal infection (tinea) — a dry, scaly patch with a raised active edge and a clearer middle. This one matters, because a steroid cream makes it worse and spreads it.
  • Hypothyroidism — dry, coarse skin all over, usually alongside tiredness, feeling cold and weight gain. That one is a blood test, not a cream.
FAQ+
What is the difference between dry skin and dehydrated skin?Dry skin lacks oil. Dehydrated skin lacks water. Dry skin is a type you tend to have long-term; dehydration is a temporary state, and oily skin can be dehydrated at the same time. Dry skin needs richer creams. Dehydrated skin needs water-binding ingredients like glycerin and hyaluronic acid, plus gentler cleansing.
Does drinking more water fix dry skin?Not really. If you are genuinely dehydrated it helps, but in someone drinking normally, extra water does not measurably change how dry the skin surface is. What you put on the outside matters far more.
When should I put moisturizer on?Within about three minutes of getting out of the shower, on skin that is still damp. You are trapping water that is already there. This timing matters more than which moisturizer you buy.
Is an expensive moisturizer better?No. Plain drugstore creams with petrolatum, glycerin or ceramides perform as well as luxury products. You are mostly paying for texture, scent and packaging.
Cream, lotion or ointment?Ointments work best and feel greasiest. Creams are the usual compromise. Lotions are mostly water and are the weakest, though they are easier to spread over large areas. As a rule, the greasier it feels, the better it works.
Can I be dry and oily at the same time?Yes. Oily areas can still be short of water, and stripping them with harsh cleansers makes both problems worse.
Why is my skin so much worse in winter?Cold air holds very little moisture and indoor heating holds even less. Add hot showers and you have the perfect setup. Most people need a thicker moisturizer from about November to March.
Does dry skin cause wrinkles?Dryness makes fine lines look more obvious, and moisturizing makes them look better within hours. It does not cause permanent wrinkles — that is sun exposure and time.
Can dry skin turn into eczema?In a sense, yes. Very dry skin can become inflamed and itchy enough to count as eczema, especially on the lower legs in older adults. If the skin is inflamed rather than just rough, moisturizer alone will not be enough.
Do I need to exfoliate the flakes off?Usually not, and scrubbing tends to make it worse. If the flaking is thick, a moisturizer containing urea, lactic acid or ammonium lactate loosens it far more gently than a scrub.
Should I use a humidifier?It helps if your indoor air is dry, which most heated homes are in winter. Put it in the bedroom, where you spend eight hours a night.
Can medications cause dry skin?Yes. Retinoids, diuretics, statins, some blood pressure drugs and acne treatments are common culprits. If the dryness started within a few months of a new prescription, mention it to your doctor.