Xerosis is a fairly common condition characterised by extremely dry skin. It can be occasional or chronic and is accompanied by several discomforts. What are the different symptoms of xerosis? Let's explore this question together.
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- Xerosis: What are the symptoms?
Xerosis: What are the symptoms?
What is xerosis?
Common with age, xerosis refers to a significant skin dryness resulting from a disruption in the skin barrier. Normally, water is retained in the skin due to the lipid organisation in lamellar bilayers of the stratum corneum, the hydrolipidic film, and the natural moisturising factor (NMF), such as urea and amino acids. When the synthesis of epidermal lipids, sebum, which partly composes the hydrolipidic film, or NMF decreases, the skin barrier weakens, making the skin more vulnerable to external aggressions, transepidermal water loss, and xerosis.
Several factors can disrupt the balance of the skin barrier and cause dry skin. Natural ageing, for example, reduces sebum production and the synthesis of lipids in the stratum corneum, thus compromising the skin barrier function. Exposure to a cold and dry environment, especially in winter, also accelerates water evaporation, while the repeated use of hot water or harsh detergents dissolves the skin's protective lipids. Finally, dry skin can be exacerbated by an alteration of the skin microbiota, impacting the lipid structure of the epidermis.
The xerosis results from a complex interaction between biological, environmental, and microbial factors.
What are the manifestations of xerosis?
Xerosis is characterised by a variety of symptoms visible on the skin. If you are prone to this extreme skin dryness, you may observe one or more of the following signs, with varying degrees of severity:
Dry and rough skin.
Cutaneous xerosis primarily manifests as skin losing its softness and becoming rough to the touch. This coarseness is due to an alteration of the skin surface, where the hydrolipidic film becomes almost absent and a depletion of lipids makes the epidermis less supple. After slight pressure, skin affected by xerosis may take longer to return to its original state, indicating a deterioration in its elasticity.
Feelings of tightness and discomfort.
Another characteristic sign of xerosis: the sensations of skin tightness, which occur especially after showering or washing hands. They are particularly pronounced in areas prone to repeated stretching, such as the face, neck and hands. The application of emollient and nourishing creams generally allows for the restoration of comfortable skin.
Itching.
Xerosis cutis, or dry skin, can also cause itching, which can be widespread or localised to certain parts of the body. This itching is sometimes accompanied by a tingling sensation or mild heat. It primarily affects areas with fewer sebaceous glands, such as the shins, where the alteration of the hydrolipidic film weakens the skin. Less protected, the skin becomes more susceptible to external aggressions, promoting the appearance of irritations and tingling.
Redness and hypersensitivity.
In some instances, xerosis is accompanied by a widespread redness that gives the skin an inflamed and sensitised appearance. This redness is often associated with hypersensitivity, making the skin reactive to the slightest touch or temperature change. Certain clothing textures, such as wool, can become uncomfortable to the touch, and the application of warm to hot water can cause a burning or tingling sensation. This heightened reactivity is particularly common in areas most exposed to external aggressions, such as the face and hands.
The inflammation sometimes observed in cases of xerosis can be explained by the stress experienced by keratinocytes due to dehydration. In response, these cells release danger-associated molecular patterns (DAMPs), which activate the local immune system. This is followed by vasodilation, that is, an increase in the diameter of the capillaries, which in turn leads to an intensification of blood flow. These two elements are visually manifested by the appearance of redness.
Flaking and cracking.
When dryness intensifies, the skin begins to flake, meaning small scales gradually detach. This flaking is particularly noticeable in areas of friction, such as the knees and elbows. If no action is taken to combat the dryness, the skin can crack and microfissures may appear, especially on the heels and finger joints, where the skin undergoes significant mechanical stress.
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Sources
GROVE G. & al. Stratum Corneum Lipids in Skin Xerosis. Dermatologica (1989).
ROBETS M. S. & al. Skin biology, xerosis, barrier repair and measurement . Drug Discovery Today: Disease Mechanisms (2008).
GIMÉNEZ-ARNAU A. & al. Xerosis: A Dysfunction of the Epidermal Barrier. Actas Dermo-Sifiliográficas (2008).
STAUBACH P. & others Diagnosis and treatment of xerosis cutis – a position paper. JDDG: Journal of the German Society of Dermatology (2019).
KOTTNER J. & al. Molecular characterisation of xerosis cutis: A systematic review. Plos One (2021).
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