Dry skin

Dry skin feels tight, rough or flaky, looks dull, and can itch. It comes from a combination of too little moisture in the outer layer and a skin barrier that is not holding what moisture there is.

With age this becomes more common: oil production drops, collagen production decreases, and skin cells lose some of their ability to hold water and maintain an even texture.

How the skin holds moisture

The outermost layer works like a wall - skin cells as bricks, lipids between them as mortar. When the lipid layer is depleted, water evaporates out and irritants get in. That is why dry skin is also often sensitive skin: the two share a cause.

Beneath that, the dermis contains collagen, elastin and other fibrous tissue supporting the skin's structure and fullness. As those reduce with age, the skin thins and dries further.

What dries skin out

Age - reduced oil and lipid production
Climate - low humidity, wind, cold, and indoor heating and air conditioning
Hot showers and long baths - among the most common causes and the easiest to change
Harsh cleansers - soap and foaming washes strip the lipid layer
Over-exfoliating - including too-frequent scrubs, acids or retinoids
Sun damage - see sun damage
Medications - including some acne, cholesterol and blood pressure medicines and diuretics
Medical conditions - eczema, psoriasis, and an underactive thyroid among them
Smoking and inadequate fluid intake
Genetics

When dryness needs a doctor rather than a skin treatment

See a doctor if dry skin is:

Severe, widespread, or not improving with good skincare
Intensely itchy, particularly if it is disturbing sleep
Cracking, bleeding, weeping or infected
Accompanied by an inflamed red rash - this may be eczema or psoriasis and needs treating as such
New and unexplained, particularly with fatigue or other symptoms

Cosmetic treatments applied to untreated eczema will not help and can irritate.

What to change at home - this does most of the work

Shorter, cooler showers
A gentle, non-foaming cleanser instead of soap
Moisturiser applied within minutes of bathing, while skin is still slightly damp
A thicker occlusive product overnight in winter
Fragrance-free products if your skin is reactive
A humidifier where indoor air is dry
Daily sunscreen
Pulling back on exfoliation and actives while the barrier recovers
Adequate fluid, and not smoking

Look for ingredients that do specific jobs: humectants (glycerin, hyaluronic acid) draw water in, emollients (ceramides, fatty acids) smooth the barrier, and occlusives (petrolatum, dimethicone) stop water escaping. Products combining all three work better than any one alone.

In-clinic treatments

Cosmeceutical skincare - the foundation, prescribed to your skin rather than bought at random
Skin needling - stimulates collagen and improves texture; used once the barrier is stable
Hydrating peels and facials
LED therapy - to calm inflammation
Platelet-rich plasma (PRP) therapy, where indicated
Microdermabrasion - used carefully, and not on an already-compromised barrier
Mineral make-up - less drying than many conventional foundations

A note on sequencing: resurfacing and exfoliating treatments on a damaged barrier make dryness worse. Repair first, then treat.

What results are realistic

Most dry skin improves substantially with a corrected routine alone, often within a few weeks. In-clinic treatment adds to that, particularly for texture and fine lines.

The improvement is maintained rather than permanent - stop the routine and dryness returns, because the underlying causes are unchanged. Dry skin associated with a medical condition needs that condition managed. Individual results vary.

Risks

Irritation, stinging or contact reaction to new products
Increased dryness or flaking from treatments applied too aggressively
Breakouts from heavy occlusive products on acne-prone skin
Redness, swelling and peeling after peels or needling
Changes in pigmentation, more likely in darker skin types
Infection
Incomplete improvement, particularly where a medical cause is untreated

See risks and complications.

Cost

As at September 2024 and including GST, a skin assessment is $50 and a Cosmetic Doctor consultation is $150. Dermal skin treatments start from $130. A plan is quoted after assessment. Not covered by Medicare.

Booking

Me Clinic, 4 Burke Road, Malvern East VIC 3145. Phone 1300 852 050 or (03) 9569 3511, or use the online consultation form. Treatment-room skin work is provided by Michelle Casey, Paramedical Aesthetician.

Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.