Dry skin on the body: the bathing mistakes that make it worse

Legs that feel tight and flake, shins with a “scaly” pattern, itching straight after the shower, dull arms that absorb cream in seconds. Dry skin on the body is extremely common, especially in winter and from the age of 50. And, often, one of the main causes lies in something we do every day to look after ourselves: the bath.

Hot water, soap, the length of the shower, the way we dry ourselves and what we do (or don't do) in the following minutes can protect the skin or leave it drier than it was. The good news: small changes usually make a big difference within a few weeks.

The skin barrier and what bathing does to it

The outermost layer of the skin, the stratum corneum, has an essential function: keeping water in and aggressors out (Proksch et al., 2008). It is often compared to a wall:

• The bricks are flattened cells filled with keratin and with substances that retain water (the so-called natural moisturising factor).
• The cement is a mixture of lipids (ceramides, cholesterol and fatty acids) that seals the spaces between the cells.
• On the surface, a film of sebum and sweat, slightly acidic (pH around 5), protects and contributes to the balance of the skin's microorganisms.

On the body, there are fewer sebaceous glands than on the face, especially on the legs and forearms. That is why these areas dry out more easily.

What happens during the bath

• Hot water dissolves part of the lipids on the surface and of the “cement”, and temporarily increases water loss from the skin.
• Detergents (soaps and surfactants) remove dirt and sebum, but also lipids and moisturising substances. Some are deposited on the skin and continue to irritate it (Ananthapadmanabhan et al., 2004).
• Traditional soaps are alkaline (pH 9 to 10), which disturbs the skin's pH and the activity of the enzymes that maintain the barrier.
• Water evaporates from the surface after the bath and, if the skin is not protected, takes some of its hydration with it.

A bath, in itself, is not the problem. The problem is the sum of hot, long baths with harsh detergents, day after day, on skin that already tends to dry out.

The bathing mistakes that dry out the skin

None of these habits is serious on its own. Added up, every day, for years, they make a difference.

A bath that protects the skin, step by step

• Lukewarm temperature. If the skin is very red when you get out, the water was too hot.
• Short shower, between 5 and 10 minutes.
• A gentle cleanser, soap-free and fragrance-free, in small quantity. Apply mainly to the armpits, groin, feet, hands and sweaty areas. On the legs, arms and back, on very dry skin, water or a bath oil may be enough.
• No scrubbing. Use your hands or a soft sponge.
• Rinse well, so as not to leave detergent residue.
• Pat dry, without rubbing, leaving the skin slightly damp.
• Moisturise within the next 3 minutes, with the skin still damp, all over the body, focusing on the legs, shins, elbows and hands.
• Wear cotton clothing or soft fabrics; wool directly on the skin can irritate.

What if I have little time in the morning?

A fluid cream or a quick-absorbing lotion in the morning, and a richer cream at night, is a good solution. Applying the cream at night also gives more contact time with the skin.

Bath oils and body oils

A bath oil (applied to wet skin and rinsed off) leaves a thin film that reduces water loss. A word of caution: they make the bottom of the bath slippery, especially for older people. A body oil after the bath also helps, but on its own it moisturises less than a cream that combines oil and water with humectants.

How to choose the moisturiser

A good body moisturiser for dry skin combines three types of ingredients (Lodén, 2003):

For very dry skin, creams and ointments (which are richer) work better than fluid lotions. For shins and elbows with scaling, creams with urea or lactic acid help remove the excess cells. Choose fragrance-free products. Price is not an indicator of effectiveness: simple pharmacy products are often the most effective.

Hard water, winter and age

Hard water

In many parts of Portugal the mains water is rich in calcium and magnesium (hard water). A 2018 study, with 80 participants (Danby et al., 2018), showed that washing the skin with an ordinary detergent in hard water left more detergent residue on the skin, which increased water loss and irritation, especially in people with atopic dermatitis and genetic changes of the barrier. Softened water reduced this effect. The study was funded by a water-softener company, and there are not yet any trials showing that installing a softener improves dry skin. In practice: with hard water, use less detergent, prefer gentle products and rinse well.

Winter

Cold, wind and indoor heating reduce the humidity of the air and of the skin. This is when dry skin and itching increase the most. Using more moisturiser, lowering the water temperature and using a humidifier in the bedroom help.

Age

From the age of 50 to 60, the skin produces fewer lipids and less sebum and renews itself more slowly. Dry skin (xerosis) is very common in older people and is one of the main causes of itching at this age (Mekic et al., 2019). The same rules apply, and matter even more.

When dry skin is a sign of something else

In most people, dry skin on the body improves in two to four weeks with these changes. Seek medical assessment if:

Chronic itching has its own European guideline (Weisshaar et al., 2019).

At Luxmed, we assess the skin of the body and help adjust your bathing and moisturising routine to your skin. When there are signs of skin disease or an internal cause, we refer you for medical assessment.

This article is for information purposes and does not replace a consultation.

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