Dry skin (xerosis cutis) can range from mild to severe. Symptoms may include:

• Tightness or discomfort, especially after bathing or washing
• Rough texture and dull appearance
• Fine scaling or flaking, often on the shins, forearms, hands, and trunk
• Itching that can be mild or intense
• Redness or irritation when the skin barrier is inflamed
• Cracking or fissures, particularly on the hands, heels, or fingertips
• “Ashy” appearance in darker skin tones due to surface scaling
• Secondary rash if scratching leads to inflammation, thickening, or small excoriations

When fissures form, the skin may sting or bleed and can be more vulnerable to infection. Persistent itch and repeated scratching can also trigger a cycle of irritation that makes symptoms more difficult to control.

Dry skin (xerosis cutis) most often results from a combination of barrier disruption and moisture loss. Common causes and contributors include:

• Low humidity and cold weather, which reduce ambient moisture and increase water loss from the skin
• Hot showers or frequent bathing, especially with prolonged water exposure
• Harsh soaps and detergents that strip protective oils from the skin
• Frequent handwashing and sanitizer use, particularly in healthcare and service occupations
• Aging, as the skin produces fewer natural lipids over time
• Atopic dermatitis (eczema) tendency, which is associated with a weaker skin barrier
• Irritants and friction, including occupational exposures and frequent glove use
• Certain medications, which can contribute to dryness in some individuals
• Medical conditions, such as thyroid disease, diabetes, kidney disease, or nutritional deficiencies, which can worsen generalized dryness in select cases

Identifying the key drivers often helps determine whether symptoms are primarily environmental, irritant-related, eczema-associated, or influenced by an underlying medical issue.

Dry skin (xerosis cutis) is typically diagnosed with a focused skin examination and a review of daily habits and exposures. Dr. Knackstedt and the team at Peak Skin Center assess:

• The distribution of dryness (localized hands versus generalized body involvement)
• Presence of inflammation, redness, or thickened areas from scratching
• Signs that suggest a related condition such as eczema, contact dermatitis, psoriasis, ichthyosis, or a fungal process
• Lifestyle factors such as bathing routines, soap selection, workplace exposures, and seasonal patterns

When dryness is severe, persistent, or generalized without a clear explanation, additional evaluation may be considered to rule out contributing systemic conditions. In some cases, diagnosis includes identifying overlapping dermatitis that benefits from targeted anti-inflammatory treatment.

Treatment of dry skin (xerosis cutis) focuses on repairing the skin barrier, reducing moisture loss, and calming inflammation when present.

• Gentle cleansing and bathing: Use fragrance-free, non-soap cleansers, limit showers, and use lukewarm water. Apply moisturizer within minutes after bathing to help lock in hydration.
• Moisturizing strategy: Prefer thick creams or ointments over lotions. Products with petrolatum, ceramides, glycerin, urea, or lactic acid can help restore barrier function and improve roughness and scale.
• Itch or rash control: When redness or significant itching is present, short courses of prescription anti-inflammatory topical therapy may be recommended to treat associated dermatitis while barrier repair continues.
• Hands and feet support: Frequent moisturizer use and nighttime ointment occlusion can help fissures. Keratolytic moisturizers may be used for thick scale on heels or elbows when appropriate.
• Trigger reduction: Limiting irritants, protecting skin during wet work, and improving indoor humidity may reduce flares.