What is Xerosis and what causes it?
Xerosis in dermatology is what is commonly referred to as dry skin. Dry skin can have many causes and these causes can vary according to age. It is not the same in an elderly person, who are usually patients who have an inability to synthesize lipids well, have an increase in transepidermal water loss, which causes dry, cracked, fissured skin that causes itching. In children, on the other hand, the most frequent cause of dry skin is atopic dermatitis, known as Atopy, which is a disease that has a genetic background and is caused by an alteration in the formation of the skin barrier. They genetically have a problem in synthesizing the cement that would bind the skin cells together.
What are the main symptoms?
The main symptom produced by Xerosis, dry skin, is itching. Itching induces the person to scratch, to create lesions, erosions, linear lesions many times due to that self-inflicted wound. And with these lesions, many times what the patient induces is eczematization, inflammation, causing dermatitis in those scratched areas and also many times with it the over infection of those lesions, so we often see children with eczema, scratched, over infected and it is a vicious circle since it itches them more. When a patient scratches a lot or rubs a lot in the same area because it causes a lot of itching, the skin has a defense mechanism which is lichenification, which makes it fatter, and that is even worse because it is a vicious circle that makes the skin itch much more, so it is very important to cut this cycle of itching and scratching in these patients.
Does it affect children more frequently?
Xerosis in children mainly appears in atopic dermatitis and atopic dermatitis is a disease that has experienced in the last three decades an increase of up to 20% of incidence in the countries around us, generally in industrialized countries. It is the second cause of visits to the dermatologist in this age group. The reason why it affects the pediatric age group more than adults is probably because the cause of atopic dermatitis actually originates in a genetic disorder whereby these children are not able to synthesize a mature skin, a correct skin that serves as a barrier against external aggressions. And what usually happens is that slowly throughout the first years of life that skin matures and learns to create that barrier. That is why we can normally see atopic dermatitis in up to 10% or 20% of children, especially in the first years of life, while in adults it only has an incidence of 5% or 7%.
What does the treatment consist of?
The treatment of dry skin is basically hydration. One thing is maintenance hydration, not in an acute outbreak of eczema, when the skin is already affected and inflammation and dermatitis are already visible on the skin, which would be maintenance by means of mollients, moisturizers… we must even help sometimes with good hygiene products for bathing. Another thing is the treatment in outbreak. The treatment of atopic dermatitis, for example in outbreak, when there is already that redness, that desquamation, we must use treatment creams that would be based on corticosteroids many times, corticosteroids of very different potency, depending on the age of the child, of the localization; with very different vehicles, it is not the same to give a cream, a lotion or an ointment. And sometimes other types of treatment, sometimes even systemic, depending a little bit on the intensity of the symptoms.