For the past  month, I noticed that my thumb would get little red spots  that itched so much it woke  me up at night.  As a  health writer I began to wonder if this was the start of a bigger problem like psoriasis, eczema or ( horrors)   even bedbugs.  When I showed  my spotty thumb to Dr Marmur, she smiled and nodded her head.  Her diagnosis?  My skin was so dry it was ready to crack open.   It was a reminder that  what we see as beauty  problems are actually  physical and chemical changes in the body that are causing unwanted consequences.  And the solutions  have to be based on  science, not the latest fad ingrdient or celebrity interview.

What Causes Dry Skin?

For  many years  experts  felt that dry skin was due to lack of  oil and recommended rich creams and lotions to relieve the problem.  Later doctors recognized that it was the loss of water that  produced rough flaking skin– and that the creams acted like a shield  to prevent evaporation of water from the skin.  More  recent  research  has drilled deeper into the issues and determined that chemicals in the skin play different roles  in keeping skin hydrated.  For example hyaluronic acid  is a naturally occuring molecule that  can hold 100x its weight in water.  Ceramides are equally important as they act like glue to keep the cells together and  not flaking off.   It will probably come as no big surprise to learn that as we get older  the levels of hyaluronic acid and ceramides drop sharply.  That’s the bad news.  The good news?  Skin care products  now can resupply these ingredients in their formulations.

 Circumstances outside the skin can also  be a bad actor in dry skin  problems.  Windy, cold, dry weather  rob  skin of  its natural moisture.  My long hot  showers actually  made my skin drier.  My Mom  has also been in and out of the hospital and I have been using up bottles of alcohol based hand sanitizer.  The skin on my face and  neck had been exposed to the same external issues, but I had been using  mild cleansers and well formulated moisturizers as party of  my regular  skin care routinue.  My thumb was on its own.

I had been putting a mild steroid cream on  my thumb  spots and covering it with a bandaid.  I was so wrong on so many levels.   The innocent looking bandaid was actually creating a soggy environment that  was  making  matters worse.  Dr Marmur prescribed both a stronger steroid and    super emollient  creams and soaps as well as  a ban on hot showers.  It turns  out that once your skin gets this dry its  hard to treat and will take a  month  to get back  to its own normal.