There are always some friends around once the winter heating will be all over the skin uncomfortable, dry, itchy, peeling skin always accompanied by around. Sometimes with hot water to feel a special relief itch, but after the itch more powerful. In addition, some friends complain that their skin is always very rough and looks like snakeskin. Is dry skin due to dehydration? Can burning the skin with hot water relieve itching? How to prevent dry skin from peeling off? This article will give you detailed answers to dry itchy skin coping strategies. Barrier function of the skin When it comes to dry skin, first of all, we need to understand the barrier function of the skin. A complete skin barrier can isolate the organism from external harmful factors, resist their invasion and damage to the organism, and prevent the loss of nutrients and water in the body. If the skin barrier is damaged, water will be lost by evaporation through the epidermis and the skin will become dry, flaky and itchy. At the same time, the damaged skin barrier can weaken the resistance to external microorganisms and allergic substances, which can induce and aggravate some skin diseases. So, what is such an important skin barrier made of? The foundation of the skin barrier structure is the stratum corneum, which is located on the surface of the skin and is made up of dead epidermal keratinocytes arranged in a staggered pattern overlapping each other, which is often called “dead skin”. These cells are bonded to each other by intercellular lipids, forming a solid “brick wall structure”: the bricks are the dead keratinocytes and the cement is the intercellular lipids. Intercellular lipids are mainly composed of fatty acids, ceramides and cholesterol, etc. These lipids not only maintain the integrity of the skin barrier and prevent excessive water evaporation through the epidermis, but also moisturize the stratum corneum, inhibit bacterial growth, and resist skin aging. Therefore, excessive cleansing and exfoliation are in fact damaging the skin barrier structure. The “brick wall structure” of the skin barrier The counterpart of intercellular lipids is the skin surface lipids, also called sebum. Sebum is secreted by the sebaceous glands and is composed mainly of fatty acids, wax lipids and squalene. Together with water from sweat and skin metabolites, sebum forms the outermost hydrolipidic film of the skin. In addition to lubricating the skin, this hydrolipidic film reduces the evaporation of water from the skin surface and is an important part of the skin barrier and the first line of defense. Excessive washing can cause the loss of these lipids to destroy the hydrolipid membrane barrier of the skin, resulting in excessive evaporation of water and dry skin, which is the cause of senile pruritus. The hydrolipid membrane of the skin also has many metabolites or water-soluble substances that play an important moisture retention function in the skin barrier structure, known as natural moisturizing factors (NMF), which are mainly composed of amino acids, pyranoid ketone carboxylic acids, lactates, urea and other substances. These components of natural moisturizing factor are not only present in the epidermal hydrolipid membrane but also distributed in the intercellular spaces of the stratum corneum. Together with proteins and lipids, they keep the stratum corneum at a certain water content and maintain the water balance inside and outside the stratum corneum. Disruption of the skin barrier structure leads to the loss of natural moisturizing factors and a corresponding decrease in the skin’s moisturizing effect. The source and composition of skin surface lipids and intercellular lipids are different, with squalene as a hallmark component of skin surface lipids (sebum) and ceramide as a characteristic component of intercellular lipids. Therefore, moisturizing skin care products focus on slightly different barrier protection and repair effects depending on their main ingredients. For normal skin, skin care products containing fatty acids, wax lipids, squalene and other skin surface lipids or their similar ingredients are sufficient, while for patients with dry, itchy, sensitive or inflammatory skin diseases combined with skin barrier damage, skin care products with extra ceramides should be used to help repair the “brick wall structure” of the stratum corneum. Is dry skin due to dehydration? In fact, the skin’s “water supply system” is internal and external, with the dermal vascular network responsible for supplying moisture and nutrients to the epidermis. Dry skin is often not due to a lack of water, but to a loss of natural moisturizing factors and excessive evaporation of water due to a damaged lipid barrier on the skin surface. Therefore, the essence of dehydration is still a lack of oil. To hydrate, we must first replenish the physiological lipids of the skin. The way to moisturize is not by applying cucumber or mask, but by protecting and repairing the skin barrier so that the lipids on the surface of the skin stop excessive evaporation of water. Using moisturizers that contain ingredients similar to skin surface lipids can restore moisturization to the skin and also help repair the damaged skin surface barrier structure and relieve dry skin. Why does skin get more itchy when I scratch it? A long time ago, itching was thought to be a specific type of pain. However, later studies have shown that itching is felt and transmitted by separate neurons and is not the same as the neurological perception and transmission mechanism of pain. Most of the itching associated with dermatological diseases is related to damage of the skin barrier and the entry of external irritants and allergens into the skin, stimulating the release of itch-related inflammatory mediators (e.g., histamine and substance P). Also, the physical properties of the skin change when it is dry, and this change can also produce pruritic symptoms if sensed by the nerve endings receptors in the lower stratum corneum. Scratching can temporarily control itching through neural inhibitory mechanisms, but instead makes the nerves more sensitive to mechanical stimuli. Scratching also stimulates the skin and increases the release of itch-related inflammatory substances in the skin, bringing about more intense itching, forming a vicious cycle of “itch-scratch-itch”. What are the possible causes of long-term recurrent dry skin itching? Many skin diseases have combined dryness and itching symptoms, but most of them are transient and can gradually improve as the skin ages and repairs itself. However, some chronic or hereditary skin diseases, due to damaged skin barrier and impaired repair, can bring about persistent or recurrent dry skin and itching, including atopic dermatitis, common ichthyosis, psoriasis, pruritus in the elderly and hand eczema. Atopic dermatitis: Also known as hereditary allergic eczema, patients often have a family history of allergic diseases such as eczema and allergic rhinitis, recurrent episodes of eczema since childhood, dry skin, and frequent pruritic papules, with the elbow fossa of the upper extremity and the N fossa of the lower extremity being characteristic sites of onset. It has been found that many of these patients have abnormalities in the structure or function of filoproteins and therefore have reduced levels of natural moisturizing factors in the skin. In addition, the ceramide content in the stratum corneum of the patient’s skin was also significantly reduced and, as a result, the skin lipid barrier was weak or incomplete. Appropriate use of emollients containing ceramides in these patients can improve the skin barrier, relieve disease symptoms, and reduce the frequency of itchy episodes. Atopic dermatitis Ichthyosis vulgaris: This is a very common hereditary skin disease in which the skin has a varying degree of “snakeskin” appearance, i.e., dry skin with snakeskin-like cracks on the surface and ichthyosiform scales, which worsen in winter. There are many different types of ichthyosis, but all patients have hyperkeratosis, flaking and disruption of the skin barrier. The most common type is called common ichthyosis, in which the skin has a disorder of ceramide metabolism, causing the keratinocytes to fail to “bond” properly with each other, so the keratinocytes loosen and fall off, resulting in thick, flaky skin and winter itching. Psoriasis: commonly known as psoriasis, it is an inflammatory skin disease with a certain genetic predisposition, manifesting as well-defined erythematous skin patches and plaques, as well as extensive flaking, often accompanied by severe itching, but scratching or forceful removal of scales can lead to subtle bleeding on the skin surface. Because the epidermal turnover rate of psoriasis patients is many times faster than normal people, the epidermal stratum corneum often lacks a variety of intercellular lipids, and the keratin barrier is not complete, coupled with the abnormal inflammatory reaction of the skin, thus showing a reddish, dry and flaky appearance. Psoriasis (provided by the Department of Dermatology, Peking Union Medical College Hospital) Pruritus in old age: the elderly have reduced sebaceous gland function, skin atrophy, dryness, and excessive hot water washing, prone to generalized itching, called pruritus in old age. Research shows that with increasing age, the lipid composition of the stratum corneum of the elderly has changed to a certain extent, with reduced cholesterol and triglyceride content, and the skin barrier function is more fragile and vulnerable to damage, resulting in water loss and making the skin dry. At the same time, the adhesion between keratinocytes decreases and flaking increases. As a result, itching is easily stimulated by various external factors. Adhering to the use of emollients can significantly relieve the itchy skin and improve the condition. Hand eczema: Friends who often do housework often have flushed, dry, rough, cracked, itchy hands, which worsen in winter, medically called hand eczema, and is also a skin condition that often occurs with dry problem skin. Damage to the skin barrier due to excessive hand cleaning, combined with the fact that individuals often have varying degrees of allergies, and thus after exposure to potentially allergenic substances such as dust and synthetic detergents, these substances tend to enter the skin internally, causing allergic reactions and chronic inflammation, along with direct stimulation of the itchy nerves by some chemicals, leads to the development of hand eczema. Hand eczema (dermis.net) 5 points for dry skin care What should I pay attention to in the daily care of dry itchy skin? Since skin barrier disruption can cause or aggravate dry and itchy skin, dry skin care revolves around the protection and repair of the skin barrier. The following 5 points can help to deal with various problems of dry skin: 1. Reduce excessive cleaning: foaming cleaning products will more or less remove dirt while taking away the lipids on the skin surface, so dry skin friends should reduce the frequency of bathing, 1-2 days in summer and 3-5 days in winter, to give time for the skin barrier to repair itself. In addition, you should try to be careful with exfoliating scrubs and other daily products to avoid excessive loss of the stratum corneum. 2. The cleaning process of skin should be as mild as possible: alkaline soap or cleaning products with too much cleaning power can quickly take away the lipids on the skin surface, destroy the hydrolipid film and cause skin barrier damage. Although too hot water can temporarily suppress the itching sensation, but on the other hand, it will accelerate the loss of lipids on the skin surface (think about washing dishes is not hot water easier to remove grease), but also stimulate the release of inflammatory substances on the skin, leading to increased itching. In addition, prolonged soaking of the skin (such as foot baths, baths and prolonged swimming) can also cause sebum loss, excessive water absorption and expansion of the stratum corneum, and increased permeability, leading to skin barrier damage, so dry skin should avoid these habits mentioned above. 3, choose the right moisturizer for you: If you want to take a bath every day, but do not want dry and itchy skin, then it is essential to choose a suitable moisturizer for you. The ideal moisturizer should contain ingredients that are similar to the physiological lipid composition of the skin: free fatty acids, ceramides, and cholesterol. Remember, glycerin and cooking oil are not ideal moisturizers! Glycerin is not an oil, but a water-soluble alcohol that does not stop the evaporation of water from the skin, and instead draws moisture from the skin when the outside air is dry. Edible oils such as olive oil are rich in fatty acids, but lack other physiological lipid components that can effectively protect and repair the skin barrier. Therefore, we need to choose proven moisturizing skin care products made by regular manufacturers. Use emollients quickly after bathing to “lock” the moisture absorbed by the skin and promote skin barrier repair. 4, avoid scratching to stimulate the skin: to interrupt the vicious circle of “itch – scratch – itch”, control of their hands is very important. Dry skin itching should try to avoid scratching. In addition to actively treating the primary skin disease, severe itching can be controlled at the source by using emollients that help repair the skin barrier and by using antihistamines under the guidance of a doctor. 5. Pay attention to labor protection: If your skin barrier is fragile, you may want to use the ability of foreign “mercenaries” and buy a pair of rubber gloves to protect your hands. For example, when engaged in some work that requires water to clean (such as shampooing, catering, printing and dyeing) and household chores (washing clothes, dishes, washing dishes), wearing gloves regularly is a very good way to protect your hands.