INTRODUCTION
The majority of people experience xerosis during their lifetime and the condition can be acute or chronic.1,2 Both endogenous and exogenous factors contribute to the development of xerosis (Figure 1).3 Xerosis can occur due to changes in the environment, skincare regimen, age, medications, hereditary disorders such as ichthyosis, or secondary to inflammatory skin conditions such as atopic dermatitis, psoriasis, and seborrheic dermatitis.2,4-6 Clinically, signs of xerosis include scaling, white/flaky skin, cracks and fissures, erythema, hyperkeratosis, and lichenification. Symptoms of xerosis commonly include pruritus, which can be a significant and chronic problem in older individuals.7 Other signs and symptoms of xerosis range from the physical sensation of dryness or discomfort of the skin to pain or stinging.8 Deficiencies of several individual molecules and structural components in the epidermis can contribute to xerosis, including NMFs and ceramides; abnormalities in the skin's moisture network also play a role.9,10
The impact of xerosis is increasingly appreciated by healthcare professionals, particularly as the population ages, since dry skin in older patients can lead to problems that can be significant.11 For example, excoriation of dry, pruritic skin can lead to infection, fragile and dry or cracked skin in individuals with poor mobility can lead to pressure ulcers, and in those with insulin-dependent diabetes, dry skin can be a precursor to foot erosions and infections.11 Dry skin may also be a sign of malnutrition among elderly individuals.11
The impact of xerosis is increasingly appreciated by healthcare professionals, particularly as the population ages, since dry skin in older patients can lead to problems that can be significant.11 For example, excoriation of dry, pruritic skin can lead to infection, fragile and dry or cracked skin in individuals with poor mobility can lead to pressure ulcers, and in those with insulin-dependent diabetes, dry skin can be a precursor to foot erosions and infections.11 Dry skin may also be a sign of malnutrition among elderly individuals.11
Role of Moisturizers in Xerotic Conditions
Moisturizers serve as the foundation of the management of xerotic conditions.8 These products can have both short- and long-term effects on skin hydration, barrier function, skin texture, elasticity, and appearance.8 Incorporation of specific ingredients into moisturizer formulations can enhance some of these beneficial effects.12 Over the years, there have been significant advances in the development of moisturizers, from occlusives formulated as basic skin barrier protection to humectant-enriched moisturizers developed for hydrating care.8 Occlusives are substances that form a confluent layer on the skin surface, physically blocking the evaporation of water (transepidermal water loss) and can shield the skin from irritants, allergens, and pathogens. Commonly used occlusives include oils (eg, soybean oil, olive oil, and mineral oil), waxes (eg, carnauba and beeswax), dimethicone, lanolin, and petrolatum.8 Emollients are saturated and unsaturated lipids (eg, colloidal oatmeal, shea butter, and isopropyl palmitate)
