Dry Skin Information

Dry, itchy, scaly skin is common complaint in dialysis patients. The best way to relieve dry skin is to use a moisturizer. Too much water can cause the skin to dry out. Showering or bathing more than once a day should be avoided to prevent dry skin.

Eczema is dry skin that develops into red, itchy, or painful patches that become cracked. If the skin becomes cracked or broken, infection can develop must be treated by a physician.

Causes

Approximately 60 percent of dialysis patients complain of itchy, dry skin, which is often generalized but may be most prominent on the back. A number of factors may contribute to these symptoms:

• dry skin due to impaired sweat glands
• high phosphate
• inadequate dialysis
• anemia (low blood counts)
• high aluminum levels
• high vitamin A levels
• decreased immune system
• washing with excessively hot water
• using non-moisturizing soap
• showering or bathing more than once a day and for long periods of time

Treatment

Emollients or moisturizers are creams that can be applied to the affected area to prevent water from evaporating from the skin's surface. Emollients also smooth over the scaly edges that can flake off and cause intense itching. Emollients should be applied after washing or showering and frequently throughout the day.

Lotions, which have a high water and low oil content, can worsen dry skin via evaporation and trigger a flare. In contrast, thick creams (eg, Eucerin, Cetaphil, Nutraderm), which have a low water content, or ointments (eg, petroleum jelly, Aquaphor, Petrolatum), which have zero water content, better protect against dry skin.

Creams and lotions that contain keratolytic agents, such as urea, salicylate, lactic acid, vitamin A, and propylene glycols are also available. These lotions are not as moisturizing as emollients but are more effective on thicken skin areas such as the heels.

Application

Moisturizers should be applied generously and frequently, particularly after washing, or being outdoors in cold weather for long periods of time. Skin care products that contain alcohol and fragrances are more likely to dry out the skin and should be avoided. Most moisturizers and lotions require at least twice-a-day application for the prevention of dry skin. Ointments are usually applied at bedtime.

Prepared by:
Séadna Ledger BSc.Phm (May 2013)