Top ten tips to relieve dry itchy skin

Dry itchy skin, whatever the cause, can result in great discomfort and frustration. The skin can feel tight and painful, look red or flaky and be so itchy that it can keep you awake at night and make you feel miserable. It is a very common problem, particularly if you suffer from dermatitis (eczema).

The good news is that there are a number of things that can be done to help improve dry itchy skin:

• Avoid any identified triggers where possible
• Use an emollient daily - often called a moisturiser - as it is important to keep your skin well hydrated.

Your doctor may prescribe a corticosteroid (a cortisone cream, lotion or ointment) for short periods when the skin becomes inflamed during a flare-up.

1. Try to avoid the triggers

Inflammation of the skin can flare-up for no obvious reason. In some cases however, flare-ups may be caused by triggers such as soaps, cosmetics, perfumes, detergents, some clothing, stress and infection. Where possible, avoid the triggers.

2. Moisturise, moisturise, moisturise

It is important to keep your skin healthy and well moisturised. Emollients are non-cosmetic moisturisers available as lotions, creams, ointments and bath/shower additives. They moisten the skin to keep it supple and healthy.

Emollients help to protect the skin from irritants, can prevent itch and reduce the frequency of flare-ups.

An emollient can be applied as often as you need. This may be several times a day and at bedtime.

Regular use of emollients is one of the most important aspects of treatment of dry skin and dermatitis.

3. Choose an emollient (moisturiser) to suit your skin

There are many different types of emollients. Talk to your doctor or pharmacist about which one will best suit you.

Examples of emollients that your doctor may prescribe for you are:

• Alpha Keri^® lotion
• Urederm^® cream

If a corticosteroid is required during a flare-up, it is important to use an emollient first, and then wait at least 30 minutes before applying the corticosteroid cream.

4. Avoid washing too frequently

Avoid over-bathing or showering, as even water alone can dry out the skin.

Enjoy a short shower, not necessarily every day. Use warm (not hot) water.

Emollients are best applied immediately after bathing or showering.

Avoid over-use of hand sanitisers.

5. Use a soap substitute cleanser

Soaps can remove the natural oils from the skin, making it dry, itchy and sensitive. If normal soap or shampoo is a trigger for you, try a soap substitute for bathing or showering.

Hamilton^® Skin Therapy Wash is an example of a soap substitute cleanser that may be prescribed to DVA card holders.

An emollient should also be used after bathing.

Warning: Take care as soap substitute cleansers may make surfaces slippery.

6. Use a corticosteroid only when prescribed for you by your doctor

Corticosteroids are generally used for a short time during a flare-up when the skin becomes inflamed. They work by reducing inflammation.

They come in a number of different strengths. The strength prescribed by your doctor will depend on how severe the flare-up is and where it occurs. Higher strength products should not be used in sensitive areas for long periods.

Your doctor will advise the correct strength for you.

Unless advised by your doctor, corticosteroids should not be used on the face or genital area.

Corticosteroids should not be used as a daily moisturiser. If a corticosteroid is required, it is important to continue to use your emollient.

7. For how long should I use a corticosteroid?

Corticosteroids should only be used for as long as necessary to relieve your skin condition, since long term use may damage your skin and lead to thinning or skin tears.

Use these products only for a short time, or as directed by your doctor.

Don’t forget to keep using an emollient when you have stopped your corticosteroid, as this will keep your skin moist and may avoid future flare-ups.

8. Return your old medicines to the pharmacy

Don’t share your corticosteroids with others or use old tubes as they may be out of date or the wrong strength.

Remember to return any old medicines, including ointments, lotions or creams to the pharmacy.

9. Use the right amount of corticosteroid

It is sometimes difficult to judge the correct amount to use, some people may use too much, others not enough. The best way to measure the correct amount is the fingertip unit.

One fingertip unit is the amount of cream or ointment squeezed from a tube to cover the tip of your index finger to its first crease.

The number of fingertip units required will depend on the size of the area being treated (see Figure 1). Make sure you spread the cream or ointment as demonstrated by your doctor or pharmacist.

Figure 1: Number of fingertip units required to completely cover different areas of the body. Reduce as appropriate to cover smaller area of dermatitis.

10. Talk to your doctor

Make an appointment to talk to your doctor:

• about managing your skin condition
• about the best emollient to use
• about using an emollient with your corticosteroid
• about how to measure the required amount of the corticosteroid
• about using corticosteroids only for a short time, or as directed
• if you have been using a corticosteroid on an ongoing basis.

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