Xerosis, or abnormally dry skin, is a common dermatological condition that becomes more prevalent with age, low humidity, or underlying health issues. In some cases, xerosis can contribute to reduced joint mobility, particularly when the dryness leads to skin thickening, cracking, or stiffness around joint areas like the elbows, knees, and hands (1).
Symptoms
Symptoms of xerosis-related skin changes may vary depending on severity and location. Common signs include:
- Dry, flaky, or rough skin, especially around joints
- Cracking or fissures, often painful during movement
- Itching or irritation in affected areas
- Tightness or stiffness of skin over joints
- Decreased flexibility or joint range of motion
- In chronic cases, hyperkeratosis (thickening of the outer skin layer) (1)
Causes and Risk Factors
Xerosis is often caused by environmental and internal factors. These include:
- Cold or dry weather
- Long-term use of harsh soaps or hot water
- Aging, which reduces skin oil production
- Chronic dehydration
- Nutritional deficiencies (e.g., Vitamin A or essential fatty acids)
- Underlying medical conditions like hypothyroidism, diabetes, or atopic dermatitis (1)
Risk factors that increase the chance of mobility-limiting xerosis include:
- Elderly age group
- Poor skincare routines
- Autoimmune or inflammatory skin diseases
- Lack of hydration or moisturization
- Occupational exposure to irritants or repeated hand-washing (2)
Complications
If untreated, xerosis can lead to complications that may limit joint mobility or comfort:
- Skin fissures that worsen with movement
- Infections through cracked skin
- Reduced physical function due to pain and tightness
- Psychosocial impact, including reduced quality of life and self-esteem
In severe cases, chronic xerosis may resemble or coexist with conditions like eczema craquelé or ichthyosis, further complicating mobility (2).
Diagnosis
Diagnosis of xerosis-related joint issues is usually clinical. A healthcare provider will assess:
- Skin appearance and texture around joints
- Patient history (e.g., bathing habits, climate, pre-existing conditions)
- Exclusion of other skin diseases like psoriasis or eczema
In rare cases, skin biopsy or patch testing may be done to rule out contact dermatitis or systemic causes (2)(3).
Treatment
Management of xerosis focuses on restoring skin hydration and preventing further damage. Options include:
Topical Treatments
- Emollients and moisturizers (e.g., urea, lactic acid, ceramide-based creams)
- Barrier repair creams for cracked areas
- Corticosteroid creams if inflammation is present
Lifestyle Measures
- Use of lukewarm water and mild soaps
- Applying moisturizer immediately after bathing
- Hydration and balanced diet
- Avoiding irritants and excessive scrubbing
Physical Therapy (if joint function is limited)
- Gentle range-of-motion exercises
- Use of compression wraps or gloves in severe cases (3)
Living With Xerosis
Xerosis, commonly known as dry skin, can cause discomfort, itchiness, flaking, or even painful cracks, especially during cold weather or in people with sensitive skin. While not typically serious, chronic xerosis can significantly affect quality of life.
To manage xerosis:
- Moisturize regularly, especially after bathing. Use fragrance-free, thick creams or ointments.
- Avoid hot showers and harsh soaps that strip natural oils from the skin.
- Use a humidifier during dry weather to keep indoor air moist.
- Stay hydrated – drink plenty of water daily.
- Wear soft, breathable fabrics like cotton to avoid skin irritation.
In persistent or severe cases, use medicated creams recommended by a dermatologist (3).
References
1. Dalgleish L, Campbell J. Xerosis in Older Adults. Adv Skin Wound Care. 2022 Jan 1;35(1):62-63. doi: 10.1097/01.ASW.0000803780.72502.f4. PMID: 34935723.
2. Augustin M, Wilsmann-Theis D, Körber A, Kerscher M, Itschert G, Dippel M, Staubach P. Diagnosis and treatment of xerosis cutis – a position paper. J Dtsch Dermatol Ges. 2019 Nov;17 Suppl 7:3-33. doi: 10.1111/ddg.13906. PMID: 31738016.
3. Choi SH, Lee BJ, Lee SY. A study on skin mobility according to joint movement: Variations in mobility according to joint motion range and correlation and influence with hydrica composition. Skin Res Technol. 2023 Feb;29(2):e13288. doi: 10.1111/srt.13288. PMID: 36823503; PMCID: PMC10155801.
