dry, tight skin and treatment

[adz]

I have had dry, coarse skin since my late twenties (I’m forty now) and have managed it by moisturing after showers and last thing at night.  I think this was caused by excessive sunbathing but I have avoided the sun carefully for the last 5 years.  Within the last several months, my skin – especially that on my legs – doesn’t seem to be responding favourably to anything.  I moisturise, exfoliate, avoid hot baths and am moisturising maybe four or five times daily to keep the dehydrated and ‘tight’ sensation at bay.  This is becoming tiresome and distracting.  I was considering having an Obagi Blue Peel on the legs to possible alleviate the fine lines and cracked skin appearance, but was disappointed to read your view that the benefits of a peel only lasted 6-8 months.

Have you any suggestions why my skin is getting drier and drier, what I might do about it if moisturisers have limited effect and explain why a Blue Peel is a temporary measure?  I mean, removing a top layer of skin means new stuff comes up and is ‘untainted’ surely?

[Alan Rockoff, MD]

I would have to wonder whether your skin is really that dry, or whether you are moisturizing it so often that as soon as the lotion settles, you start to think about your skin and notice that "tight" sensation.  It's a little like trying not to think that your lips are dry, which makes them feel dry, and then you lick them, and so on.

Obagi Blue Peels (trichloroacetic acid) don't do anything for dehydration.  They're fine for sun damage and fine lines on the face, less fine for pigmentation on the chest, and not much good at all for legs, certainly not what you're complaining of.  If I were you, I'd stay away from peels for this purpose.  Also, I'd skip the exfoliation, which isn't going to do much for your sense of tightness.

My advice is to limit your moisturizing to once daily.  Either soak in a tub with bath oil for 15 minutes, or apply a moisturizer containing ammonium lactate (ask your pharmacist) immediately after showering.  

Also a good idea might be a visit to a dermatologist, just to make sure you haven't got eczema or some other skin condition which aggrvates the sense of "dryness."

Best.

Dr. Rockoff