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CONTINUING PROFESSIONAL DEVELOPMENT
motion in the direction of hair growth,
to reduce the risk of blocking the
hair follicles. Treatment should be
continued even if dryness improves, as
regular moisturising therapy will help
to prevent exacerbations.
containing perfumes and colouring
agents should be avoided, as they have
no therapeutic value and can exacerbate
skin dryness. The additives can alter
skin pH and cause irritation or contact
It is important to apply an
adequate quantity of moisturiser. The
recommended amount of moisturiser
for use by an adult is 600 g per week,
although some patients may require
as much as 1 kg (see Table 3 for more
If the skin becomes inflamed or
eczematous, a low-potency topical
corticosteroid (e.g. 1% hydrocortisone
ointment) can be used for a short
How can skin dryness be
Some lifestyle modifications can be
recommended to improve or prevent
xerosis. These include2,5,6,10,17
• Shower or bathe daily in lukewarm
(not hot) water for 10 minutes.
• Avoid soap and instead use a non-
irritant, soap-free cleanser (soap
• Avoid using bath oils; although they
have emollient properties, they can
make the bath slippery and increase
the risk of falls in elderly people.
• Pat the skin dry with a soft towel;
do not rub vigorously; rubbing can
abrade and weaken the skin.
• Apply a suitable moisturiser after
showering/bathing, while the skin
is still warm and damp; repeat
application of moisturiser at bedtime
and as often as necessary throughout
• Avoid skin products containing
perfumes, dyes or alcohol.
• Do not use powders on the skin; they
act as drying agents.
• Wear loose clothing and cotton (or
other natural fibres) next to the skin
and under wool or synthetic clothing
– may help to reduce skin irritation.
• Apply lip balms to the lips and thicker
moisturisers to the hands frequently.
• Use a humidifier to increase the
humidity of the air inside the home.
• Keep room temperature as low as
tolerated and comfortable.
Where can I find more
The following websites and resources
can be recommended if consumers
would like more information:
The PSA Eczema and dermatitis
Self Care Fact Card contains useful
information about skin care
Better Health Channel. Healthy
ageing – the skin. 2015. At: www.
DermNet NZ website provides
information about skin diseases,
conditions and treatments. Useful
Ageing skin. 2015. At: www.
Dry skin. 2015. At: www.dermnetnz.
Emollients and moisturisers.
2016. At: www.dermnetnz.org/
MedlinePlus website provides links
to various topics on skin ageing.
Eileen’s dry skin continued
Eileen’s skin has the dry, scaly
appearance typical of xerosis. There are a
few red patches where she has scratched
it, but it is not broken, bleeding or
severely inflamed. She should be
advised to apply a generous quantity
of moisturiser to all the dry areas at
least twice daily (soon after bathing
and at bedtime, and at other times if
necessary). The correct application
technique (i.e. in a downward motion in
COUNSELLING IN PRACTICE
If the skin becomes inflamed or eczematous, a low-
potency topical corticosteroid (e.g. 1% hydrocortisone
ointment) can be used for a short period.
Aqueous cream was originally
intended for use as an emollient soap
substitute. However, it is often used
incorrectly as a leave-on moisturiser.
Aqueous cream is emulsified with
emulsifying ointment, which contains
the anionic surfactant sodium lauryl
sulphate. Sodium lauryl sulphate
can cause skin irritation, increase
the permeability of the skin barrier
and increase TEWL. Therefore,
aqueous cream (and emulsifying
ointment) is not recommended for
use as leave-on moisturisers. They are
suitable to use as soap substitutes,
because the product is washed off
and is only in contact with the skin
for a short period of time. Sorbolene
cream is emulsified with non-ionic
cetomacrogol emulsifying wax, and
can be safely used as a leave-on
moisturiser. It is often formulated
with 10% glycerin for greater
Box 1. Aqueous versus Sorbolene cream
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