Dry skin, water, and lubrication.

Lubrication of the skin will become more important as our population ages. Many excellent moisturizers are available for lubrication. Individual ingredients that are touted heavily are not as important as the total mixture. The single most important factor is the regular use of the products to prevent overdrying of the skin. How should we use this information to achieve our aims? 1. The frequency of bathing, showering, and cleansing should be reduced. The water should be kept at the coolest temperature practical, and one should get out as soon as possible. Sponge bathing should be encouraged. Bath oils make tubs slippery and are wiped off by towels. It is better to apply an emollient directly on skin that is still damp. 2. Room temperatures should be kept low and comfortable and humidity should be kept as high as possible without causing damage. 3. Overdrying should be avoided by limiting the exposure to soap, detergents, solvents, and water. In addition, friction from washcloths, rough clothing, and abrasives should be avoided. 4. Emollients should be used frequently and selected to be compatible with the individual's situation. Bedridden individuals should use petrolatum, whereas the ambulatory would be better served by the use of lotions and creams. 5. If itching is present or reticulated cracking (eczema craquelé) is seen, more aggressive treatment is indicated, including possible use of topical steroid preparations. 6. A preparation that is cosmetically acceptable, so that it will be used regularly, should be prescribed. One must emphasize its importance so that the individual avoids serious and chronic dermatitis.