Etiology and pathomechanism of xerosis cutis

Xerosis cutis or dry skin is one of the most complaints in the dermatology field, especially in the elderly. It is usually accompanied by an itchy sensation, burning sensation, or manifests as sensitive skin. This skin condition often affects the quality of life. It can be caused by external factors, such as low humidity, cold, heat, sunlight, workplace environment, or skin cleansing activity. It may also be caused by endogenous factors, such as dermatoses, internal diseases, psychiatric disorders, dietary imbalances, or drug-related causes. The stratum corneum consists of corneocytes and lipid-rich intercellular matrix, which play a role in skin barrier functions to maintain skin hydration and skin humidity, to prevent high level of transepidermal water loss (TEWL), and to protect the skin from physical or chemical agents. The main pathomechanism of xerosis cutis is disruption of the stratum corneum barrier function that may be caused by dermatoses, systemic diseases, or external agent exposure. The effective management of xerosis cutis is given based on the etiology, underlying disease, and its pathomechanism.