How do I manage my dry skin, severe itching, and open cuts?

Question

Hello doctor,

My age is 48 years, and my height is 5.4 feet. I have been suffering from dry skin, open cuts, and severe itching for the past ten years. What steps should I take to manage this?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Based on the history of long-standing dry skin with recurrent open cuts and severe itching for the past ten years, this pattern is most consistent with a chronic dry skin condition commonly seen in atopic dermatitis.

Atopic dermatitis leads to a defective skin barrier, which causes excessive dryness, itching, cracking, and sometimes painful fissures. These symptoms can persist for years if proper skin care is not maintained.

Dry skin worsens due to frequent bathing, use of harsh soaps, exposure to cold or dry climates, and lack of regular moisturization. Persistent itching results in repeated scratching, which further damages the skin barrier, leading to open cuts and increasing the risk of secondary infections. This creates a vicious itch–scratch cycle that needs to be broken with consistent skin care.

Management mainly focuses on repairing the skin barrier and controlling itching. So, I would suggest the following:

A bland emollient such as petroleum jelly should be applied generously over the entire body at least two to three times daily, especially immediately after bathing, while the skin is still slightly damp. This helps lock in moisture and heal skin cracks.
For cleansing, a mild, fragrance-free cleanser should be used.
Scrubbing, loofahs, and hot water baths should be avoided.
Baths should be short and taken only with lukewarm water.
To control itching, Cetirizine hydrochloride tablet 10 milligrams can be taken twice daily for seven days, preferably after meals. This helps reduce itching and improve sleep.
Scratching should be avoided as much as possible, and keeping the nails trimmed short is very important to prevent skin injury.

Atopic dermatitis is a chronic inflammatory skin condition caused by an impaired skin barrier and an overactive immune response. In patients with long-standing, severe, or treatment-resistant disease, biological therapies are an effective and scientifically proven option. These medicines target specific immune pathways responsible for inflammation and itching rather than suppressing the entire immune system.

Biological treatment options for atopic dermatitis include injectable medicines such as Dupilumab. This significantly reduces itching, redness, skin thickening, and the frequency of flares. It is one of the most commonly used and safest biological agents for moderate to severe atopic dermatitis.

Another option is Tralokinumab, which specifically targets interleukin-13 and has shown good results in improving skin lesions and itching. In selected severe cases, newer targeted agents may be considered under specialist supervision after proper evaluation. These treatments are given as injections at fixed intervals and usually require monitoring, but are generally well tolerated.

Atopic dermatitis is a lifelong condition with periods of flare-ups and remission. The goal of treatment is long-term control rather than a permanent cure. Regular and liberal use of moisturizers is the cornerstone of management, even when the skin appears normal.

Medicines work best only when basic skin care measures are strictly followed. Scratching worsens inflammation and can lead to thickened skin and infections. Early treatment of flare-ups helps prevent progression to severe disease.

Lifestyle modifications play an important role in symptom control. So, follow these measures:

Bathing should be limited to once daily using lukewarm water, followed immediately by moisturization.
Harsh soaps, antiseptic washes, and perfumed products should be avoided.
Loose-fitting, soft cotton clothing is recommended, while wool and synthetic fabrics should be avoided as they can irritate the skin.
The home environment should be well ventilated, and very dry air should be avoided when possible.
Stress management is important because emotional stress is a known trigger for flare-ups. Adequate sleep, regular physical activity, and a balanced diet support immune function and skin repair.

Known triggers such as dust, strong detergents, fragranced products, and excessive sweating should be avoided.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.