Randy Jacobs, M.D. Patient Education

To return to the Dry Sensitive Skin page, click here.

To return to the Patient Education page and read more articles, click here.

Dry Skin and Skin Barrier Education


Randy Jacobs, MD


What is Dry Skin?

Quite simply, dry skin is skin that has lost its moisture. This loss of moisture is, most commonly, the result of inadequate daily moisturization  in personal skin care habits, plus, the overuse of strong soaps, plus, exposure to dry air. All of these factors ead to  a damaged skin barrier. So you can learn more,  I have put together an explanation, below, with diagrams.

The answer to dry skin and a damaged skin barrier, is to moisturize on a regular daily basis with a heavy cream or ointment like Vaseline. Also, avoid harsh soaps like Ivory, Dial, Zest, and Irish Spring. And, if this is not enough, try adding a room humidifier for your bedroom. I suggest that you download my booklet, “The ABC’s of Dry and Sensitive  Skin.”

What is Dry and Sensitive Skin?

What is dry and sensitive skin? Dry skin is common problem, especially in cool weather when hot furnaces are turned on and the air is dry. Young and old, infants and adults, millions of people suffer with dry and sensitive skin. It may be you or your spouse, your children, your parents, or even a friend. At highest risk are babies, seniors, diabetics, frequent hand washers, eczema prone people, atopics, psoriatics, and people on water pills, acne meds, or wrinkle creams. These people usually suffer with dry and extra sensitive skin.

If you look in the dictionary, there is no good definition for the term" sensitive skin," but those of you who have it sure know what it is. Sensitive skin dries out ever so easily, can ignite like a hot match, and any allergic thing can set it off. If this skin type is neglected and exposed to soap, dry air, and allergens, simple dry skin can deteriorate into itchy eczema or the "Dry Skin Rash." Eczema, the Dry Skin Rash, and most dry and sensitive skin problems can be traced to an easily damaged skin barrier located in the upper layers of the skin. Microscopically, the skin barrier resembles tiny bricks and mortar. Here is a simplified diagram of the human skin barrier.


If you are a dry and sensitive person and you neglect your skin barrier, you will have problems forever. The truth is, your skin barrier needs daily care, but ironically, most dry and sensitive people are unaware of their skin barrier organ. A well-tuned skin barrier will keep body water inside and will prevent allergens and microbes from entering your body. The "bricks" are the corneocyte skin cells. The "mortar," situated between skin cells, is made of three lipid-oils: Free fatty acids, ceramide, and cholesterol. For normal skin barrier functioning to occur, the three lipids must be "organized" into precise layers called "lipid bilayers."


Here is an example of well organized, healthy, skin barrier lipids: Lipid Bilayers organ smaller
Here is an example of disorganized, unhealthy, skin barrier lipids: Lipid Bilayers disorg leaky


How Do You Get Dry Skin?


If cholesterol, ceramide, and free fatty acids are stripped away as with excessive soap use, the lipid bilayers will break down and the skin barrier is damaged.
In this depleted state, the skin barrier will leak, and thus, water will evaporate, allergens will penetrate, and microbes can enter to infect. The skin becomes dry, inflamed, and infected. A rash ensues: The Dry Skin Rash. Help! Some people try calamine, but dry calamine does nothing for dry skin. Some people head to the shower and scrub their bodies with soap. This only adds fuel to the fire. Hoping for relief, some splash rubbing alcohol all over their lipid-depleted body. Itchy Man ps no hat


They don't realize that soap and alcohol are only stripping more lipids and causing more skin barrier damage. Finally, the dry person goes to a local urgent care and gets cortisone pills. But, cortisone is only a short-term fix for a long-term skin problem. What this suffering dry and sensitive soul really needs is the ABC Skin Care System.


Dry Skin is like a dry lakebed.

This is Dry Skin


Eczema 2.jpg



Eczema 2.jpg



Learn To Recognize Dry Skin


This is what happens when you lose all of your skin lipids

Eczema 1.jpg




What causes the dry skin rash?


Your skin is put together like bricks and mortar.


Chol Cer FFA.jpg


Entrance   Exit.jpg




healthy lipids.jpg

This skin is full of lipids.



unHealthy Lipid Bilayers.psd This skin is empty of lipids.



Asteatotic dermatitis

Means a Loss of Lipids






You Feel Dry.jpg

crack in skin.jpg


Infection develops



Cracks develop.

Hand Eczema 3.jpg


Vaseline will make a temporary skin barrier for you.





Dry Skin is also related to Filaggrin Deficiency












These are before and after photos showing extremely dry skin in a diabetic leg treated with Guitar Hands Lotion six times per day for three weeks.  Please see dates on photos.