Dry Skin in People with Down Syndrome

Key Points

• Dry skin is more common in people with Down syndrome.

• Some individuals with Down syndrome find treatment challenging because of negative sensory response to creams and ointments on the skin.

• Good hydration by drinking plenty of fluids is an important part of the treatment.

• Hypothyroidism (underactive thyroid) is more common in people with Down syndrome and can be a contributing cause of dry skin.

 

Introduction

Dry skin is very common in adults with Down syndrome. Although it is generally not a serious problem, it can be quite bothersome. Dry skin can be itchy, red, cracked, and/or flaky. Feet and hands tend to be particularly problematic areas for dry skin in people with Down syndrome.

 

What can cause or contribute to dry skin?

In addition to Down syndrome being a contributing factor, other factors that can contribute to dry skin include:

• Exposure to dry air

  • The temperature of the air seems to be less important than how dry it is. The dry air can be in the winter where it is cold and dry or the summer in places where it is hot and dry.

• Exposure to windy conditions

• Sun exposure

• Drying soaps

  • Some types of soap can be particularly drying. Soaps that contain artificial fragrances, synthetic dyes, alcohol, or an ingredient called sodium lauryl sulfate (SLS) can dry out skin.

• Long duration of showers or baths, especially if the water is hot

• Inadequate oral hydration (not drinking enough fluids)

• Undiagnosed or untreated hypothyroidism (underactive thyroid function)

  • Hypothyroidism is more common in people with Down syndrome. One of the symptoms is dry skin. 

 

Treatment

Unfortunately, for most people with Down syndrome, dry skin is not a problem that will be cured with a short-term treatment. It typically requires ongoing attention and treatment.

Environment

• Limit exposure of skin to dry air conditions. For example, in cold, dry air, covering the skin with gloves, scarves, etc. can be helpful.

• Similarly, covering skin can help limit exposure to sun and wind. Sunscreen (30 SPF or higher) can also limit the drying effect of sun exposure. 

• Some individuals benefit from having a humidifier in the home when the air is dry. Caution is advised to make sure it is cleaned regularly to avoid spreading bacteria, viruses, fungi, etc. 

Hygiene

• Using mild soap or moisturizing soap. Due to recurrent skin infections, many people with Down syndrome benefit from a soap with an anti-bacterial effect. We often recommend Lever 2000 or Dial with moisturizer for both their anti-bacterial and moisturizing effects.

• Limiting shower or bath duration and using lukewarm rather than hot water. 

• In the shower or bath, a soft brush on a handle or a loofah can help the person reach areas and "buff off" some of the dry skin. Additional shower and bath recommendations are available in our Bathing and Showering Tips article.

• Rinsing thoroughly. Some people do not give rinsing the attention it needs. Leaving soap on the skin causes the skin to become drier.

Creams, ointments, or lotions

• Liberal use of moisturizing creams, ointments, or lotions. Creams and ointments tend to be a heavier formula and contain more oil than lotions. These products help keep the naturally occurring moisture in the skin and limit evaporation of moisture on the skin. Use the topical treatment 2-3 times per day or more if necessary. It is best to apply it right after drying from a shower or bath when the skin is still moist. Vaseline is a time-tested, effective treatment that we find is particularly effective.

• For those who have a sensory aversion to topical products, covering the skin (such as with cotton gloves, socks, etc.) after applying the topical product can be helpful. There are also spray products that are sometimes less challenging for some individuals. See our Lotion Options  resource.

• When the skin becomes thickened or flaky, it may be helpful to use a product with alpha hydroxy acids or urea to help to loosen layers of dry skin. There are many products that contain one of these.

• When the skin gets very dry and chapped, a short course of a steroid cream (such as over-the-counter hydrocortisone cream (0.5 to 1%) can be helpful.

 

Additional considerations

• Drinking plenty of fluids. See our Tips for Staying Hydrated article. 

• Assessing for and treating hypothyroidism. 

• People with celiac disease (which is more common in people with Down syndrome) may be sensitive to skin products that contain gluten. There are skin products that are gluten-free.

• An appointment with your primary provider or dermatologist is recommended if the problem is not responding to home treatments.

 

Resources

Tips for Dealing with Dry Skin Video (video of two women with Down syndrome describing how they manage dry skin)

Skin Conditions in Down Syndrome Podcast Episodes (podcast from the Down Syndrome Center of Western Pennsylvania hosted by Kishore Vellody, MD, and featuring dermatologist Jillian Rork, MD, from Dartmouth-Hitchcock Medical Center)

At-Home Treatments for Common Health Conditions of People with Down Syndrome Webinar Recording (dry skin starts at 24:30)