Home » Conditions & Treatments » Chronic Dry Skin Treatment in London

Chronic Dry Skin Treatment in London

London’s Leading Skin Specialists

Persistent dry skin can be uncomfortable, distracting and difficult to manage without knowing what is causing it. Although some cases result from cold weather, indoor heating or unsuitable skincare products, chronic dry skin can also be associated with eczema, psoriasis, contact dermatitis, ichthyosis or another medical condition.

Every dermatologist appointment is conducted directly by Consultant Dermatologist Dr Björn Thomas. This provides continuity from the initial assessment through to treatment and follow-up, without patients being passed between different practitioners.

A consultation begins with a detailed discussion of your symptoms, medical history, skincare routine and possible triggers.

Dr Thomas will then examine the affected skin and, where clinically appropriate, may recommend further investigation, if needed.

This diagnosis-led approach allows treatment to go beyond repeatedly trying different pharmacy creams. Instead, you will receive a plan suited to the cause and severity of your symptoms. This may involve an appropriate emollient routine, prescription treatment, changes to cleansing products, trigger avoidance and guidance on protecting the skin barrier over the longer term.

Dr Thomas has a PhD in cutaneous medicine and previously held an NIHR Clinical Lectureship. His research has included work on eczema, environmental exposure, the skin barrier and filaggrin, an important skin barrier protein. He also spent dedicated clinical time in severe eczema and psoriasis services at the Royal Free Hospital and received the Royal Society of Medicine Dermatology Trainee Research Prize. You can view his prizes, presentations and publications.

Arrange a Dermatologist Appointment for Persistent Dry Skin

You can contact the clinic directly to arrange a private dermatologist appointment, and a GP referral is not required. The team can explain current availability, consultation arrangements and the registration process before your visit.

Whether your symptoms have recently appeared or have been troubling you for several years, an assessment can help establish whether you are dealing with straightforward dryness or a condition that needs more targeted treatment.

What Is Dry Skin?

Dry skin is known medically as xerosis or xerosis cutis. It develops when the outermost layer of the skin, called the stratum corneum, does not retain enough water and natural oils.

A healthy skin barrier helps keep moisture within the skin while protecting it from allergens, irritants and microorganisms. When that barrier is weakened, water is lost more readily, and the skin can become rough, tight, flaky, itchy or sore.

The British Association of Dermatologists explains that emollients help protect and moisturise this outer layer by retaining water and shielding the skin from substances that may cause irritation. However, an emollient doesn’t necessarily treat the underlying cause if the dryness is part of an inflammatory or genetic skin condition.

Dry skin can vary considerably in severity:

Mild dryness: Tightness, dullness, roughness or fine flaking
Moderate dryness: More widespread scaling, itching and visible changes in texture
Severe dryness: Cracking, peeling, bleeding, soreness or deep fissures
Inflamed dryness: Red, darker, grey or ashy-looking skin, depending on skin tone
Infected dry skin: Increasing pain, swelling, crusting, discharge or rapidly worsening symptoms

It is also useful to distinguish between temporary dryness and chronic dry skin:

Seasonal dryness: Often linked to cold weather, low humidity, indoor heating or changes in washing habits
Irritant-related dryness: Associated with soaps, detergents, solvents, frequent handwashing or repeated contact with water
Inflammatory dryness: Found in conditions such as eczema, psoriasis and contact dermatitis
Genetic dryness: Seen in inherited conditions such as ichthyosis
Medically associated dryness: Sometimes linked to medication, age-related skin changes or an underlying health condition

Mild, seasonal dryness can often be improved through consistent moisturising and gentler skincare. However, persistent, painful or inflamed skin may require an accurate dry skin diagnosis before an effective treatment plan can be recommended.

When Is It Time to See a Doctor?

You may be able to manage mild dryness at home when the skin is only slightly tight, rough or flaky and responds to regular moisturising.

However, it is sensible to arrange a dermatologist appointment when you experience:

Dryness that does not improve after several weeks of appropriate self-care
Deep cracks, bleeding or painful fissures
Recurrent or increasingly severe flare-ups
Persistent itching, inflammation or a visible rash
Oozing, crusting, spreading redness or increasing pain
Sudden or widespread changes in the skin
Symptoms affecting sleep, work or everyday activities
Scaling that may be related to eczema, psoriasis or a fungal infection
Reactions following contact with skincare products, detergents, metals or workplace substances

The NHS advises seeking medical assessment for persistent, recurrent or severe symptoms of contact dermatitis. Increasing pain, discharge, rapidly worsening symptoms or feeling generally unwell can indicate infection and should be assessed promptly.

How a Dry Skin Dermatologist Can Help

A dry skin dermatologist can establish whether the problem is simple xerosis or a symptom of another condition. This distinction matters because similar-looking patches of dry or scaly skin may require very different treatments.

For example, eczema usually requires management of both dryness and inflammation. Psoriasis involves accelerated skin-cell production and may require prescription medication in addition to emollients. Meanwhile, contact dermatitis is unlikely to settle fully unless the relevant irritant or allergen is identified and avoided.

Your consultation may include:

A discussion of when the symptoms began and how they have changed
Review of products, medication and treatments you have already tried
Examination of the pattern, texture and distribution of the dryness
Questions about work, hobbies, washing habits and exposure to irritants
Review of personal and family history of eczema, asthma, hay fever or psoriasis
Consideration of patch testing where contact allergy is suspected
Further investigation when the presentation is widespread, unusual or medically unexplained
A clear explanation of the likely diagnosis and available treatment options

Patch testing is the established method used to investigate suspected allergic contact dermatitis. Small amounts of potential allergens are applied to the skin and reviewed over several days to identify delayed reactions.

Treatment can then be tailored to the findings rather than relying on trial and error. Depending on the diagnosis, your plan may include emollients, soap substitutes, prescription anti-inflammatory treatment, antifungal medication, keratolytic preparations or advice on avoiding specific triggers.

How Private Dermatology Care Can Help

For anyone living with persistent or severe dryness, a private dermatologist appointment offers time to discuss the problem in detail and receive a plan based on an examination of the skin.

Consultations are led by the same consultant dermatologist, which supports continuity of care. This is particularly valuable when symptoms fluctuate, products need adjusting or the response to prescription treatment must be reviewed.

Treatment decisions are explained clearly, including:

What the likely diagnosis is
Whether further tests are appropriate
What can realistically be improved
How prescribed products should be used
Which symptoms should prompt further advice
How to reduce future flare-ups
What follow-up may be needed

Pricing and practical arrangements can be discussed before treatment begins. As a result, you can make an informed decision without feeling pressured into unnecessary products or procedures.

Book Your Dermatologist Consultation in London

You can arrange a private dermatologist appointment directly by telephone, email or through the online registration system. A GP referral is not required.

A consultation may be appropriate when you need a first assessment, have not responded to previous treatment or would like a second opinion on a diagnosis or skincare plan.

During the appointment, you will have the opportunity to explain how the condition affects you, ask questions and understand the available options before deciding what to do next.

Contact The Clinic

Types of Dry Skin Conditions

There are several types of dry skin and a number of medical conditions in which dryness is a prominent feature. Although they may share symptoms such as scaling, itching or cracking, their causes and treatments differ.

Xerosis

Xerosis cutis is the medical term for abnormally dry skin. It occurs when the outer skin barrier is unable to hold sufficient moisture.

Symptoms can range from mild tightness and fine flaking to widespread scaling, itching and painful cracks. It often becomes more noticeable during cold weather or when the skin is exposed to frequent washing, harsh soaps or low humidity.

How Xerosis May Present

Mild: Tightness, dullness, rough texture and fine flaking
Moderate: More generalised scaling, itching and visible dryness
Severe: Deep fissures, peeling, bleeding and pain

Most mild xerosis improves with appropriate emollients and changes to washing habits. However, professional assessment is advisable when symptoms remain despite consistent treatment or when inflammation, infection or extensive scaling develops.

Ichthyosis

Ichthyosis describes a group of conditions that cause persistent dry, thickened and scaly skin. Some forms are inherited and begin during childhood, while acquired ichthyosis can appear later in life.

The British Association of Dermatologists explains that ichthyosis vulgaris, the most common inherited form, is associated with altered filaggrin function. Filaggrin helps the outer skin form an effective barrier and contributes to the skin’s natural moisturising substances.

Common forms include:

Ichthyosis vulgaris: Usually causes fine white or grey scaling, particularly on the arms, legs and abdomen
X-linked ichthyosis: Affects males and can cause larger, darker scales on the trunk and limbs
Congenital ichthyoses: Rare conditions that are present from birth and may require specialist lifelong care
Acquired ichthyosis: Develops later and may be associated with medication or another health condition

Treatment usually focuses on regular moisturising and, where appropriate, products containing ingredients such as urea or lactic acid to soften and loosen scale. More severe forms may require specialist medication and monitoring.

Conditions That May Involve Dry Skin

Eczema and Atopic Dermatitis

Eczema is a common inflammatory condition that causes dry, itchy and sometimes inflamed skin. It is often associated with a weakened skin barrier and may run in families alongside asthma or hay fever.

Unlike simple seasonal dryness, eczema tends to follow a pattern of flare-ups and quieter periods. Symptoms may include:

Persistent itching
Dry or scaly patches
Red, brown, purple or grey areas, depending on skin tone
Cracking or weeping
Thickened skin caused by repeated rubbing or scratching
Sleep disturbance and reduced day-to-day comfort

Emollients form an important part of eczema care, but inflamed areas may also require prescribed anti-inflammatory treatment. NICE describes emollients as first-line therapy for maintaining the skin barrier and preventing painful cracking, while topical corticosteroids are commonly used during active flare-ups.

Read more about our eczema treatment in London.

Fungal Skin Infections

Some fungal infections cause dry, scaly or itchy patches that may be mistaken for eczema or ordinary dry skin.

Ringworm, for example, can produce a dry, scaly and itchy rash. Depending on the affected area and skin tone, the characteristic border may not always be immediately obvious.

Using a topical corticosteroid on an undiagnosed fungal infection can alter its appearance and allow it to spread. Therefore, persistent scaling on the feet, groin, trunk or other localised areas should be properly assessed when the diagnosis is uncertain.

Testing may involve collecting a small skin scraping for microscopic examination or culture. Treatment generally involves topical antifungal medication, although oral medication may be needed for some widespread or resistant infections.

Read more about our fungal skin infection treatment.

Psoriasis

Psoriasis is an immune-mediated condition that causes skin cells to build up more quickly than usual. This produces dry, flaky and often well-defined patches with visible scaling.

Psoriasis commonly affects areas such as the elbows, knees, scalp and lower back, although it can occur elsewhere. On lighter skin, patches may appear pink or red with pale scales. On brown or black skin, the plaques may look grey, purple or darker than the surrounding skin.

Key differentials include:

Psoriasis: More clearly defined plaques with visible scale
Eczema: Often more diffuse, intensely itchy and frequently found in skin creases
Simple xerosis: More generalised dryness without distinct inflammatory plaques

Moisturisers can reduce scaling and improve comfort, but they do not treat the underlying immune activity. Depending on the severity and location, psoriasis treatment may involve vitamin D preparations, topical corticosteroids, phototherapy or systemic medication.

Read more about our private psoriasis treatment.

Contact Dermatitis

Contact dermatitis develops when the skin reacts to a substance that damages the barrier or triggers an allergic response.

There are two principal forms:

Irritant contact dermatitis: Caused by repeated exposure to soaps, detergents, solvents, water or other irritants
Allergic contact dermatitis: Caused by an immune reaction to an allergen such as fragrance, preservatives, hair dye, rubber or certain metals

Both forms can produce itching, dryness, cracking, soreness and inflammation. Symptoms commonly affect the hands and face, although any area exposed to the trigger can be involved.

Moisturisers may improve the damaged barrier, but identifying and avoiding the relevant trigger is often central to successful treatment. Where an allergy is suspected, patch testing can provide more precise answers.

Why Choose the Thomas Clinic for Dry Skin Treatment and Assessment?

Choosing an appropriate skin specialist in London can help you move beyond temporary symptom relief and understand why the dryness keeps returning.

Direct Consultant Care

Each consultation is conducted by Dr Thomas. Therefore, the same dermatologist can oversee your assessment, treatment decisions and subsequent review.

A Diagnosis-Led Approach

Dryness is treated as a symptom that may have several possible explanations. The assessment considers the appearance of the skin, the distribution of symptoms, previous treatment, lifestyle factors, occupational exposure and relevant medical history.

Individual Treatment Plans

No single moisturiser or prescription suits every patient. Recommendations are based on the diagnosis, body area, severity, skin sensitivity, personal preferences and practical daily routine.

Clear Explanations

You will be told what the likely condition is, what the recommended treatment is intended to do and when results should be reviewed. Any important risks, limitations or safety instructions will also be discussed.

Ongoing Support

Some cases of chronic dry skin require treatment to be adjusted over time. Follow-up provides an opportunity to review progress, change formulations and address any new symptoms.

Transparent Next Steps

Consultation arrangements and treatment options are explained before you proceed. This helps you make decisions based on clear information rather than pressure or unrealistic promises.

What to Expect from Your Dry Skin Assessment

A dry skin diagnosis is usually based on a detailed history and examination rather than a single test.

During your appointment, you may be asked about:

When the dryness started
Whether symptoms are constant or intermittent
Which parts of the body are affected
Itching, soreness, cracking, bleeding or discharge
Changes associated with seasons, work or travel
Soap, skincare and laundry products
Occupational exposure to water, detergents or chemicals
Existing medical conditions and medication
Personal or family history of eczema, psoriasis, asthma or allergy
Products or prescriptions you have already tried

The skin will then be examined to assess its pattern, texture, level of inflammation and any features suggesting infection or a specific skin condition.

Further investigation is not required for every patient. However, patch testing may be appropriate when allergic contact dermatitis is suspected. Skin scrapings can help investigate fungal infection, while blood tests may be considered if symptoms suggest an internal cause.

You will then receive a practical plan. This may include moisturising treatment, changes to cleansing products, prescription medication, trigger avoidance and a timeframe for review.

Moisturisers: Modern vs Traditional Options

Finding a suitable moisturiser can be confusing because products vary considerably in texture, ingredients and purpose.

The medical term for a moisturiser is an emollient. Emollients soften and hydrate the skin while creating a protective layer that reduces water loss. They are used for dry and scaly conditions including eczema, psoriasis and ichthyosis.

The best product is not necessarily the most expensive or the one with the longest ingredient list. It needs to be suitable for the severity and location of the dryness, comfortable to apply and practical enough to use consistently.

Traditional Ointments and Paraffin-Based Emollients

Ointments are thick, greasy products that create a strong protective barrier over the skin. They can be particularly useful for very dry, thickened areas or overnight treatment.

Potential advantages include:

Strong occlusive protection
Suitability for very dry or thickened skin
Fewer preservatives in many ointment formulations
Longer-lasting coverage than lighter lotions

Potential limitations include:

Greasy texture
Staining or transfer onto clothing and bedding
Reduced acceptability for daytime use
Possible follicle blockage in some areas

Creams and Lotions

Creams contain a mixture of oil and water. They are generally lighter than ointments and often more convenient during the day.

Lotions have a higher water content and spread easily, which can make them useful on hairy areas or large areas of skin. However, they are usually less moisturising than thicker creams and ointments.

The NHS notes that creams are often convenient for daytime use, while ointments are more suitable for very dry, thickened skin and overnight application.

Barrier-Supporting Ingredients

Some modern formulations contain ingredients intended to attract water or replace components found within the skin barrier.

These may include:

Glycerin: A humectant that attracts water
Urea: Helps hydrate and soften thickened or scaly skin
Lactic acid: Can support hydration and gentle scale removal
Ceramides: Lipids found naturally within the skin barrier
Hyaluronic acid: Helps retain water within a formulation
Dimethicone: Provides a lighter protective layer
Niacinamide: May support barrier function in suitable products

These ingredients are not automatically better for every patient. For example, urea and acids can sting on cracked or inflamed skin, while fragrances and botanical extracts can cause irritation or allergy.

Relief vs Treatment

Emollients are helpful to treat symptoms and appearance of dry skin, but they are not a cure for every underlying condition.

The British Association of Dermatologists advises that emollients may reduce flare-ups and improve the effectiveness of other treatments for eczema. However, inflamed skin will likely require a prescribed anti-inflammatory medicine alongside regular moisturising.

Similarly:

Psoriasis may require treatment that slows excessive skin-cell production
Contact dermatitis requires identification and avoidance of the trigger
Fungal infections require antifungal medication
Ichthyosis may require keratolytic preparations or specialist treatment
Infected cracks may require antimicrobial treatment

Practical Guidance for Using Emollients

Apply the product as often as advised and whenever the skin feels dry
Smooth it gently in the direction of hair growth rather than rubbing vigorously
Apply soon after washing, while the skin still retains some moisture
Consider a lighter cream during the day and an ointment at night
Use an emollient or suitable soap substitute instead of fragranced soap
Stop and seek advice if a product repeatedly stings, irritates or causes a rash
Use a clean spoon or pump rather than putting fingers into a shared tub
Take care because emollients can make baths, showers and floors slippery

Important Emollient Fire-Safety Advice

Emollient residue can build up on clothing, bedding, dressings and other fabrics. The products are not generally flammable on the skin, but fabric containing dried residue can ignite more easily and burn more intensely.

The Medicines and Healthcare products Regulatory Agency advises users of both paraffin-containing and paraffin-free emollients to keep away from cigarettes, naked flames and other ignition sources. Washing fabrics can reduce residue but may not remove the risk completely.

This warning should be included whenever regular emollient use is discussed, particularly when products are applied extensively or repeatedly.

Frequently Asked Questions About General and Chronic Dry Skin

What Causes Dry Skin?

The causes of dry skin usually involve a weakened skin barrier, reduced natural oils, environmental exposure or an underlying condition.

Common external factors include:

Cold weather and low humidity
Indoor heating and air conditioning
Long or very hot baths and showers
Frequent handwashing
Harsh soaps, detergents and solvents
Fragranced or irritating skincare products
Repeated exposure to water
Occupational contact with chemicals or cleaning products
Friction from clothing or protective equipment

Internal or medical factors can include:

Age-related changes in the skin
A personal or family tendency towards eczema
Psoriasis
Ichthyosis
Contact dermatitis
Medication-related dryness
Thyroid, kidney or metabolic conditions in selected cases

Often, several factors are involved. For example, someone with an eczema-prone skin barrier may experience much worse dryness during winter or after repeated use of a harsh hand cleanser.

Sudden, unexplained or widespread dryness should be assessed rather than attributed automatically to weather or age.

How Do I Get Rid of Dry Skin?

The most effective approach depends on the cause.

For mild xerosis, improvement may come from:

Taking shorter baths or showers using lukewarm water
Replacing soap with a gentle emollient cleanser
Patting the skin dry instead of rubbing
Applying moisturiser shortly after washing
Reapplying emollient whenever the skin feels dry
Protecting the hands from detergents and repeated wet work
Avoiding fragranced products and abrasive exfoliation
Using a thicker ointment on very dry areas overnight

The NHS and British Association of Dermatologists both recommend regular emollient use for dry and scaly skin. Different formulations can be used at different times of day according to the severity and location of symptoms.

When dryness is caused by eczema, psoriasis, dermatitis, fungal infection or ichthyosis, moisturiser alone may not be enough. Appropriate prescription treatment may be needed to address inflammation, infection or excessive scaling.

Why Is My Dry Skin Cream Not Working?

A moisturiser may fail to improve your skin for several reasons.

The Product Contains an Irritant

Fragrance, preservatives, botanical extracts and some active ingredients can irritate sensitive skin. Even useful ingredients such as urea may sting when applied to cracked skin.

Your Washing Routine Is Undoing the Benefit

Long hot showers, frequent soap use and repeated exposure to detergents can continue damaging the skin barrier despite regular moisturising.

The Diagnosis Is Different

What appears to be dry skin may actually be eczema, psoriasis, contact dermatitis or a fungal infection. These conditions require treatment directed at the underlying cause.

There Is Ongoing Exposure to a Trigger

Contact with a workplace chemical, glove material, metal, fragrance or cleaning product may continue driving inflammation.

Professional advice is appropriate when a cream has been used consistently for several weeks without improvement or when the skin is painful, inflamed, infected or affecting daily life.

Why Does Dry Skin Hurt?

Severely dry skin can become painful when the barrier loses flexibility and begins to crack.

Pain may result from:

Deep fissures on the hands, heels or joints
Exposed and irritated nerve endings
Inflammation within the skin
Infection entering through broken areas
Tightness when the skin stretches
Repeated reopening of cracks during movement

The pain may feel sharp, sore, burning or stinging. Water and skincare products can also sting when the barrier is badly disrupted.

Increasing pain, discharge, warmth, swelling or spreading redness can indicate infection and should be assessed promptly.

Where Can You Get Dry Skin?

Dry skin can occur almost anywhere, although some areas are particularly vulnerable.

Lower Legs

The shins commonly become dry and scaly, particularly during colder weather and in older adults.

Hands

Frequent washing, cleaning products, gloves, water and workplace exposure can cause hand dryness and contact dermatitis.

Feet and Heels

Pressure and friction can cause thickened skin and painful cracks. Persistent scaling across the soles may also suggest fungal infection.

Elbows and Knees

These areas are exposed to friction and are common sites for thickened dryness and psoriasis plaques.

Face and Lips

Over-cleansing, acne treatments, cold weather and unsuitable products can cause facial tightness and flaking. The lips are particularly vulnerable to chapping.

Scalp

Fine flaking may reflect dryness, although dandruff, seborrhoeic dermatitis, psoriasis and fungal conditions can look similar.

Trunk

Long hot showers, low humidity and eczema can cause widespread dryness across the abdomen, back and sides of the body.

How the symptoms look can vary by location and skin tone. For example, inflammation may appear red on lighter skin but grey, purple, brown or darker than the surrounding area on darker skin.

Why Should I Go to a Private Dermatologist?

A private dermatologist appointment can be useful when you need timely assessment, more time to discuss your concerns or a second opinion on treatment that has not worked.

Potential benefits include:

Direct access without a GP referral
A consultation led by a specialist dermatologist
Time to discuss previous products and treatments
Assessment of possible underlying conditions
Access to patch testing or other investigations when appropriate
A treatment plan suited to your routine and preferences
Follow-up with the same consultant
Clear discussion of expected results and limitations

Many causes of chronic dry skin are managed rather than permanently cured. Therefore, the aim is usually to control symptoms, reduce flare-ups and provide a routine that is realistic enough to maintain.

Useful UK Medical Resources for Dry Skin

Patients who would like independent information alongside their consultation may find the following resources helpful:

These organisations provide independent information, although individual advice and treatment may differ according to your diagnosis and medical history.

Get Specialist Advice About Persistent Dry Skin

Chronic dry skin can be painful, frustrating and difficult to manage when you do not know why it keeps returning.

A consultation provides an opportunity to establish whether your symptoms are related to simple xerosis, eczema, psoriasis, contact dermatitis, ichthyosis, infection or another cause. You can then receive clear advice on suitable moisturisers, prescription treatment, trigger avoidance and long-term care.

You do not need to decide in advance which treatment you require. The first step is to arrange an assessment and explain what has been happening with your skin.

To book a dermatologist appointment in London, contact the clinic by telephone or email or complete the secure online registration form.

Other Skin Treatments at the Thomas Clinic

Alongside specialist care for chronic dry skin, the Thomas Clinic on Harley Street offers a wide range of consultant-led dermatology services. Many patients choose to address more than one concern during their care, knowing that every treatment is delivered with the same attention to detail, discretion, and professionalism.

Our additional services include:

Mole Removal – Safe, precise procedures for both medical reassurance and cosmetic improvement.
Skin Tag Removal – Quick, discreet removal of harmless but often irritating or unsightly skin tags.
Rosacea Treatment – Targeted care to manage redness, flushing, and visible blood vessels.
Eczema Treatment – Specialist management of eczema and atopic dermatitis, with accurate diagnosis, tailored plans, and ongoing support.
Skin Cancer Screening – Comprehensive checks to identify suspicious moles or lesions early, providing peace of mind and prompt treatment where required.

Book an appointment