Skin Care: Limit Washing, Study Product Labels

FORT LAUDERDALE, FLA. — Skin manifestations of Sjögren's syndrome may not be unique to the disease, but they require specific interventions and close monitoring, Darren L. Casey, M.D., said at a meeting sponsored by the Sjögren's Syndrome Foundation.

Sjögren's syndrome affects the body's moisture-producing glands, resulting in chronically dry, itchy, and scaly skin.

Remind patients that they should try to maintain a protective barrier on the skin. “When we wash too aggressively, we get rid of that barrier,” said Dr. Casey, a dermatologist in private practice in Atlanta.

Dr. Casey suggests that patients limit washing to 20 minutes and recommends using Cetaphil, Dove, or Oil of Olay gentle skin cleansers.

Use of emollients such as Aquaphor immediately after a bath or shower can help retain moisture if lotions and creams do not provide relief.

For patients who don't respond to over-the-counter products, prescription humectants such as Carmol 20 and Carmol 40 may help.

He also advises patients to use humidifiers and fragrance-free laundry detergents to reduce irritation of dry skin.

In addition to dry skin, Sjögren's patients may develop red or purple palpable spots related to small vessel disease.

Urticarial vasculitis, which affects some patients, is characterized by hives that last hours to days. When these lesions are biopsied, they show inflammation in the blood vessels.

Medium-sized vessel disease typically manifests as nodules on the hands and feet or as livedo reticularis, characterized by a whorl pattern of pigmentation brought on by constricted blood flow. Medium-sized vessel disease should be a red flag to investigate central nervous system or severe organ involvement.