Thyroid Dry Skin: Know Everything Here!

Dry skin occurs when the skin loses too much moisture. It can manifest differently in individuals with symptoms ranging from mild discomfort to severe distress. While ageing, cold or dry weather, overbathing, sun damage, using harsh soaps, and having some skin conditions are well-known reasons behind dry skin, it can also be caused by thyroid disorders. Read ahead to learn more about thyroid dry skin.  

Understanding Thyroid and Skin Health

The thyroid is a butterfly-shaped gland that is located in the front of the neck below Adam's apple. It is an endocrine gland that releases the following thyroid hormones (TH):

• Thyroxine (T4): Though it is the primary hormone released by the gland, it does not affect metabolism. Upon releasing into the bloodstream, T4 gets converted to T3 through the deiodination process.
• Triiodothyronine (T3): Although it is produced in lesser amounts, it has a much greater impact on the metabolic rate.
• Reverse triiodothyronine (RT3): Produced in very small amounts, the hormone reverses the effects of T3.
  Calcitonin: It aids in regulating the amount of calcium in the blood.

Notably, the thyroid gland traps iodine from the food to prepare thyroid hormones. Consuming too little or too much iodine can affect the level of thyroid hormones.

Functions of Thyroid Gland

Thyroid hormones help regulate the body's metabolic rate or metabolism, the process in which the body transforms food into energy. As all the cells in the body need energy to function, it can impact the entire body when the thyroid is not working properly. The most common problems with the thyroid gland include its overactivity (hyperthyroidism) and underactivity (hypothyroidism).

Besides, thyroid hormones affect bodily functions, such as the heart rate, breathing, digestion, body temperature, brain development, mental activity, fertility, and skin and bone maintenance.

Further, peripheral thyroid hormones (T4 and T3) regulate various functions at a cellular level. By binding to their receptors, they regulate epidermal cell proliferation (cell growth and division), differentiation (development of a cell into a specialised, mature form) and homeostasis (the process of maintaining a stable internal environment in the cell). 

When it comes to the relationship between thyroid hormones and skin health, it is to be noted that thyroid dysfunction has multiple manifestations at the skin level. And, many issues like oedema, carotenemia, and coarsened, thin, scaly skin are linked to thyroid hormone dysregulation.  

How Thyroid Dysfunction Leads to Dry Skin?

Thyroid dysfunction is responsible for alterations in skin architecture, including epidermis, dermis and hypodermis, and homeostasis. For instance, T3 is known for accelerating epidermal barrier formation. But, the hormone can hinder the epidermal barrier function (limit passive water loss, prevent microbial infection and protect against environmental aggressions) in hypothyroidism.

It is observed that in hypothyroid people, the skin becomes dry, cold and rough. Also, the epidermis is hyperkeratotic (increased thickness of the outer layer of the skin), alopecia may develop, and there is diffuse myxedema (non-pitting oedema of the leg).

On the other hand, in hyperthyroid individuals, the epidermis is usually thinner than normal. And, skin often presents symptoms like itching, chronic urticaria, vitiligo and diffuse skin pigmentation.

 Symptoms of Thyroid-induced Dry Skin

In hypothyroid individuals, skin is rough and covered with fine scales, especially on the extensor extremities. Also, palms and soles may be quite dry. Dry skin may resemble an acquired ichthyosis. Notably, this dryness is attributed to the decreased eccrine (or sweat) gland secretion.

Further, here are some other symptoms of thyroid-induced dry skin:

• Itchy skin without a rash
• Deep cracks 
• Rashes, especially in the creases of the skin
• Painless patches of discoloured skin that feel hard 

Besides, people with hypothyroidism have a yellowish tone to the skin owing to the increased carotene in the dermis.

It is important to visit a doctor to identify the cause of dry skin accurately and get the right treatment. Often, dry skin is a symptom of skin conditions like psoriasis and dermatitis. But, it can also be caused by hypothyroidism. 

Diagnosing Thyroid Disorders Affecting the Skin

Thyroid disease symptoms can look like those of other conditions. Some women may experience symptoms similar to those they might have during pregnancy. That is why, thyroid disorders are tricky to diagnose.

A healthcare provider will begin by inquiring about the symptoms and the medical history. He/she will order one or some of the following tests to confirm a thyroid disorder:

• Physical Examination: It is a simple and painless test that involves the doctor feeling the neck to check for any growth or enlargement of the thyroid gland.
• Blood Tests: They are of several types like thyroid-stimulating hormone (TSH), T3, T4, and thyroid antibodies. Measuring the amount of thyroid hormones in the blood, these tests can help identify whether it is hypothyroidism or hyperthyroidism. 
• Imaging Tests: A thyroid ultrasound can help find out nodules (lumps) and/or goitre. Further, nuclear medicine imaging can be used to know if nodules are overactive.
• Iodine Uptake Test: In the case of hypothyroidism, this test is ordered to find out the cause. This test tracks the amount of iodine absorbed by the thyroid gland, which indicates how much hormone it is making.

Treatment Options for Managing Dry Skin in Thyroid Disorders

Generally, thyroid hormone therapy is prescribed when the thyroid gland is not making enough TH naturally. The therapy uses manmade thyroid hormones, usually given in the form of pills, to increase abnormally low levels of natural TH in the body. Notably, pure synthetic thyroxine (T4) is the most commonly prescribed thyroid hormone replacement. 

While thyroid hormone therapy can help address hypothyroidism, dry skin can be treated by rehydrating the skin. Here are some treatment options for dry skin:

• Moisturisers: They soften dry skin, prevent cracking and help recreate the natural skin barrier. Moisturising creams and lotions feature emollients that soothe and hydrate the skin. Also, some lotions feature hyaluronic acid, which increases moisture in the skin. 
• Medications: Topical steroids can help decrease swelling (inflammation) in the skin that causes a rash and itching. In severe cases of dry skin, oral or injectable medications may be appropriate.

Lifestyle and Dietary Tips to Improve Skin Health

Here are some tips that can help people with thyroid issues improve their skin health:

• Maintain a balanced diet to support thyroid health, ensuring adequate iodine intake to promote better thyroid function.
• Take thyroid hormone replacement medications exactly as prescribed by your doctor. Typically, they should be taken on an empty stomach for optimal absorption. Avoid taking them simultaneously with walnuts, soybean flour, multivitamins containing iron, or iron and calcium supplements, as these can interfere with the medication's effectiveness. 
• Stay hydrated by drinking plenty of water throughout the day to support healthy, moisturised skin.
• Limit or avoid foods and drinks containing alcohol, caffeine, sugar, and salt, as they can contribute to dehydration by depleting water out of the body. 

In summary, it’s essential to draw moisture into the skin and retain it to enhance its appearance and texture. The skin has a natural barrier designed to lock in moisture. The stratum corneum, the outermost layer, is composed of dead skin cells (corneocytes) stacked like bricks, with fats or lipids serving as mortar. This cellular brick wall plays a key role in retaining moisture within the skin.

In addition, the following measures can be taken to keep the skin moist and healthy:

• Use a gentle, alcohol-free, nonfoaming cleanser to wash the face at least twice a day.
• Apply moisturisers with healing ingredients like glycerine, shea butter, ceramides and cocoa butter, several times a day.
• Avoid hot water during showers and limit bath time.
• Use a humidifier to add moisture to the air inside the home.
• Go for natural fabrics that are kind to the skin.

When to Seek Medical Advice for Thyroid-related Skin Issues?

Dry skin can manifest differently for different people. The skin may:

• Feel rough, tight or itchy 
• Appear flaky, scaly, dull or lifeless. 

Connect with a dermatologist to get the right treatment for dry skin, which is often caused by cold or dry weather, overbathing, harsh soaps, and some skin conditions.

Simultaneously, if a person experiences the symptoms of thyroid disorders, then it is time to see an endocrinologist to get a diagnosis and begin treatment. Often, thyroid diseases run in families. Updating the doctor about the family history of thyroid dysfunction can help one stay a step ahead of complications. 

Tips to Maintain Skin Health with Thyroid Issues

The below-mentioned tips must be followed to promote skin health:

• Eat a balanced diet, including fruits, vegetables and whole grains
• Manage stress well with meditation and yoga 
• Treat the skin gently by using a mild cleanser and hydrating moisturiser 
• Avoid smoking as it damages collagen (a protein that is abundant in the skin) and elastin (a key protein in tissues) that give skin strength and suppleness 
• Use protection (like sunscreen, umbrella, wide-brimmed hats, long pants and long-sleeved shirts) against the sun

Conclusion

Thyroid dysfunction can alter skin architecture and homeostasis. In the case of hypothyroidism, the T3 hormone can affect the functioning of the epidermal barrier, which is responsible for limiting passive water loss, preventing microbial infection and protecting against environmental aggressions. Hence, it leads to dry skin in hypothyroid individuals.

Besides, dry skin is also caused by other factors like ageing, hot and cold weather, and some skin conditions. Therefore, it is crucial to connect with a specialist to diagnose the accurate cause behind the symptoms and start with the right treatment. While thyroid hormone therapy can help treat hypothyroidism, dry skin can be improved by using moisturisers and topical steroids. 

Also, eating a healthy diet and managing stress can not only help with thyroid disorders and dry skin, but also maintain overall well-being.