What Causes Dry Skin and How to Fix It Naturally

Last updated 14 July 2026

You know the feeling. You step out of a long, hot shower, run a finger down your arm, and it squeaks. Clean. Properly clean. Twenty minutes later your skin feels tight and papery, and your shins start to look like cracked paint. That squeak was not the sound of clean skin. It was the sound of a stripped skin barrier.

Dry skin, or xerosis, is one of the most misunderstood complaints in Malaysia, so let us begin with an honest correction to the usual internet promise. Dry skin and eczema are not cured. They are managed, sometimes very well, often for life. The Malaysian Skin Foundation, set up by dermatologists from the Dermatological Society of Malaysia, says as much in plain language: there is no cure for eczema, but there are many ways to manage it.

It is also getting commoner. The Ministry of Health’s Clinical Practice Guidelines on the Management of Atopic Eczema record that the twelve-month prevalence of atopic eczema among Malaysian children rose from 9.5% in the mid-1990s to 12.6% by 2002 to 2003, an increase of roughly half a percentage point every year. What science has given us in return is a clear picture of why skin dries out, and a set of cheap, boring, genuinely effective things that keep it comfortable.

Dry skin is a barrier problem, not a water-drinking problem

The outermost layer of your skin, the stratum corneum, is about as thick as cling film. Dermatologists describe it as a brick wall. The bricks are flattened dead cells called corneocytes. The mortar is a matrix of fats: ceramides, cholesterol and free fatty acids. Inside each brick sits a mixture of small water-loving molecules called natural moisturising factor, or NMF, a sponge built into the cell that holds water where it is needed.

NMF comes from a protein called filaggrin, and this is the piece the listicles never mention. Malaysia’s national eczema guideline explains that the barrier defect behind eczema may be caused by genetic alterations in the filaggrin gene. Less filaggrin means a weaker wall and less NMF, so water escapes.

How common is that fault in people like us? The Malaysian guideline points to a study in neighbouring Singapore, where 20.2% of eczema patients carried at least one filaggrin-null mutation, against 7.3% of people without the condition. It is not a rare curiosity. It is a common inherited weakness in the wall.

That escape has a name: transepidermal water loss. Damaged mortar and low NMF mean water leaks out and irritants leak in. That is dry skin, in one sentence. It is also why moisturiser works from the outside, and why a glass of water does not.

The eight glasses of water myth, put to rest

Drink eight glasses a day and your dry skin will vanish. It is among the most repeated skincare claims in the world, and there is no good evidence for it. A systematic review by Akdeniz and colleagues, published in Skin Research and Technology in 2018, examined whether dietary fluid intake affects skin hydration in healthy humans and found the evidence thin and inconsistent, with no clear benefit in people who are already adequately hydrated.

Water you drink is absorbed into your bloodstream and shared around the body. It does not queue up at the surface of your shins. Drink enough because dehydration is bad for you, but it will not repair a barrier.

The Malaysian paradox: a humid country full of dry skin

Malaysia sits at around 80 percent relative humidity most of the year, which on paper makes it one of the friendliest climates for skin on earth. So why is dry skin so common here? Largely because of what we do to our skin, and to escape the climate, rather than the climate itself.

Hot water, and long showers

This is the one with the clearest local evidence behind it. The Ministry of Health guideline notes that physical irritation from hot water, sweating and ultraviolet exposure further weakens the skin barrier, and its review of bathing found that a longer bath, meaning more than ten minutes, may be associated with more severe eczema. Interestingly, how often you bathe was not associated with severity. In a hot country you will shower twice a day, and you do not need to stop. Just make it shorter.

On temperature, the guideline is refreshingly honest: there is no good evidence on the ideal water temperature, but its development group advises against extremes, too hot or too cold, because both worsen skin.

Foaming cleansers and the scrub-till-it-squeaks habit

There is a belief here that skin is not clean until it squeaks. That squeak is stripped skin. The national guideline lists soaps, detergents and disinfectants among the irritants that worsen flares, and the Malaysian Skin Foundation’s advice is blunt: avoid harsh soaps and detergents, and use gentle, fragrance-free skincare products. Harsh gels remove the very fats your barrier is made of, and a rough loofah takes what is left. If you also use scrubs or acids, read how often we should really exfoliate our skin, because over-exfoliation and dry skin are cousins.

Air-conditioning, with a caveat

Air conditioners do not just cool air, they wring the water out of it. A KL office at 22 degrees is a desert compared with the street outside, and many of us spend twenty hours a day in artificially dried air, moving between office, car and bedroom. A 2016 review by Goad and Gawkrodger in the Journal of the European Academy of Dermatology and Venereology found that low ambient humidity alters the water content of the stratum corneum, reduces skin elasticity and increases roughness.

Here is the honest caveat, because you will not read it elsewhere. When Malaysia’s own guideline looked at climate and eczema severity, it found warm conditions and high sun exposure associated with poorly controlled disease, but no association with humidity. So treat air-conditioning as a plausible driver of everyday dryness, not as a proven cause of eczema flares. Turning the aircon down a degree is cheap and harmless. It is not a treatment.

Frequent washing, and haze

Hands take the worst of it. Repeated washing and sanitiser strip the barrier fastest, which is why hands are usually where dryness shows first. Haze season adds oxidative stress on top, and the guideline notes outdoor air pollution is significantly associated with eczema symptoms.

What actually works

1. Moisturiser, and the three types nobody explains

Moisturiser is not a nice-to-have. The Ministry of Health guideline calls emollient therapy the mainstay of management at any stage of eczema, from mild to severe, and the pooled trial evidence it cites is strong: people using an emollient had a lower risk of flares and needed less topical steroid than people using none.

Most people buy one moisturiser and wonder why it fails. Moisturisers do three different jobs, and you usually need more than one.

Type	What it does	Look for
Humectant	Pulls water into the outer layer, topping up what NMF should be doing	Glycerin, hyaluronic acid, urea, lactic acid
Emollient	Fills the gaps between cells so skin feels smooth and supple	Squalane, fatty acids, jojoba oil, shea butter
Occlusive	Seals the surface so water cannot evaporate away	Petrolatum, dimethicone, mineral oil, lanolin

A humectant alone in an air-conditioned room can even draw water up from deeper skin and let it evaporate. It needs something sealing it in, and the champion sealant is petrolatum, plain petroleum jelly, which the national guideline names as the example of an ointment. Work by Czarnowicki and colleagues in the Journal of Allergy and Clinical Immunology showed petrolatum is far from the inert grease people assume, with measurable barrier repair effects and increased expression of the skin’s own antimicrobial peptides. It costs a few ringgit, it is not glamorous, and it outperforms most expensive alternatives.

2. Apply straight after bathing, to damp skin

This one habit is worth more than most product upgrades, and almost nobody does it. Pat dry, do not rub, then moisturise while the skin is still damp so the water is trapped in rather than lost. The written eczema action plan published with the Ministry of Health guideline puts it simply: bathe with a gentle cleanser for less than ten minutes, apply moisturiser to all body parts immediately after bathing, and apply it a minimum of three times a day. Three. Not once, if your skin is genuinely dry.

3. Which moisturiser? Less important than you think

Here is the finding that should save you money. Reviewing the trials, the Malaysian guideline concluded there is no reliable evidence that one emollient is more effective than another. Ointments are greasy and work well. Creams and lotions contain water, feel nicer and are easier to actually use, which matters, because the moisturiser you apply three times a day beats the luxurious one you use twice a week.

So buy the one you will use, in a quantity you will not ration, and keep the thickest stuff for the worst patches.

4. Change your cleanser before you change anything else

Swap bar soap and foaming shower gel for a fragrance-free soap substitute or syndet (synthetic detergent) cleanser, which cleans without stripping lipids. Fragrance-free is not the same as unscented, which can still contain masking fragrance.

The honest verdict on natural remedies

Coconut oil: real evidence, and a real catch

Coconut oil deserves better than uncritical praise, and better than blanket dismissal. A randomised, double-blind trial by Evangelista and colleagues, published in the International Journal of Dermatology in 2014, compared virgin coconut oil with mineral oil in 117 children with mild to moderate atopic dermatitis. Coconut oil came out ahead: severity scores fell by about 68% in the coconut oil group against 38% for mineral oil, with a bigger reduction in water loss through the skin. That is a real result from a real trial, more than most kitchen remedies can claim.

Now the catch, which the internet usually leaves out. Pure coconut oil is highly comedogenic, meaning it readily clogs pores, and dermatologists advise against putting it on acne-prone facial skin. It also irritates a minority of people, and inflamed skin reacts more easily than healthy skin. So: reasonable on dry arms, legs and body, especially in children with eczema and with your doctor’s input. Not the first thing to reach for if you break out on your face. If it stings or burns, stop.

Colloidal oatmeal: the strongest of the natural options

Colloidal oatmeal is finely milled oat suspended in water, and it is not folklore. It appears in the evidence review inside Malaysia’s own eczema guideline, where oat-containing moisturisers reduced the rate of flares and the amount of topical steroid needed, compared with no treatment. Its anti-inflammatory activity is credited largely to compounds called avenanthramides. For itchy, irritated skin, it is a sensible and well-evidenced choice, and it comes ready-formulated, which is safer than tipping breakfast oats into a bath.

Honey, aloe, shea butter, and the quiet winner

Shea butter is a decent emollient. Aloe vera and honey are soothing and have small trial evidence in atopic dermatitis, almost always as one ingredient in a formulated cream rather than raw from a jar or a plant. They are no substitute for a proper moisturiser. And the quiet winner is still petroleum jelly, which has no fragrance, almost never causes allergy, and seals the barrier better than any botanical on this list.

When it is not just dry skin

Sometimes dryness is a symptom rather than the whole story. See a doctor if any of these apply.

• It does not improve after two to four weeks of gentle cleansing and consistent moisturising.
• There is a rash, oozing, cracking, bleeding or any sign of infection.
• The itch is severe, keeps you awake, or is all over your body with no visible rash. Widespread itch without a rash can point to thyroid, liver, kidney or blood disorders.
• You have chronic kidney disease. Itch is a recognised and often severe complication of kidney failure, known as uraemic pruritus, and it needs specific treatment rather than moisturiser alone.
• You have diabetes or an underactive thyroid. Both are linked to dry skin.
• You started a new medicine. Statins, diuretics and retinoids are recognised causes of skin dryness. Never stop a prescribed medicine on your own, but do raise it with your doctor or pharmacist.

One local reality worth knowing. The Malaysian Skin Foundation points out that there are fewer than 200 trained dermatologists in the country, and access is hardest outside the cities. That is exactly why people give up waiting and buy another cream, or worse, an unlabelled one from a stall. Start with your GP or a government clinic, who can treat most eczema and refer you if it is not settling.

A routine that holds up in Malaysia

Shorter showers, warm not hot, and under ten minutes. A fragrance-free soap substitute instead of a foaming gel. Pat dry, do not rub. Moisturise immediately afterwards on damp skin, with both a humectant and an occlusive, and reapply through the day rather than once and hoping. Reapply after every hand wash. Keep petroleum jelly for shins, heels, elbows and lips.

None of that is exciting, and none of it is a cure, because there is no cure. What it is, is a barrier that holds. Skin looked after this way also ages better, which is why so much of it overlaps with how to slow down skin aging naturally. If your dryness is persistent, painful or spreading, book an appointment rather than buying another cream, and browse our dermatology articles in the meantime.