Thyroid hormone is an important regulator of skin cells. Because skin cells have a short lifespan and rapid turnover, they may be more sensitive to low thyroid levels than other tissues.
A study in The Journal of General Internal Medicine shows that 74% of hypothyroid patients report dry skin, and many say that their skin issues get worse over time. Changes in the skin that cannot be attributed to allergies or new products could be indicative of a thyroid problem.
The eccrine glands are the major sweat glands located nearly all over the body. These glands secrete moisturizing factors such as lactate, urea, sodium, and potassium to keep skin hydrated. A healthy, moisturizing barrier forms when secreted sweat mixes with oil on the skin surface. Eccrine glands also help to stabilize body temperature.
But what happens when thyroid hormone production drops? When your thyroid slows down, your body processes slow down and change. One such change is a decrease in eccrine gland secretion, resulting in dry hypothyroid skin. Skin without enough moisture can quickly become dry and flaky.
Dry skin affects those with hypothyroidism in substantially the same way it affects those who don't have the condition. This similarity means that treatment can be managed in the same way as all dry skin conditions.
Water alone isn't a strong enough ingredient to keep your skin moisturized. In fact, too much showering or bathing may dry out your skin faster. The American Academy of Dermatology recommends to keep showers short, and using warm (not hot) water. After showering, pat your skin dry and apply moisturizer right away.
When washing, use mild soaps and body washes. Look for gentle, fragrance-free cleansers that contain emollients (fats and oils).
Then, when moisturizing, make sure your skin gets the moisture it needs with these two factors:
- Hydrate with humectant ingredients that absorb water from the atmosphere/skin and hold it in place on your skin. Look for products with hyaluronic acid, aloe vera, or honey.
- Moisturize with oil-based ingredients create a seal on the surface of the skin to prevent water from escaping. Try shea butter, coconut oil, or lanolin.
To give the hydrator something to hold onto, you might consider using a humidifier.
Of course, everyone's skin is different, so find what works best for you! It doesn't hurt to use both a moisturizer and hydrator. Hydrate your skin, and then lock it in with a moisturizer.
If these steps don't relieve your dry skin, see your doctor who can assess your symptoms within the context of your overall health. Your thyroid treatment plan may need tweaking, or perhaps a chronic skin condition like eczema is at play.
Eczema is a chronic inflammatory skin condition that creates dry skin patches that are red and intensely itchy. Sometimes these patches ooze, become scaly, crusted, or hardened.
Eczema may be caused by genetic, immunological, or environmental factors. While foods allergies or sensitivities do not cause this skin condition, a particular food may contribute to a flare-up of eczema.
Keeping your skin moist is the first step in managing eczema. It is also helpful to control environmental triggers to minimize flare-ups.
Environmental triggers could include:
- Dust mites
- Cleaning products
- Cosmetics products
- Seasonal change
- Change in weather
To identify your triggers, keep a log of the things around you that might contribute to your flare-ups. Is your eczema worse in the winter? Does it flare-up when you clean the kitchen?
If all else fails, your doctor may prescribe medication to ease the horrible sting, itch, and discomfort. Make sure to coordinate with your thyroid specialist, too, to ensure medication doesn't affect thyroid function or the absorption of thyroid medication.
If you have chronic hives, a thyroid condition may be the culprit. About 25%-30% of people with chronic hives (urticaria) have an underlying autoimmune thyroid disease like Hashimoto's thyroiditis. Often an autoimmune condition like this causes exaggerated or inappropriate body reactions to toxins or allergens.
The symptoms of hives are often mistaken for those of other skin conditions like eczema, rosacea, or pityriasis rosea. However, the specific characteristics of hives distinguish them from other skin conditions:
- The elevated area of skin has a clearly defined border
- When you press the rash, it turns white
- They will be (very) itchy, and there may also be pain or a burning sensation
- They can appear anywhere on the body and change shape, move around, disappear, and reappear over short periods
- When they resolve, the skin will return to normal without scarring
- Most will not be accompanied by systemic reactions such as fever, nausea, muscle aches, joint pain, or headaches.
The difference between acute and chronic hives is the length of time it takes to resolve. Acute hives clear on their own in a matter of hours, whereas chronic hives may be present for several years and often require treatment.
Managing hives starts with identifying and avoiding triggers that irritate the skin. Over-the-counter topical antihistamines can help relieve hives. If the hives are widespread, your doctor may prescribe oral medication for more accessible treatment. However, it should note that oral steroids and antihistamines can suppress thyroid function, and you should consult your doctor about treatment.
A study in the Journal of Advanced Pharmaceutical Technology & Research suggests that treating the underlying hypothyroidism with levothyroxine may speed up recovery from chronic hives. In the study, 72 people with chronic hives and TPO antibodies were split into two groups. Both groups were given low-dose antihistamine, and the first group was also administered levothyroxine. Patients in the levothyroxine group experienced decreased severity in itching more quickly than the other group.
Acne and Breakouts
No one likes visible acne. It can make you feel vulnerable or unconfident and can lower self-esteem. Many teens get acne because of hormonal changes that happen during puberty. But what about acne in adulthood? What causes it, and how can you treat it?
Acne may be caused by immunological factors, food sensitivities, or nutrient deficiencies.
Dermato-Endocrinology published a study that reports thyroid autoimmunity (such as Hashimoto's) detected in several inflammatory skin conditions, including acne and chronic hives. This connection may be because when your thyroid hormone production slows down, the body has difficulty converting cholesterol to steroid hormones like pregnenolone, progesterone, and DHEA. The body needs these steroid hormones to help control inflammation. So, low thyroid function increases internal inflammation. If you experience post-adolescent acne, you should test for TPO antibodies to determine if autoimmune thyroiditis may be at the root of the problem.
Food sensitivities may also contribute to acne. Reactive foods may trigger an inflammatory response in the gastrointestinal tract, leading to an autoimmune flare-up. Many people experience a significant reduction in gut symptoms, skin breakouts, and pain by eliminating reactive foods. Changes in diet may also help lower TPO antibodies.
To uncover reactive foods or food sensitivities, you might try an elimination diet. This diet is an eating plan that omits one food or food group for a certain period of time. Then, you reintroduce that food or food group to learn which foods are causing symptoms or making them worse. This diet is considered safe and reliable for identifying problematic foods, as long as the rest of your diet remains balanced and nutrient-rich. To self-manage, keep a log of what foods you eat, how you feel, and what's improving or getting worse. It may also be helpful to work with a nutritionist to guide this experience.
Similarly, nutrient deficiencies can affect your skin. For instance, zinc helps your body monitor thyroid hormone levels and tells it to increase production when levels are low. Omega-3 fatty acids provide cellular membrane integrity, which protects them from becoming damaged and enables your cells to communicate well with each other. Vitamin A plays a vital role in skin, eye, and reproductive health, and immune function. Work with your care team to determine your specific nutritional needs to optimize your thyroid health.
Optimize Thyroid Function
You cannot outsmart your thyroid. If you deal with hypothyroidism, the health of your skin links directly to the health of your thyroid.
Get a blood test to understand how your thyroid is working. At Paloma Health, we believe it's helpful to measure TSH, fT3, fT4, and TPO antibodies to understand the full picture.
With those results, you'll know if there is a need for further evaluation of your thyroid function. Working with a doctor to identify the appropriate medication and treatment plan for your condition will help to also alleviate your symptoms, like pesky skin issues.