What deficiency causes xerosis?

October 16, 2025 •

2 min read

Globally, a significant number of children suffer from severe vitamin A deficiency, which is known to cause xerosis of the eyes, and in the most advanced cases, blindness. This severe form highlights a critical connection between specific nutrient shortages and xerosis, a condition that can manifest in various ways on both the eyes and skin.

Quick Summary

Xerosis, or abnormally dry skin, is frequently caused by dietary inadequacies, particularly deficiencies in vitamin A, essential fatty acids, and zinc, which are crucial for maintaining skin moisture and barrier function.

Key Points

Vitamin A Deficiency: A primary cause of ocular xerosis, a condition of dry eyes, and can also cause dry, scaly skin and follicular hyperkeratosis.
Essential Fatty Acid Deficiency: Inadequate intake of omega-3 and omega-6 fatty acids compromises the skin's lipid barrier, leading to increased water loss and scaly dermatitis.
Zinc Deficiency: This micronutrient is vital for healthy skin cell growth and barrier function. A shortage can result in rough, dry skin and worsen existing dermatological conditions.
Malabsorption: In developed countries, underlying medical conditions that cause poor nutrient absorption, such as intestinal disorders or post-bariatric surgery, are key drivers of these deficiencies.
Treatment: Correcting the deficiency requires supplementation and dietary changes, alongside topical emollients and protective skincare practices to manage symptoms effectively.

The Primary Culprit: Vitamin A Deficiency

Vitamin A deficiency is a well-known nutritional cause of xerosis, particularly affecting the eyes (ocular xerosis). This fat-soluble vitamin is vital for maintaining epithelial tissues in the eyes and skin. A lack of vitamin A reduces mucin production in the eyes, leading to dryness and haziness. It also causes keratinization, replacing moist cells with hardened ones, resulting in dry, scaly skin and potentially corneal xerosis. Follicular hyperkeratosis, or 'toad skin,' characterized by rough, bumpy skin from keratin buildup, is also linked to this deficiency.

The Role of Essential Fatty Acids

Essential fatty acids (EFAs), such as linoleic and alpha-linolenic acids, are key to the skin's lipid barrier. A deficiency compromises this barrier, increasing water loss and causing skin dehydration. This often presents as scaly dermatitis, sometimes confused with other conditions. Diagnosis typically involves measuring plasma fatty acid levels.

The Impact of Zinc Deficiency

Zinc is crucial for skin health, involved in cell growth, differentiation, and immune function. Low zinc levels impair the skin barrier and keratinocyte differentiation, leading to rough, dry skin. Zinc deficiency is common in certain types of xerotic dermatitis, with supplementation showing marked improvement. Severe deficiency can also cause hair loss and other skin problems.

Nutritional Deficiencies and Xerosis: A Comparison


Deficiency	Primary Role in Skin/Eye Health	Associated Xerosis Symptoms	Other Key Signs
Vitamin A	Maintains epithelial tissues, produces moisture	Ocular xerosis (dry eyes), scaly skin, follicular hyperkeratosis	Night blindness, Bitot's spots, increased infection risk
Essential Fatty Acids	Maintains skin's lipid barrier and hydration	Generalized scaly dermatitis, increased transepidermal water loss	Alopecia, poor wound healing
Zinc	Involved in cell growth, differentiation, and immunity	Rough skin, impaired barrier function, exacerbated dermatitis	Hair loss, nail changes, increased infections

Causes of Deficiency

Nutritional deficiencies can result from poor diet, malabsorption issues like those from Crohn's or cystic fibrosis, bariatric surgery, chronic alcoholism, or restrictive diets. Dehydration also contributes to dry skin.

How to Address Xerosis Caused by Deficiency

Treatment involves identifying and addressing the specific deficiency through dietary changes or supplementation. Supplementation with the necessary nutrient can quickly reverse symptoms. A diet rich in vitamin A (liver, eggs, fortified dairy, colorful vegetables), omega-3s (fatty fish, flaxseed), and zinc (meat, nuts, legumes) is recommended. Topical treatments with ingredients like urea and ceramides help manage symptoms and restore the skin barrier. Minimizing hot showers, using gentle cleansers, and humidifiers also help.

Conclusion

Xerosis, while often linked to environmental factors, can significantly stem from nutritional deficiencies. Lack of vitamin A, essential fatty acids, and zinc impairs the skin's moisture barrier, causing dryness and discomfort. Consulting a medical professional for accurate diagnosis and intervention is key. Correcting the deficiency with supplements and dietary changes, alongside consistent topical care, can effectively manage and reverse symptoms. Understanding the role of these nutrients is vital for improving skin health. More information on vitamin A deficiency is available from the WHO.

Frequently Asked Questions

The most common deficiency causing ocular xerosis, or dry eyes, is a severe lack of vitamin A. This can also lead to night blindness and other eye-related pathologies.

Yes, a poor diet can cause dry skin all over the body. Deficiencies in essential fatty acids and zinc, for example, disrupt the skin's moisture barrier, leading to generalized dry, scaly skin.

While environmental factors often cause dry skin, a nutritional cause might be suspected if you also experience other symptoms like hair loss, poor wound healing, or night blindness. A healthcare provider can order blood tests to check your nutrient levels.

Excellent food sources of vitamin A and its precursor, beta-carotene, include liver, eggs, dairy products, and brightly colored vegetables like carrots, sweet potatoes, and dark leafy greens such as spinach.

Besides vitamin A, a deficiency in essential fatty acids (EFAs), particularly omega-3s and omega-6s, can cause dry and scaly skin by impairing the skin's lipid barrier.

Staying hydrated is important for overall skin health, and dehydration can contribute to xerosis. However, if the cause is a specific nutrient deficiency, simply drinking more water will not correct the underlying issue.

Along with correcting the nutritional deficiency through diet or supplements, applying topical moisturizers containing ingredients like ceramides, urea, and glycerin can help to restore the skin's protective barrier and improve hydration.