Body skin care: the bumps on your arms, the spots on your back, and the heels that crack every winter

The face gets all the attention and most of the budget. Below the neck people use whatever soap is in the bathroom and wonder why their arms are rough and their back breaks out. Body skin is thicker, has different follicle density and takes longer to respond - but it responds.

Those rough bumps on the upper arms

Keratosis pilaris - small hard bumps on the backs of the upper arms and thighs, sometimes with a red halo. It is keratin plugging the follicle opening, it is extremely common, it is harmless, and it is not dirt, so scrubbing makes it worse.

• Urea at 10 to 20 per cent in a cream, which both hydrates and gently breaks down the plug.
• Lactic acid or glycolic acid body lotions, used a few times a week.
• Salicylic acid body washes, as a supporting step rather than a treatment.
• Moisturise immediately after showering, on damp skin.
• Expect improvement over weeks, and recurrence if you stop. It is managed rather than cured, and it often improves with age.

Back and chest acne

Same disease as facial acne, thicker skin, more friction, more sweat. Treatment is the same set of actives in formats built for larger areas.

Itchy, uniform, monomorphic small bumps on the chest and back that do not respond to acne treatment - particularly in humid weather - may be malassezia folliculitis, which is fungal and needs a different treatment entirely. That is a dermatologist visit, not another acne wash.

Dry shins, elbows and cracked heels

These are barrier problems with a mechanical component, and they respond to the least fashionable ingredients in the shop.

• Urea 20 to 40 per cent for heels; it softens hardened keratin better than any oil.
• Petrolatum-based ointments overnight, with cotton socks over them. Unglamorous and unmatched.
• Lactic acid lotions for shins and elbows a few times a week.
• Shorter, cooler showers. Hot water is the most common cause of winter itch.
• A pumice or foot file on damp skin, gently. Aggressive filing causes the thickening it is meant to remove.
• Deep, painful heel fissures that bleed need a doctor, especially for anyone with diabetes, where foot care is a medical matter rather than a cosmetic one.

Two things that quietly cause a lot of body skin trouble

First, friction. Tight synthetic clothes in humid weather, damp gym wear worn home, backpack straps and helmet chin straps all produce breakouts and irritation exactly where they press.

Second, detergent. Residue from a heavy dose of washing powder or a strong fabric softener sits against skin all day. If your body itches in a pattern that matches your clothing, run a rinse cycle and change detergent before buying another lotion.

Sunscreen below the neck

The parts of the body that show ageing and pigmentation most clearly - hands, forearms, neck, chest - are the ones people never protect. If you do nothing else, extend your face sunscreen to the neck and the backs of the hands, and use a body sunscreen on days you will be out in a short-sleeved shirt.

Body products are also where a large bottle makes sense: you need a lot, you use it daily, and cost per application is what decides whether you keep doing it.