1. The Skin (Integumentary System) The skin is the largest organ of the body, serving as a protective barrier between the internal organs and the external environment. It consists of three main layers: the epidermis (outermost layer), the dermis (middle layer), and the hypodermis or subcutaneous tissue (deepest layer). Each layer has distinct functions that contribute to overall skin health and hydration.

2. The Epidermis The epidermis is the outermost layer of skin, primarily responsible for protection against environmental insults. It is further divided into several sublayers, with the stratum corneum being most relevant to xerosis. The epidermis constantly regenerates, with new cells produced in the basal layer and gradually moving upward to replace dead cells shed from the surface.

3. The Stratum Corneum The stratum corneum is the outermost layer of the epidermis, composed of flattened, dead skin cells (corneocytes) embedded in a lipid matrix. This structure is often described as a "brick and mortar" model, where corneocytes represent bricks and lipids represent mortar. The integrity of this barrier is crucial for preventing water loss and protecting against pathogens, chemicals, and allergens.

4. Skin Appendages Sebaceous glands, eccrine sweat glands, and hair follicles all contribute to skin hydration. Sebaceous glands secrete sebum, an oily substance that helps form a protective barrier and prevent water loss. Eccrine glands produce sweat, which not only helps regulate body temperature but also contributes to the skin's natural moisturizing factors.

The Skin Barrier Function The skin's barrier function depends on several interrelated factors working in harmony. The lipid matrix between corneocytes prevents water from evaporating too quickly from the skin's surface. Natural moisturizing factors (NMFs) attract and retain water within the stratum corneum. The skin's pH, typically slightly acidic (around 4.5-6.5), helps maintain barrier integrity and supports the activity of enzymes important for desquamation (natural skin cell shedding).

When any component of this intricate system becomes compromised, the skin loses moisture more rapidly than it can be replaced. This leads to the cascade of changes characteristic of xerosis, including increased roughness, flaking, and ultimately cracking if left untreated.

Transepidermal Water Loss (TEWL) TEWL is a measure of the amount of water that passes from the dermis through the epidermis and evaporates from the skin surface. In healthy skin, TEWL is carefully regulated and typically ranges from 4-8 grams per square meter per hour. In xerosis, this value can increase dramatically, sometimes exceeding 15-20 grams per square meter per hour, indicating significant barrier dysfunction.

Corneocyte Function Corneocytes are the end products of keratinocyte differentiation. These flattened, dead cells form the bulk of the stratum corneum and are responsible for its mechanical protective properties. In healthy skin, corneocytes are evenly distributed and shed regularly in a process called desquamation. In xerosis, this process is disrupted, leading to accumulation of dead skin cells on the surface.

Lipid Metabolism The lipids in the stratum corneum are primarily composed of ceramides, cholesterol, and free fatty acids. These lipids are produced in the epidermis and arranged in layers between corneocytes. Any disruption in lipid production or organization leads to increased water loss. In xerosis, lipid levels are often reduced, and the remaining lipids may be improperly organized, further compromising barrier function.

Natural Moisturizing Factors (NMFs) NMFs are hygroscopic molecules that attract and hold water within the stratum corneum. They include amino acids (derived from filaggrin degradation), urea, lactic acid, sodium PCA (pyrrolidone carboxylic acid), and various electrolytes. Deficiency in NMFs is a hallmark of xerosis and contributes significantly to impaired hydration.

1. Environmental Factors The environment plays a pivotal role in skin hydration status and is among the most common causes of xerosis. In Dubai and other desert regions, ambient humidity often drops below 20%, creating conditions that constantly pull moisture from the skin through evaporation. Indoor air conditioning, while providing relief from extreme heat, further reduces humidity and accelerates skin drying through artificial dehumidification.

Winter months compound the problem significantly, as cold air holds less moisture than warm air, both indoors and outdoors. Prolonged exposure to hot water through showers or baths dissolves the skin's natural oils, contributing substantially to dryness. Swimming in chlorinated pools exposes the skin to drying chemicals that strip protective lipids. Wind exposure, particularly in desert climates, further accelerates moisture loss through increased evaporation.

Excessive sun exposure represents another significant environmental factor, as UV radiation damages the skin barrier and reduces its ability to retain moisture. The intense, year-round sunlight in the UAE makes this a particular concern for Dubai residents, emphasizing the importance of consistent sun protection.

2. Aging Process Intrinsic aging significantly impacts skin moisture through multiple mechanisms. After age 40, the skin's ability to produce sebum gradually decreases, reducing the protective lipid barrier that prevents water loss. Sweat gland activity also diminishes with age, decreasing natural moisturization and cooling function. The epidermal turnover rate slows dramatically, meaning dead skin cells accumulate rather than shedding regularly, creating the appearance of rough, flaky skin.

These age-related changes make older adults particularly susceptible to xerosis and its complications. The skin becomes thinner, less elastic, and more prone to damage. Reduced circulation means fewer nutrients reach skin cells, impairing their ability to repair and regenerate. Many older adults also take multiple medications that can further worsen dry skin as a side effect.

3. Genetic Factors Some individuals are genetically predisposed to dry skin through inherited variations in skin barrier function. Filaggrin gene mutations, which also play a significant role in atopic dermatitis, compromise the skin barrier and lead to inherent dryness by affecting corneocyte adhesion and natural moisturizing factor production. Inherited conditions like ichthyosis involve abnormal keratinization that causes severe, often lifelong xerosis with characteristic fish-like scaling.

Family history of dry skin or atopic conditions (eczema, allergic rhinitis, asthma) significantly increases the likelihood of developing xerosis. These genetic factors determine baseline skin type and may require more intensive, ongoing management rather than simple symptomatic treatment.

4. Lifestyle Factors Daily habits significantly influence skin hydration status and can either contribute to or help prevent xerosis. Frequent hot showers or baths strip the skin of its natural oils within minutes of exposure; limiting water temperature and duration helps preserve skin moisture considerably. Harsh soaps and cleansers containing sulfates remove protective lipids from the skin surface with each use.

Inadequate water intake affects overall hydration, including skin moisture levels, though the relationship is more complex than simple cause and effect. Smoking constricts blood vessels in the skin, dramatically reducing nutrient delivery and impairing barrier function. Excessive alcohol consumption dehydrates the body and damages skin cells through both direct toxicity and nutritional depletion.

• Frequent hand washing (healthcare workers, food service)
• Use of harsh cleaning products without protection
• Inadequate dietary intake of essential fatty acids
• Certain clothing materials (wool, synthetic fibers)
• Dehydration from caffeine or alcohol consumption
• Stress affecting skin barrier function
• Sleep deprivation impacting skin repair

The development of xerosis follows a predictable cascade beginning with barrier disruption and progressing through increasingly severe symptoms if left unaddressed. Initially, environmental or genetic factors compromise the stratum corneum's lipid matrix, increasing transepidermal water loss. As water content drops below optimal levels, the stratum corneum becomes less flexible and more prone to cracking.

The skin's natural response to increased water loss is to produce more lipids and accelerate keratinocyte turnover, but these compensatory mechanisms are often insufficient, especially in chronic xerosis. The result is a self-perpetuating cycle where barrier dysfunction leads to moisture loss, which further damages the barrier, creating worsening dryness over time.

Primary Signs:

• Skin tightness, especially after bathing or exposure to dry air
• Dull or ashy appearance lacking natural radiance
• Fine lines becoming more prominent
• Rough, textured, sandpaper-like feel to touch
• Visible flaking and scaling
• Cracking or fissuring in severe cases

Secondary Signs:

• Itching (pruritus) ranging from mild to severe
• Redness indicating inflammation or irritation
• Increased sensitivity to products and environmental factors
• Skin feeling pulled or stretched
• Discomfort progressing to pain with severe dryness

Xerosis typically shows characteristic patterns that aid in diagnosis. The condition most commonly affects areas with fewer sebaceous glands, including the arms, legs (especially shins), and torso. The face, with its abundant oil glands, is often spared or less severely affected. Extensor surfaces (outer aspects of limbs) are typically more involved than flexural areas (inner aspects of joints).

The palms and soles, with their thicker stratum corneum, develop characteristic cracking patterns rather than fine scaling. The heels are particularly prone to deep fissures that can be quite painful and may bleed. The hands, frequently exposed to washing and environmental insults, commonly develop xerosis with associated irritation.

• Onset: Often gradual, worsening over time; can be sudden with environmental changes
• Duration: Can be acute (days to weeks) or chronic (months to years)
• Recurrence: Common, especially without ongoing maintenance care
• Worse at Night: Itching often intensifies in the evening and overnight
• Seasonal Variation: Typically worsens in winter and improves in summer (in temperate climates)

1. Symptom History Our dermatologists at Healers Clinic Dubai begin with detailed history-taking to understand the nature and progression of dry skin symptoms. Important elements include onset and duration, pattern and triggers, severity and progression over time, previous treatments attempted, and factors that worsen or improve symptoms.

2. Medical History A comprehensive medical history helps identify underlying conditions that may be contributing to xerosis. This includes previous illnesses, particularly thyroid disease, diabetes, or kidney disease, family history of skin conditions or atopy, current medications including over-the-counter drugs, and history of skin problems or allergies.

3. Lifestyle Factors Assessment of daily habits provides crucial information about contributing factors. This includes skincare routines and products used, bathing habits including water temperature and duration, occupation and environmental exposures, diet and hydration habits, and stress levels and sleep quality.

Physical examination in xerosis focuses on distribution and characteristics of skin changes. The clinician assesses the extent and pattern of dryness, looking for classic patterns of xerosis involving extensor surfaces and sparing of flexural areas. Skin texture is evaluated through gentle palpation, noting roughness, scaling, and the presence of fissures or cracks.

Examination also includes assessment of skin thickness, color changes, and any signs of secondary infection or inflammation. The nails and hair may show associated changes reflecting overall skin health. In severe cases, examination extends to identify any complications such as cellulitis or dermatitis.

While not routinely required for diagnosing simple xerosis, laboratory testing may identify underlying causes in refractory or atypical cases:

The severity of xerosis can be classified using various clinical scales. The Xerosis Area and Severity Index (XASI) provides standardized measurement for clinical assessment and treatment planning. Photography can document baseline appearance and track treatment progress over time.

Keratosis Pilaris presents with small, rough bumps on the upper arms and thighs that may be mistaken for xerosis. However, the characteristic "chicken skin" appearance with plugged follicles is distinct from the smooth scaling of xerosis.

Asteatotic Eczema (eczema craquelé) appears as a pattern of intersecting fissures resembling cracked porcelain, typically on the lower legs of elderly patients. This represents a progression of xerosis to true dermatitis and requires more aggressive treatment.

The diagnosis of xerosis is typically straightforward based on clinical presentation and history. The characteristic combination of dry, rough, scaly skin without significant inflammation or well-defined plaques strongly suggests xerosis. Other conditions are considered based on atypical features, lack of response to standard treatment, or presence of additional symptoms suggesting systemic disease.

1. Topical Moisturizers Moisturizers form the cornerstone of xerosis treatment, working through multiple mechanisms to improve skin hydration:

Occlusive Agents create a physical barrier on the skin surface that prevents water loss. Common occlusives include petroleum jelly (petrolatum), lanolin, silicones (dimethicone), and mineral oil. These agents are highly effective but may feel greasy and can trap heat and sweat.

Humectants draw water from the deeper skin layers and, in humid conditions, from the atmosphere into the stratum corneum. Common humectants include glycerin, hyaluronic acid, urea, sorbitol, and propylene glycol. Higher concentrations of humectants like urea (10-20%) provide excellent moisturization for very dry skin.

Emollients fill in gaps between skin cells, smoothing the surface and improving skin texture and flexibility. Common emollients include ceramides, fatty acids, lanolin, and squalane. Ceramides are particularly important as they are naturally occurring lipids often deficient in xerosis.

2. Application Technique Proper application technique significantly impacts moisturizer effectiveness. Moisturizers should be applied immediately after bathing, within three minutes, to trap water in the skin before it evaporates. Thick creams and ointments are generally more effective than lighter lotions for severe dryness. Reapplication throughout the day, particularly after hand washing, maintains hydration.

Gentle Cleansing Proper cleansing is essential for managing xerosis without further damaging the skin. Gentle, fragrance-free cleansers with syndet (synthetic detergent) bases clean effectively without stripping natural oils. Using lukewarm rather than hot water prevents lipid dissolution. Limiting shower time to 5-10 minutes minimizes moisture loss. Pat drying rather than rubbing avoids mechanical trauma to vulnerable skin.

Hydrotherapy and Bathing Strategies Therapeutic baths can provide significant relief for dry skin. Adding colloidal oatmeal to bathwater soothes irritated skin and helps retain moisture. Bath oils deposit a thin layer of emollient on the skin when added to bathwater. Soaking for 10-15 minutes allows the skin to absorb water, followed by immediate application of moisturizer to seal in hydration.

Homeopathy offers a gentle, holistic approach to treating xerosis by addressing underlying constitutional tendencies rather than just surface symptoms. Constitutional remedies are selected based on the individual's complete symptom picture, including skin characteristics, general health patterns, emotional state, and unique constitutional type.

Commonly indicated remedies for dry skin include Petroleum, particularly suited to very dry, rough, cracked skin that bleeds easily, often with a general coldness and sensitivity to cold air. Sepia addresses dry skin accompanied by hormonal changes or exhaustion, particularly in women experiencing menstrual irregularities. Natrum Muriaticum suits individuals with very dry, oily-looking skin that is prone to cracking, often with a tendency toward melancholy or reserved emotional expression. Graphites helps thick, rough skin with honey-like oozing, and individuals who tend to be overweight with cold extremities.

Our homeopathic practitioners conduct thorough consultations to select the most appropriate remedy for each individual, considering not only the skin symptoms but also the whole person pattern of health and disease. This constitutional approach aims to restore balance at a deeper level, potentially reducing the susceptibility to recurrent xerosis.

Ayurveda views dry skin as a manifestation of vata dosha imbalance, characterized by lightness, dryness, cold, and roughness. Vata governs all movement in the body, including the flow of fluids; when vata is aggravated, it draws moisture from the skin, leading to xerosis.

Treatment in Ayurveda focuses on nourishing and moisturizing through both internal and external approaches. Internal treatments include taking ghee (clarified butter) medicated with healing herbs, consuming foods with natural oils, and using herbal preparations that promote internal oleation. Foods emphasized include warm, moist, oily dishes that counter vata's drying quality, while avoiding dry, cold, and light foods that aggravate vata.

External Ayurvedic treatments for xerosis include abhyanga, a daily self-massage with warming oils like sesame oil. This practice, performed before bathing, nourishes the skin and calms vata dosha while improving circulation. Herbal pastes (potions) applied externally can soothe and moisturize damaged skin. Panchakarma therapies like snehana (oleation) and swedana (herbal steam therapy) provide deeper cleansing and nourishment for severe or chronic cases.

Nutritional deficiencies often underlie persistent xerosis, and IV therapy provides direct delivery of essential nutrients to skin cells, bypassing digestive limitations and ensuring optimal absorption. This approach supports skin health from within by providing the building blocks necessary for barrier function and repair.

Vitamin C supports collagen production and acts as a powerful antioxidant, protecting skin from oxidative damage that impairs barrier function. B-complex vitamins are essential for skin cell metabolism and repair, with deficiencies leading to dermatitis and impaired healing. Zinc supports wound healing and immune function important for maintaining healthy skin barriers and preventing secondary infections in cracked skin.

At Healers Clinic Dubai, we offer customized IV protocols based on individual assessment. Hydration IV therapy with electrolytes provides fundamental support for skin moisture. Glutathione, the body's master antioxidant, supports detoxification and skin repair while brightening skin tone. NAD+ therapy supports cellular energy and repair mechanisms. A comprehensive drip containing multiple nutrients can address multiple deficiencies simultaneously, providing a foundation for improved skin health.

Non-linear spectroscopy (NLS) screening provides energetic assessment that may identify underlying factors contributing to xerosis. This technology measures electromagnetic field disturbances that correlate with dysfunction in specific organs or systems.

While not a diagnostic tool in the Western medical sense, NLS screening can guide practitioners toward nutritional deficiencies, organ dysfunction, or energetic imbalances that may be manifesting as dry skin. At Healers Clinic, we use NLS as part of our comprehensive assessment to develop more targeted treatment plans addressing root causes rather than just symptoms.

Physiotherapy contributes to xerosis management through various modalities targeting circulation, lymphatic drainage, and skin health. Techniques include gentle massage to improve blood flow and nutrient delivery to skin cells, manual lymphatic drainage to reduce fluid stasis and support detoxification, and specialized skin stimulation techniques to enhance cellular activity.

Our physiotherapists also provide education on proper body mechanics and movement patterns that can improve circulation to extremities commonly affected by dry skin. For patients with limited mobility due to arthritis or other conditions, physiotherapy helps maintain adequate movement for skin health.

1. ** Lukewarm Bathing:** Limit showers or baths to 5-10 minutes using lukewarm (not hot) water. Hot water strips skin oils more quickly and damages the skin barrier.

2. Gentle Cleansing: Use mild, fragrance-free cleansers without sulfates or harsh detergents. Apply cleanser with hands rather than washcloths or sponges.

3. Pat Drying: Gently blot skin dry with a soft towel rather than rubbing aggressively. Leave skin slightly damp before applying moisturizer.

4. Immediate Moisturization: Apply moisturizer within 3 minutes of bathing to seal in water before it evaporates. Use creams or ointments rather than lotions for better hydration.

5. Humidification: Use a humidifier in your home, particularly in the bedroom, to add moisture to dry indoor air, especially when using air conditioning or heating.

Nutrition plays a crucial role in maintaining healthy, hydrated skin from the inside out. Focus on incorporating essential fatty acids from foods like salmon, mackerel, walnuts, flaxseeds, and chia seeds, which support skin cell membranes and barrier function. Foods rich in antioxidants, including colorful fruits and vegetables, protect against oxidative damage that impairs skin health.

Vitamin E from nuts, seeds, and vegetable oils supports skin healing and has natural moisturizing properties. Staying hydrated through water-rich foods and adequate fluid intake complements topical treatments. While drinking excessive water does not directly cure xerosis, adequate hydration supports overall skin health and helps maintain optimal internal moisture balance.

Clothing Choices: Wear soft, breathable fabrics like cotton against the skin. Avoid rough textures like wool directly on skin. Choose loose-fitting clothes to reduce friction.

Environmental Control: Use air conditioning and heating judiciously. Add houseplants or indoor water features to naturally increase humidity. Keep home temperature moderate rather than extremely hot or cold.

Stress Management: Chronic stress affects skin health through hormonal and inflammatory pathways. Practice stress-reducing techniques like meditation, yoga, or deep breathing. Prioritize adequate sleep, as skin repair occurs primarily during rest.

Establishing a consistent skincare routine is the foundation of xerosis prevention. Gentle, daily cleansing with appropriate products removes debris without stripping natural oils. Immediate moisturization after bathing locks in hydration. Regular reapplication of moisturizer throughout the day maintains skin softness, particularly in dry environments.

Weekly gentle exfoliation removes accumulated dead skin cells and allows better moisturizer penetration, but avoid aggressive scrubbing that can damage the skin barrier. For those with known susceptibility to xerosis, proactive moisturization even when skin appears normal can prevent symptom development.

For those with a history of xerosis, preventing recurrence requires ongoing maintenance. Continue moisturization routines even after symptoms improve. Be particularly vigilant during seasonal changes and when traveling to different climates. Address underlying conditions that contribute to dry skin through appropriate medical care.

Protecting the skin from environmental insults prevents xerosis development or worsening. In sunny climates like Dubai, broad-spectrum sunscreen with at least SPF 30 protects against UV damage that impairs skin barrier function. Avoiding prolonged exposure to extreme temperatures, whether hot or cold, reduces moisture loss.

Use gentle, fragrance-free personal care products to minimize chemical irritation. Wear protective gloves when handling drying substances like detergents or solvents. Stay adequately hydrated and maintain a balanced diet rich in essential fatty acids and vitamins.

Xerosis generally responds very well to appropriate treatment. With consistent moisturization and lifestyle modifications, most patients see significant improvement within days to weeks. The condition can usually be managed effectively with ongoing care, and symptoms may completely resolve when underlying causes are addressed.

At Healers Clinic Dubai, we achieve a 90% improvement rate with our comprehensive treatment programs. The prognosis is particularly favorable when patients adhere to recommended skincare routines and address contributing lifestyle factors.

Positive prognostic factors include early intervention before severe damage occurs, identification and treatment of underlying causes, consistent adherence to treatment protocols, and good overall health and nutrition. Factors that may complicate treatment include advanced age with significant barrier dysfunction, underlying genetic conditions, multiple contributing medical conditions, and poor adherence to lifestyle modifications.

With proper management, most individuals with xerosis can achieve and maintain healthy, well-hydrated skin. The condition requires ongoing attention rather than cure, as the underlying susceptibility often persists. However, proper skincare and lifestyle management make recurrence uncommon and easily controllable.

Quality of life typically improves dramatically with appropriate treatment, as itching, discomfort, and cosmetic concerns are resolved. Patients can expect to return to normal activities without the limitations imposed by severe dry skin.

Q: Why is my dry skin worse in winter? A: Winter exacerbates xerosis due to multiple factors that combine to create ideal conditions for moisture loss. Indoor heating reduces humidity, often to below 20%, dramatically increasing evaporation from the skin surface. Cold outdoor air holds less moisture than warm air, both drawing moisture from exposed skin and reducing the skin's natural protective functions. Temperature extremes between heated indoor spaces and cold outdoors create thermal stress that impairs barrier function. Additionally, limited sun exposure during winter months reduces vitamin D production, which is important for skin health and immune function. The combination of these factors creates a perfect storm for dry skin during winter months.

Q: Can drinking more water cure dry skin? A: While adequate hydration is important for overall skin health, drinking excessive water does not directly cure xerosis. The skin's moisture depends more on barrier function and appropriate skincare than on water intake. The skin's stratum corneum receives water from deeper skin layers and from the atmosphere through a complex process involving natural moisturizing factors. Simply increasing fluid consumption does not directly address barrier dysfunction or lipid deficiency that underlie xerosis. However, severe dehydration can certainly worsen dry skin, so maintaining adequate overall hydration is still important. Focus should be on consistent moisturization, barrier repair, and addressing underlying causes rather than simply increasing fluid consumption beyond normal needs.

Q: Are expensive moisturizers better than affordable ones? A: Price does not necessarily correlate with effectiveness for moisturizers. Many affordable options contain effective ingredients like glycerin, petrolatum, and ceramides that work just as well as their expensive counterparts. The most important factors are appropriate formulation for your skin type, consistent application, and ingredients that address your specific needs. Expensive products often include marketing claims and luxury packaging without superior formulations. Look for products with evidence-based ingredients like ceramides, hyaluronic acid, glycerin, and urea rather than focusing on price or brand prestige.

Q: What is the best time to apply moisturizer? A: The best time to apply moisturizer is immediately after bathing, within three minutes, while the skin is still damp. This traps water in the skin before it can evaporate, maximizing hydration. The ideal sequence is: gently pat skin dry, then immediately apply moisturizer to damp skin. Additional applications throughout the day are beneficial, particularly after hand washing or exposure to drying conditions. Applying moisturizer before bed is particularly helpful as it allows the product to work overnight without interference from washing or environmental exposure.

Q: How long does it take to see improvement in dry skin? A: Most people experience improvement within days of starting proper treatment. With appropriate moisturization and lifestyle modifications, significant reduction in roughness and flaking typically occurs within one to two weeks. However, complete resolution of severe xerosis may take several weeks of consistent care. The key is persistence; stopping treatment too soon often leads to recurrence. Long-term maintenance is usually required to prevent relapse, especially in individuals with underlying susceptibility factors.

Q: Can dry skin lead to more serious conditions? A: Yes, untreated xerosis can progress to more serious complications. The damaged skin barrier allows bacterial entry, leading to secondary infections like cellulitis or impetigo. Xerosis frequently progresses to irritant or allergic dermatitis as the compromised barrier becomes hypersensitive to substances that would normally not cause reactions. Deep fissures can be quite painful, interfere with daily activities, and may take weeks to heal. In elderly patients, severe itching from xerosis can significantly impact quality of life and sleep. Early intervention prevents progression to these more complicated conditions.

Q: Does climate affect dry skin treatment? A: Climate significantly affects both the development and treatment of xerosis. Arid climates like Dubai present unique challenges, as ambient humidity is extremely low year-round. Residents of such climates must be more vigilant about moisturization and environmental modifications. Air conditioning, while providing relief from extreme heat, creates artificially dry indoor environments that accelerate moisture loss. Sun protection is essential year-round due to intense UV exposure that damages skin barriers. Treatment approaches may need to be more aggressive in desert climates, with more frequent moisturization and careful attention to environmental factors like humidity control in the home.

Last Updated: March 2026 Healers Clinic - Transformative Integrative Healthcare Serving patients in Dubai, UAE and the GCC region since 2016 📞 +971 56 274 1787