Winter Skin – Itchy, Dry and Associated Rashes, Winter 2015 Newsletter
In the winter there are many rashes that occur, in addition to just getting itchy from being overly dry.
It is important in general to moisturize your body and face more often and with richer creams than we do in the warmer seasons. The reason is that the humidity plummets. Our skin’s number one component is water, and by the principles of osmosis (which you learned in high school science but don’t remember), water will flow across a membrane to equalize on either side. This means the air is literally sucking the water out of your skin! This loss of water causes a reduction in the barrier function of the skin, its primary function. The skin prevents chemicals, excess water, bacteria and viruses from getting through to the inside of our body. When this barrier is compromised, it is easier to get an infection, irritation or allergy. It is important to use cleanser/soap that is less drying and has no fragrance in the winter months. Good choices for body cleanser are La Roche-Posay™ Lipikar Surgras Cleansing Bar ($12) (in skinfo® – my favorite, I love that it never dries me out but it leaves me feeling clean with no residue), Avène XeraCalm A.D. Lipid Replenishing Oil ($30). The place most likely to dry out is the lower leg! Do NOT forget to moisturize this area. My favorite body moisturizer for the winter is Avène XeraCalm A.D. Lipid Replenishing Cream ($32), as it goes on so smoothly and feels elegant. Another nice choice is skinfo® Vital Tea Body Balm ($48). Cetaphil® RestoraDerm® ($20) is the most economical and excellent at barrier repair.
If you have problem skin, such as eczema or psoriasis, this is your danger season. Eczema (atopic dermatitis) is actually a genetic condition where the skin can’t hold onto water as well leading to a a reduced barrier function. Adding the loss of moisture from lack of humidity is a double whammy. People with eczema should use either the Cetaphil® RestoraDerm® ($20) or the Avène XeraCalm A.D. Lipid Replenishing Cream ($32), but for severely dry or cracked skin I recommend Theraplex® Emollient ($38). This is a pure ointment, but doesn’t have the irritants that can be in Aquaphor® or Vaseline®, as well as being more hydrating. If you have painful cracks in your hands or elsewhere, this helps out by using at night for a few days. If you get cracks on your fingertips, applying a drop of superglue in the crack works wonders. It reduces pain due to enclosing nerve endings that had been exposed to air. Although not permanent, it buys you time and helps put the two surfaces together to heal faster. Patients with eczema also need to keep on top of flares, avoid all fragrance (no fragrance in fabric softener and laundry detergent, even in shampoo and conditioner (Vanicream Free & Clear Shampoo ($14) and Conditioner ($16) as well as in moisturizers and soaps. Try to avoid wool and polyester; the former scratches and the latter causes you to sweat which is irritating on dry skin. Call us immediately if you are using your prescription medication for a flare and are unsuccessful. You may need a stronger cream or an oral medicine to get you well again. Avène XeraCalm A.D. Lipid Replenishing Oil ($30) is highly moisturizing as well.
Psoriasis sufferers are most likely to have their disease flare up in the winter. It may be due to the lack of ultraviolet light, but certainly dry weather doesn’t help. Unfortunately, Mavena has stopped supplying the US with products. In the meantime, for those of you who were using those moisturizers or others who haven’t used any, I would recommend using Cetaphil® RestoraDerm® ($20) for body moisturizer and GLYTONE Kelual DS Shampoo ($28). It is a great shampoo that helps with scaling and itching, if you are looking for an OTC solution (skinfo®).
There are three other common conditions with winter…”winter itch”, “nummular dermatitis” and ichthyosis. Winter itch occurs because the skin is dry, yet wearing heavy clothes causes sweat to accumulate and irritate the pores. The results is itchy crusty bumps. Usually, winter itch does require prescription medications to resolve, although with excellent skincare it may be avoided. Nummular (means coin-shaped in Latin) dermatitis, round scaly itchy patches occur, commonly on the legs. These are usually easily treated with prescription creams. Both of these conditions can sometimes be prevented with good attention to moisturizing daily and avoidance of irritants and harsh soaps, as discussed in the first part of this article. Avoiding polyester and wool also may be helpful; dress in layers with cotton against the skin .
Ichthyosis (fish-scale in Latin) is a condition in which you get diamond shaped scaly patches over much of the legs. This is best treated with an alpha hydroxy acid cream called skinfo® Soft and Smooth Body Lotion ($48).
The sensation of itching is terrible. People who experience it say it is worse than pain. For immediate short-term relief from itching use an ice pack. Moisturizing, proper medications and sometimes an antihistamine like Benadryl® or ZYRTEC® will help. Adding menthol or phenol to a preparation can act like an anesthetic on the skin and this sometimes also quells the itching.
These are only some of the myriad causes of itching. If you itch and can’t get it under control, call us. Stay smooth and moist this winter!