Winter dry skin

The appearance of dry skin

The normally fine lines in the skin become more visible, the skin feels rough and appears dull and flaky. In more advanced cases, fish net-like cracks resembling the fine fracture lines of cracked porcelain can occur. Dry skin occurs most commonly on the arms and legs, but can also affect the trunk of the body. Dermatologists often call dry skin "xerosis" or "asteatosis".

Problems associated with dry skin

Dry skin very commonly produces itching, which can be severe and interfere with sleep and other daily activities. Repeated rubbing and scratching can produce areas of thickened, rough skin (lichenification). Dry, thickened skin can crack, especially in areas subject to chronic trauma (e.g., hands and feet), causing painful cracks in the skin. Dry skin and scratching may result in a dermatitis or eczema when the skin becomes red in addition to dry and scaly. Round, scaly, itchy, red patches scattered over the legs, arms, and trunk may appear.

The appearance of yellow crusts or pus in these areas indicates that a bacterial infection is developing. If concerned about infection, consult your dermatologist or family physician.

Also, if your skin is very dry, or if you have an associated red dermatitis, it is a good idea to seek the advice of your dermatologist or family physician.

Causes of dry skin

The outermost layer of the skin consists of dead skin cells embedded in a mixture of natural oils that are made by underlying living skin cells. These natural skin oils keep the water inside our body from escaping into the air and also keep irritating substances and germs from entering the body. Both the skin oils and the dead skin cells hold a certain amount of water that helps keep the skin soft, pliable, and smooth.

Dry skin results when there is not enough water in the top layer of skin for it to function properly. One way this can happen is when protective oils in the stratum corneum are lost so water that is normally present in the skin is allowed to escape. Too much soap, exposure to harsh chemicals, the normal aging process, and certain types of skin diseases are some of the causes of decreased amounts of protective skin oils. As the skin dries out it shrinks and, as it shrinks, small cracks can occur. This exposes the underlying living cells to irritating substances and germs in the environment.

Treatment of dry skin

An important aspect of treatment is to identify and tackle any factors that may be contributing to the dry skin. Water alone (especially hot water) can actually worsen the problem of dry skin by removing the normal, protective skin oils. Hot, soapy water depletes the natural skin oils to the greatest degree. Water followed by the application of a thick moisturizer, is of great benefit for dry skin.

Showering tips to avoid dry skin:

• You should take a short bath or shower (no more than 10 minutes) only once in a 24-hour period.
• Bathing should be in warm rather than hot water.
• Soap should be used minimally and where/when needed (for example, under the arms, the groin and genitals, the feet, and the face).
• Mild soaps should be used (unscented, those designed for sensitive skin).
• After showering, quickly and gently pat the skin partially dry with a towel (do not rub!).
• Within three minutes of getting out, apply a moisturizer of cream or ointment to seal the water in the skin before it evaporates.
• Moisturizers should be reapplied liberally during the day and evening when possible, especially to those areas prone to dryness. If dry skin affects your hands, reapply moisturizers after handwashing.

Other helpful measures

Treat any red dermatitis (eczematous) patches with a topical cortisone (steroid) cream or ointment for a 5- to 15-day course. Over-the-counter strength cortisone creams and ointments can occasionally be helpful, but prescription strength products are often required to calm down this type of dermatitis. Make sure you understand where the cortisone cream or ointment is to be applied (only on the red patches unless instructed otherwise) and how often you should apply it (no more than twice daily). When using both a cortisone product and a moisturizer, always use the cortisone first and the moisturizer second.

Be careful about using other over-the-counter anti-inflammatory and itch-suppressing creams or lotions. Many of these products contain chemicals that can irritate or cause allergic reactions in dry, dermatitic skin.

Any way that you can increase the humidity level in the air of your home and workplaces would be advisable. If you don’t already have one, you should consider adding a humidifier to the central heating system of your home. If you use a portable humidifier, make sure it is used in your bedroom at night.

Long-term prevention and control

Dry skin is usually a long-term problem that recurs often, especially in winter. When you notice your skin beginning to get dry, resume your moisturizing routine and avoid the use of harsh soaps. If the itchy, dry, skin rash returns, use both the moisturizers and the steroid cream or ointment.

There are three basic classes of body moisturizers: ointments, creams, and lotions (listed in decreasing order of moisturizing power). It should be noted that all of the moisturizer products mentioned in this article are available without prescription.

Ointment moisturizers

The have the greatest ability to trap moisture in the skin, but they have a greasy consistency. Examples of effective ointment moisturizers include Aquaphor and plain Vaseline Petroleum Jelly. Some common household products, such as Crisco vegetable shortening, can also be used as very inexpensive body moisturizers. The key to using an ointment is to apply small amounts and rub it in well.

Cream moisturizers

These are usually white and disappear when rubbed into the skin without leaving a greasy feel. Examples of effective cream moisturizers include Original Eucerin Cream, Aquaphilic, Cetaphil Moisturizing Cream, Vaseline Cream, Vanicream, CeraVe.

Lotion moisturizers

These are suspensions of oily chemicals in alcohol and water. Examples of popular lotion moisturizers include Vaseline Intensive Care, Nutraderm Keri, Lubriderm, Curel.

Some moisturizers contain chemicals that can cause skin irritation or allergic reactions in some people (e.g., fragrances, preservatives, alpha hydroxy acids, urea, sunscreens). If moisturizers seem to aggravate your skin, see your doctor for advice.

The information presented above will help you, your family, or someone else you know get through the winter season with less dry and itchy skin.