Winter skin

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Caring for dry skin may require multiple applications of moisturizing cream throughout the day

Winter is coming!  As if cold weather and runny noses aren’t bad enough, winter brings dry, cracked and itchy skin.  Between dry weather and excessive hand sanitizer use, I have dry skin all winter!  This is a problem that I see with kids every year, and not just the kids with eczema. Therefore, this is a perfect time to brush up on your skin care regimen for everyone in the house.  First, let’s start with the basics.

Your skin

The top layer of skin is called the epidermis.  This is your waterproof barrier that keeps moisture in and offenders out.  When the weather gets cold and dry, more water evaporates from the skin and the epidermis dries out.  That loss of humidity in the atmosphere also makes it harder for your skin to hold moisture in.  Furthermore, frequent hand washing causes a loss of moisturizing oils from the skin which naturally protect the skin.  Once the skin is dry and cracked, it can increase your risk of inflammation and infection in the skin.  Therefore, you will want to know how to maintain your skin in order to prevent any complications.

What are the symptoms?

If you are experiencing dry skin, most likely your skin feels rough and scaly and may be itchy.  Sometimes the skin will dry out so much that it may crack or bleed and for some people, the skin will also get red.  The hands and lower legs are the most common place to see these symptoms but dry skin can happen anywhere.  Frequently, the lips get chapped which causes many kids to lick their lips.  This becomes a vicious cycle as the licking makes the dryness worse (the salt in the saliva draws water out of the skin).

Treatment options

The goal of treating dry skin is to get the moisture back in while limiting the amount of moisture that is taken away.  Below is a list of steps that can help relieve dry skin all through the winter.

  • Avoid hot showers
  • Limit showers or baths to 10-15 minutes only
  • Wash with a mild fragrance-free soap
  • Pat dry your skin and leave it a little damp, then apply a thick fragrance-free moisturizer over the wet skin to lock in moisture
  • Avoid alcohol based sanitizer as much as possible
  • Drink lots of fluids
  • Use a humidifier in the home
  • Apply petroleum jelly or other barrier to chapped lips
  • Avoid lip licking

The thicker the moisturizer the better it will be at holding in moisture.  That means ointments like Vaseline or Aquaphor are a good first choice.  Next best are the thick creams that come in a tub like Eucerin, CeraVe or Cetaphil.  Finally, there are thinner lotions available that are easier to apply but don’t always hold in as much moisture.  Some lotions have urea or lactic acid which can be really helpful for excessively dry skin but they can also sting when applied.  In fact, even super gentle and benign creams can sting when the skin is already irritated and inflamed.  This does not mean the cream is poorly tolerated.  It will be important to keep up with moisturization in order to reduce the stinging sensation.

My recommendations are by no means an exhaustive list of available products and I’m sure there are products out there that work really well that I have not mentioned.  I am not paid to recommend these products, they are simply common and easy to find and I know they work.  Many people love to use coconut oil and it has become very popular.  If that works well for you, stick with it.  It does not hold in moisture as well as the mineral oil based products so if you are not getting relief from coconut oil, it is time to switch.

Medication

Topical medication may be indicated if the dry skin leads to dermatitis, or inflammation of the skin.  If the skin is red and itchy, a topical corticosteroid like hydrocortisone can be used twice daily to relieve symptoms.  However, don’t use topical steroids for more than 2 weeks at a time in order to minimize the risk of side effects.  Excessive use of topical steroids can thin out the skin so never use them on the face unless directed by your doctor.  If you think your child needs topical medication, visit your pediatrician.

Hopefully with some good routines everyone in your family will maintain soft skin all winter long!