ask the expert dry skin

The Baltimore Sun

"Jack Frost nipping at your nose" may be a great line in a song, but the reality does little for your complexion. Add to the frost, blasts of dry, wintry wind, sun exposure and overheated office air and your skin may feel dry and even scaly.

Indeed, millions of people each winter experience redness and uncomfortably dry and itchy skin, says Dr. Rebecca A. Kazin, assistant professor of dermatology and director of the Johns Hopkins Cosmetic Center. And those who already suffer from more serious conditions such as eczema or psoriasis may find that the cold season exacerbates their symptoms.

What do you tell people who come to you complaining of itchy, dry skin?

We definitely see more people who say they have itchy, dry and flaky skin, and they don't know why. The first thing I ask is, 'What soap are you using?'

Often the soaps that are needed in the summer when we are active and sweaty -- the antibacterial soaps -- are not necessary in the winter. I ask them to switch to a more gentle soap and body wash. I tell them that soap should be fragrance-free.

What kinds of soaps should they be choosing?

Dove soap typically has a moisturizing base to it. Or Cetaphil makes a gentle cleanser. Purpose also makes a cleanser that is gentle. I also ask what moisturizer they are using. A lot of people use lotion-based moisturizers; a lot of lotions have high alcohol content. Instead, they should look for these ingredients in their moisturizers: petrolatum or ceramides, mineral oil or dimethicone.

Those listed ingredients are very moisturizing and usually come in a cream. Again, try to stay clear of lotions with fragrance.

What are other steps people can take to protect their skin in the winter?

Instead of taking those long, hot showers that feel so good in the winter, people should try to take shorter, lukewarm showers. Long, hot showers evaporate the moisture in your skin. When you get out of the shower, pat dry and, within a few minutes, apply a thick layer of moisturizer to trap the moisture in your skin.

I also tell people to apply moisturizer one more time before they go to bed. A lot of people have very dry, cracked skin on their hands and feet, and I tell them that after they apply the moisturizer, they should wear light cotton gloves to bed.

Anything else?

It might be good to use a humidifier in your bedroom or in any room you spend a lot of time in, like the living room. I also tell people that if they are already using skin-care products [for conditions such as acne] with glycolic acid or salicylic acid or tretinoin [used in retin-A], they might consider limiting their use of those products because they are particularly drying. And use sunscreen. Even in winter, we do still recommend a moisturizer with sunscreen with a protection factor of 15 or higher. In the summer, wear 30 or higher. The same goes for if you are going skiing: Wear 30 or higher.

Does the wintry weather affect or exacerbate other skin conditions?

Yes, conditions such as eczema and psoriasis are typically associated with dry, rough skin so we often see these flaring up in the winter. Eczema and psoriasis are both noncontagious skin conditions associated with large patches of red, dry, itchy skin on the face and body. The hands and feet also can become cracked and painful.

I suggest to people that they step up their treatments and make sure they are using the correct soaps. Rosacea -- a facial condition especially of the nose or cheeks, characterized by a rosy coloration and sometimes acne-like pimples -- is a little different. People with rosacea have very sensitive skin. Spicy foods or caffeine or alcohol may have an effect on their skin. But in winter, when exposure to high winds can cause chapped skin, I tell rosacea patients to take steps to protect their skin as well.

You often hear the admonition to drink more water. Can a person counteract the wintry conditions by drinking more water?

Water in general hydrates the body, which would then hydrate the skin. But there is not a direct correlation between the amount of water you drink and a decrease in the dryness or redness of your skin.

Another piece of advice given frequently during the winter months (and flu and cold season) is to wash your hands often. Is there anything that can help the dryness that may go with hand washing?

Certainly we all need to wash our hands. I have a 2- and a 4-year-old, and I wash my hands all the time and that perpetuates the dryness. I just tell people to try to keep a small tube of moisturizer for your hands in their pocket.


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