Managing Dry Skin During the Winter

14 December 2020

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A change in weather doesn't mean your skin has to feel dry, itchy or inflamed.

Yes, dry skin, known medically as xerosis, is common, especially in Oklahoma when the drop in temperatures and the whipping winds zap moisture from your skin. But, there are ways to manage this nuisance of a condition without it altering your lifestyle. We'll help you better understand why your skin becomes so dry in the first place, provide you with tips to treat your skin and give you guidance on how to deal with more severe conditions such as psoriasis and eczema.

Why is my skin so dry?

Your skin has several layers, most notably the dermis and the epidermis. The epidermis is the layer of skin you can see. It serves as protection against anything and everything you come in contact with. The dermis underneath contains blood vessels, oils and sweat glands.

Under normal circumstances, the epidermis creates a barrier that helps lock in moisture. In the winter, a combination of things, such as washing your hands and the drier air from low humidity and indoor heat, damages this layer. Hot water, frequent baths and some skin conditions can also damage the outer portion of your skin. As moisture escapes, you become more prone to dry, itchy skin that may crack, bleed or burn.

You may notice your hands, arms and legs are especially dry in the winter. These areas have fewer oil glands to protect the skin.

Older adults and people who tend to spend more time outdoors are more prone to dry skin. Sun exposure can damage the outer layer of your skin that you need to retain moisture. As you age, your skin also loses the natural oils necessary to protect your skin.

How to treat dry skin

Since your skin becomes dry when it loses moisture, the easy solution is to use lotion or a moisturizer to replenish the water your skin loses. When selecting a product, thicker options, such as petroleum jelly, tend to work best since they have oils to help create a protective barrier.

But, a greasy formula isn't always ideal to use on your hands. Find a product that works for you and use it several times a day. That's more important than choosing expensive ingredients. Remember that you'll have to apply it more in the winter since it's drier.

Moisturizer or lotion works best when you apply it after a bath or washing your hands. Applying a product to damp skin helps seal in the moisture. Before moisturizing, be sure to avoid using fragranced soaps or detergents that may wash oils away from your skin. Choose a mild cleanser that's free of chemicals. Cetaphil or Aveeno work well for washing your hands or body.

When you shower or take a bath, consider the temperature you use. You may think a hot bath can help soothe your skin, but anything too hot can actually make your skin drier by removing too much moisture.

Try using a humidifier in your home to retain moisture. Not only is the air outside dry, but humidity levels drop precipitously in the winter when your furnace or heating unit pumps warm, dry air into your home.

If your skin gets so dry that it cracks and begins to itch, avoid the temptation to scratch. Much like an insect bite, scratching the skin can make it worse and invite bacteria to enter your skin. For relief, try an antihistamine ointment.

Common types of skin diseases

It's one thing if you have dry skin due to weather or exposure to products that harm your skin. Many people also suffer from skin diseases, such as eczema and psoriasis, which can worsen in the winter.

Psoriasis

Psoriasis is an autoimmune disease that causes chronic skin issues. Typically, the epidermis gets rids of old skin cells and creates new ones each month. With psoriasis, your immune system mistakenly sees healthy skin cells as unhealthy, so it signals the epidermis to grow skin at an abnormal rate. The skin cells have nowhere to go, causing a buildup of inflamed, red and raised areas of skin.

Although the disease is long term, you'll deal with flare ups that lead to inflamed areas on your skin. Plaque psoriasis is the most common type in which your skin develops dry, silvery scales. Your nails may often thicken or harden, and plaque psoriasis can also lead to joint problems, known as psoriatic arthritis.

Eczema

By definition, eczema is a broad term for conditions that make skin red, itchy and inflamed. It's often used interchangeably with atopic dermatitis, a type of eczema that causes dry, scaly skin patches. This skin disease is chronic and affects all ages, although it is more common in children.

The exact cause is unknown, but research indicates people with eczema have an issue creating a protein that protects your skin. Without it, moisture can escape and you can become more prone to bacterial and viral infections.

Treating chronic skin issues

Outside of the severity, the type of treatment is the main difference between skin disorders and common dry skin. You'll need more than a trip to your local drugstore for a moisturizer or lotion.

Psoriasis and eczema are both chronic conditions, but there are several options for managing symptoms. Psoriasis treatment may range from prescription creams to stronger medications that you either take orally or get injected. Light therapy (phototherapy) can help treat psoriasis that affects a large part of the body. Your physician may also recommend immunosuppressant drugs that slow down cell growth or take PDE4 inhibitors or other biologics to block the immune system response that causes inflammation.

We've mentioned how too much sun exposure can damage your skin, but sunlight may help in small doses. Try getting some sun exposure a few times a week to slow the skin growth associated with psoriasis.

Similarly, eczema is treated by reducing inflammation with antihistamines, steroid creams or injectable steroids. There are certain drugs that also block the immune system from causing inflammation. You can talk to your doctor about topical calcineurin inhibitors, topical PDE4 inhibitors or a biologic called dupilumab. A prescription for a barrier cream can also help protect your skin.

Psoriasis and mental health

Psoriasis and mental health are a bit of a chicken or the egg discussion to determine the culprit. Dealing with psoriasis is a challenge in itself. Then there's the added issue of how the disorder can alter your physical appearance, ranging from flakes in your hair to scaly patches on your skin.

Being self-conscious and fearing judgment with how you look can cause mental health issues. But, having a mental health disorder can also lead to psoriasis. No matter the origin, these issues become cyclical as psoriasis can cause anxiety when you go in public, or it may create feelings of isolation that lead to depression. Although you can wear more clothing during colder months, you can still see psoriasis on your face, neck, arms and hands.

The pattern continues since stress often makes psoriasis symptoms worse. A review of many psychological studies found chronic stress can lead to increased levels of pro-inflammatory cytokines. This immune system response creates more inflammation and can create more difficulties with your skin conditions.

In this case, you're not only fighting the weather when winter comes around, but you also must deal with the mental health aspect. You may become more stressed during the winter months when it's dreary out and you spend more time indoors.

Managing your stress and mood is crucial during these times. Try to exercise or take part in an activity that brings you joy. If you experience any change in behavior, thoughts or feelings and think your dry skin is affecting your mental health, contact an INTEGRIS Health primary care physician to discuss next steps.