How to Battle Dry Winter Skin
It is inevitable. The beautiful golden leaves of fall are floating in the wind. We know what comes next. The heat in our homes will be turned on, dehydrating our skin. First, we notice a bit of dullness. Then perhaps some flaking. Our skin looks a bit more lined and older, Then for many of us, the itch and perhaps even cracking.
Dry skin is not only uncomfortable, unsightly and extremely common, it can also become inflamed leading to dermatitis (eczema) and can even become infected. But have no fear, there are simple and inexpensive ways of improving your scaly epidermis.
First, identify the problem. Dry skin begins to resemble the craquelae finish of a porcelain vase. Often this is accompanied by itch in the area. The first step is to use a fragrance free moisturizer every day immediately after you get out of the shower and bath. Good over the counter choices available in your local pharmacy are Cerave Cream, or Cetaphil Restoraderm . In addition, the use of a moisturizing body wash (also made by Cerave or Cetaphil Restoraderm) in the bath or shower can prevent the irritation and dryness caused by many soaps. If you want even more potent moisturizers and washes with natural anti-itch ingredients, turn to the Trixera and Xeracalm products by the French manufacturer Avene. These are available in our office or on the internet. The Avene Xeracalm Cleansing Oil is powerful help for parched, inflamed and eczematous skin, even in infants. The Avene Trixera Emollient Balm hydrates and calms using a natural sugar molecule to turn off itch. Very dry skin is more prone to allergic reactions to products, so stick to fragrance free lotions and cleansers such as the Avene products discussed above. Do not scratch, as the injury to the skin and the bacteria on your hands and under your nails can encourage infection.
If you still have dry itchy areas despite the above regimen, apply 1% hydrocortisone ointment (not cream!) to the area twice a day. Although ointment is greasy, the petrolatum in the ointment will help heal and treat the skin and allow better penetration of the hydrocortisone which will stop the inflammation which is causing the itch. Use the hydrocortisone for no more than 1-2 weeks in a row to avoid thinning of the skin. If itch continues to be an issue, an oral antihistamine such as Benadryl can help stop itch and help sleep when taken before bed. If itch is an issue during the day, try Zyrtec in the morning. This over the counter antihistamine does not cause the drowsiness that Benadryl does.
So now you are better, but somehow that scale on the legs is still visible no matter how much moisturizer you use, resembling the plates of an armadillo. Ask for Amlactin Lotion at the pharmacy desk. This over-the-counter lotion contains lactic acid. It dissolves the dead skin accumulating on the surface and makes the skin a better barrier to moisture loss. Be careful not to get Amlactin in open, scratched skin as it will cause a really uncomfortable burning sensation.
If all of this has failed to improve your skin, a visit to the dermatologist in order. You may have a different cause for your itching such as a fungal infection (ringworm), bacterial infection (impetigo) or allergic reaction. Other clues that you should see your doctor right away are pain, swelling, or fever.
Madeline Krauss, M.D.