Tips for dry winter skin
It’s been an unusually warm November in London but it will undoubtedly get colder soon. For many people that means drier skin for many people. Here are some tips to help you this season:
Look after the extremities in extreme weather
These tend to suffer the worst in the cold. The hands in particular start getting chapped and irritated. If this is the case avoid soap and shower gels and use a soap substitute such as Aqueous cream or Dermol wash. They don’t lather very well and are not very fragrant and you may think they are useless when you start but they actually do the job very well and are far less drying. Make sure you rinse off completely as they can irritate skin if left on. I like urea-based moisturisers for the hands. They are really hydrating but not as greasy as the ones with more paraffin. Keep some at home and work and in your bag and apply 2-4 times a day depending on how dry your skin is.
Lips are another problem area. If the normal lip balms aren’t helping then Aquaphor is a great hydrator. If this is hard to get hold of then my Roaccutane patients (who almost all get really dry lips ) use Elizabeth Arden 8-hour lip balm or Creme de la Mer lip balm which are great too, though more pricey. If the dryness is mainly at the corners of the mouth this maybe a condition called Angular cheilitis which can be caused by iron deficiency and it’s worth discussing this with your doctor
Feet can get really itchy for some people. About 1 in 10 people get chilblains. In addition to keeping the feet warm, a rich moisturiser at night can help skin supple during the day. Some people can benefit from tablets such as nifedipine. Rarely chilblains can be associated with internal conditions such as lupus so if yours are unusually bad, other body parts such as run of ears and nose are significantly affected or you have other symptoms then it may be worthwhile seeing your doctor.
The impact of overheating
Home environments can be overly warm and dry and this can cause asteatotic or discoid eczema, particularly in older people. This is often underdiagnosed and undertreated and commonly mistaken for fungus infections. But antifungal treatments don’t often work. The skin needs greasy moisturisers and often a short course of very potent prescription creams. On the other end of the age spectrum, babies can be kept too warm for fear of infections and this can lead to a rash called miliaria. This is self-limiting and harmless and doesn’t cause many symptoms but can be alarming for parents to look at, leading to anxiety and sometimes misdiagnosis and inappropriate treatment.
Overheated environments in winter can cause problems other than dry skin in winter too. It’s not uncommon to have to walk to the station in the cold get on to a crowded train and get really hot and then have to step into the freezing cold only to walk into an overheated office. The heat and dampness this can generate in the skin can worsen or lead to skin infections from bacteria and fungus. In addition to the usual treatments, appropriate layering can help maintain body temperature.
A lot of the sports companies now have base layers with fabric technology that help keep moisture away from the skin and still keep you warm and a number of patients have told me these can be really helpful. Stay warm!
Dr Nisith Sheth is a Consultant in the Dermatology Surgery and Laser Unit of St John’s Institute of Dermatology. He trained in the UK, Canada and the USA. He sees and treats all skin conditions.