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A Guide to Winter Skin

Posted January 03, 2014 featuring Val Jones, M.D.

Val Jones, M.D.

C.E.O., Better Health

Photo of Val Jones, M.D.

Val is an award-winning author and blogger, regular guest on ABC News in Washington, DC, CEO of Better Health, and sees patients part-time at DocTalker Family Medicine in Vienna, Virginia.

What causes winter skin?

Chapped, cracked and flakey skin is primarily caused by exposure to a dry environment. Outdoor air is drier in the winter time because colder air has a lower moisture-carrying capacity. In fact, air at 86 degrees Fahrenheit can hold three times more moisture than air at 50 degrees. In addition to colder, drier outside air, indoor air is often stripped of moisture by heating systems.

Certain areas of skin are more vulnerable to dryness because of a reduced ability to produce natural oils. While back and face skin contain a significant amount of oil-producing glands, legs have far fewer and lips don’t have any at all. When skin cells dry out, they don’t shed as quickly, causing buildup of thicker, flakey patches. Thickened skin doesn’t retain water as well as moist skin, which causes a kind of vicious dryness cycle. Exposure to cold, dry wind and UV radiation (reflecting especially strongly from snow) can further worsen the problem.

Are there any dangers of winter skin?

Frost bite

In addition to the everyday nuisance of dry skin, there are some more concerning winter skin conditions. Extended exposure to freezing temperatures can cause frost bite, a type of permanent damage to skin and underlying tissue. Just as water can break a glass container if left in the freezer for too long, our body’s cells (which have high water content) will burst and die if frozen. For this reason it’s extremely important to take precautions against frost bite if you’re planning to be outside for extended periods in sub-32-degree weather. Pay special attention to your hands and feet as they are farthest from the warmth of the body’s core and will freeze before other areas. Some of the first signs of impending frost bite include pain in the tips of fingers and toes when they are rewarmed. This stage of cold damage is reversible and is known as chill blains. With further exposure, chill blains can become frost bite and, in extreme cases, may require amputation of the damaged tissue.

Sun damage

Ultraviolet radiation from the sun can cause sunburn and skin damage in the winter, especially when rays reflect off of snow. It is a common misconception that sunblock is only needed when the weather is warm or the sky is clear. Radiation exposure can occur at any time of year, even on cloudy days. Without protecting your eyes from UV rays, you can also get “sunburn of the eyes,” often known as “snow blindness.” Of course, exposure to UV radiation permanently increases the risk of skin cancers.

Infection

Another complication of dry skin is potential infection. The skin is normally colonized with bacteria that are harmless unless they get into our tissues and blood stream. Cracked skin can provide an entry way for bacteria to invade, and this is further aggravated by scratching (common when skin is dry and itchy). If you notice pain or redness developing in an area where you have been scratching or have cracked skin, this could be a sign of a bacterial skin infection called “cellulitis.” The treatment for cellulitis is antibiotics so it’s important to contact your doctor if you think you might have a skin infection. 

Nose bleeds

Finally, winter air can promote nose bleeds by exposing delicate blood vessels (found in the nasal mucosa) to extreme dryness, damaging the vessel walls. In most cases, nose bleeds are not dangerous and will resolve on their own with some gentle pressure. In more severe cases (such as for people on blood-thinning medications), a healthcare professional will need to pack the nose with cotton gauze to stop the bleeding.

Can I prevent winter skin problems?

The good news is that most winter skin problems (including the more dangerous ones) can be prevented. Air humidifiers can improve the moisture levels in your home or work environment, while saline nasal sprays can reduce the likelihood of nose bleeds. Covering your skin with warm clothing and reducing your exposure to outdoor cold can help. However, the foundation of dry winter skin prevention and treatment is good skin care.

What is the best skincare regimen for winter skin?

Moisturizers

There are a large variety of skincare options for preventing and treating winter skin. Treatments are generally designed to moisturize and/or exfoliate dry skin, while some products also combine sunscreen or anti-blemish ingredients. Be sure to check the Drug Facts label on over-the-counter (OTC) skin care products to learn if the product contains active ingredients (medicines). If the product has no Drug Facts label (but just an ingredient list) then this means that it does not have an indication evaluated by the Food and Drug Administration. That does not necessarily mean that they don’t “work,” but rather that their ingredients haven’t been evaluated by the FDA in regards to medical effects.

A general rule of thumb is that moisturizing creams are best for mild dryness, oils for moderate dryness and ointment for severe dryness.  Common moisturizing ingredients include oils (mineral, castor, jojoba, almond, sunflower, soybean, olive, grape seed, coconut, argan and others), glycerine (a sugar alcohol), petrolatum (mineral oil jelly from petroleum), dimethicone (a type of silicone), nut butters (cocoa, shea) and waxes (palm, soy, bee, lanolin). Most moisturizers contain several additive ingredients to preserve their shelf life and keep them sanitary.

Exfoliators

Since dry skin sloughs off more slowly, moisturizers may include an acid product that can help to remove dead skin cells. Ingredients such as lactic acid, stearic acid, glycolic acid, and hyaluronic acid may help with exfoliation. Some creams include microbeads or ground apricot shells or tree bark to help rub off dead cells. Luffa or mesh body sponges and pumice stones are also commonly used to help remove unwanted dead skin.

Sensitive skin

As far as sensitive skin is concerned, there are products made specifically without perfumes, dyes, lanolins, parabens and formaldehydes. If you have skin allergies to certain ingredients, try looking for products that are fragrance-free, dermatologist-tested, hypo-allergenic or non-irritating. Most labels will display those claims on the front of the product.

Are there other tips for avoiding the complications of winter skin?

Shower tips

The best time to apply moisturizer is immediately after a shower or bath. This locks in the water that is still surrounding your skin cells with a layer of oil, cream or ointment. Avoiding harsh soaps is also important when you have winter skin because they can be especially irritating to chapped or cracked skin. Look for “soap free” body washes or cleansing products that contain moisturizers.

Clothing tips

Bundle up to protect your skin from cold wind and dry air exposure. Scarves can be worn over the face and neck to protect delicate skin from being stripped of moisture, while gloves and boots are important to protect fingers and toes from chill blains and frost bite. Keep scratchy fabrics (such as wool) out of direct contact with cracked or dry skin.

Staying hydrated

Dehydration causes skin to sag and pull away from the underlying muscle. Dry air can dehydrate the body through evaporation without your being aware of it. Skin cells thrive in moisture rich tissues, and so drinking water is one of the best ways to hydrate our skin.

When to call a doctor

It’s important to contact your doctor immediately if you think you may have a dangerous winter skin condition such as cellulitis, frost bite or a nose bleed that will not stop. An eye care professional can discuss UV protection with contact lenses and sunglasses, while your dermatologist or primary care physician can provide helpful advice regarding how to optimize your skincare regimen for allergies or worsening underlying skin conditions due to dryness.

By being proactive in protecting yourself from the cold, humidifying the air, avoiding harsh soaps and coarse fabrics, staying hydrated and selecting the best moisturizing, sunscreen and exfoliation regimen, you can keep your skin supple and moist year-round!

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