It happens to millions of people every winter: dry, cracked, red skin. It becomes the norm — something you resign yourself to during the season's cold, dry months. You slather on countless lotions and creams morning, noon and night. You tell yourself that spring is right around the corner, and you'll just deal with it until then.
It doesn't have to be that way. Don't let dry skin take over your life.
Why you're dry
Dry, scaly skin isn't just a normal seasonal variation. It's also a medical disorder with a clinical name: ichthyosis vulgaris.
Genetics play a huge part in whether you'll experience dry skin. People who have it lack natural moisturizing factor (NMF), which allows the surface of your skin to hold onto water. If you make less NMF or completely lack it, you're more likely to have dry skin, especially in the winter.
If you have children and can remember back to when they were born, you might recall how important it was to keep their skin moisturized. Babies who have ichthyosis vulgaris are more likely to have dry skin and thus a defective skin surface barrier. This abnormal barrier allows potential allergens to penetrate the skin and cause atopic dermatitis (eczema), and eventually hay fever and asthma. The progression through these disorders is called the atopic march. While atopic dermatitis may resolve in childhood, hay fever and asthma can persist throughout life.
Another factor causing dry skin is repeated hand washing — especially with antibacterial soaps. Soaps damage the skin's surface and thus its ability to retain water. The reason: Soaps contain surfactants, which cause that lathering we all like to see. But surfactants also rob the skin of it natural oils (lipids).
Salving your skin
These tips can help you combat dryness and keep your skin soft and supple:
1. Start with the right soap.
If you wash your hands frequently, use soaps that contain low levels of surfactants but also have added oils (e.g., Dove, Olay), which will help moisturize skin.
2. If you're a frequent hand washer, use hand cream to moisturize.
For anyone whose job requires frequent hand washing, including health care professionals, it's important to moisturize with hand creams in between washings. Creams are much more effective than lotions, which most people use.
Opt for skin creams that contain ceramides (lipids), such as Cetaphil, Vanicream and CeraVe. Ceramides help repair the skin, thereby allowing the skin surface to make more NMF and hold onto water molecules.
3. Use gloves to create a healing environment for your hands.
Soak your hands in lukewarm water for five minutes. Then apply a thin coat of petroleum jelly (e.g., Vaseline) — a great emollient for skin — or another cream and slip your hands into nonlatex gloves (cotton gloves will remove the petroleum jelly). This helps to heal wounded skin and creates a moist environment.
4. Moisturize right after bathing.
For overall dry skin, wet the skin in the bathtub or shower, then lightly pat dry and apply a thin coat of cream or petroleum jelly to the skin surface. This will trap moisture in the skin's upper layers.
5. Add moisture to the air with a humidifier
To help alleviate dry skin in the winter, put a humidifier in your bedroom if your furnace doesn't have one.
6. Don't clean with bare hands
Wear nonlatex gloves when you're cleaning and washing dishes to protect your hands. Dish soap and certain cleaning products can be very harsh on skin.
When you've tried all the right creams and creating a more humid environment and nothing improves, then you need to see your dermatologist.
When to see a doctor
When you've tried all the right creams and creating a more humid environment and nothing improves, it's time to see a dermatologist. You may have developed a contact dermatitis and need prescription topical corticosteroids to overcome the skin barrier damage and inflammation.
Contact dermatitis is a rash that can result from something touching the skin surface serving as either an irritatant or allergen. When the skin surface is damaged, allergens can get through the skin and stimulate an immune response. Your body also can't produce important proteins on the skin surface called antimicrobial peptides (APs). These APs protect our skin from bacteria and viruses.
Repair of the damaged skin with either moisturizing creams or prescription topical steroids allows the skin surface to make more NMF, retain water and heal. Once repaired, the skin can then repel potential allergens and fight off bacteria and viruses through the production of APs.