Question: What Can I Do for Dry Skin?

Northern Exposure

As a Texan having just moved to the North East, my first winter in Boston was full of new discoveries – torrential snowfall concealing entire streets, large ice blocks floating in the Charles River, and a souvenir from the cold weather of my new home, the pink scaly spot on my hand that put me in the club with about 30 million other Americans –

I had developed a mild form of eczema. (http://nationaleczema.org/eczema/)

Wash-and-Wear (and tear)

Those who work in the health care setting have to wash their hands numerous times each day (I have counted over 40 times on some days), and the harsh antimicrobial soaps and hand sanitizers that are used in the hospital and clinical setting can really take their toll on the skin.

For this reason, many health care workers I know have developed very dry skin, and in some cases, hand eczema.

 Frequent hand washing combined with factors such as cold dry weather, central heating, and very hot water many people like to use to wash in the winter-time, can lead to extreme dryness and irritation of the skin and trigger flares of eczema in those people who are prone to it.

Fragrance is Not Your Friend

On top of all this, many soaps, laundry detergents and even moisturizers contain irritating ingredients such as: fragrance, preservatives, alcohol, and other potential causes of allergies or irritation.

Thus, products in in a person’s everyday environment could be contributing to the problem, and sometimes it may be necessary to evaluate the types of cleansers and moisturizers one is using.

Very dry and irritated skin have been among the most common problems facing my patients this winter, and many are asking for advice on how to help very dry and eczema prone skin.

Here are 5 Helpful Tips:

1) Use only fragrance free, hypoallergenic products. When buying soaps, detergents and moisturizers, read labels for make sure these products are “unscented” or”fragrance free,” and good for “sensitive skin.”

2) Avoid long showers and using very hot water.  Shower and wash hands with water that is no warmer than lukewarm. Also, it is best to take short showers (≤ 10 min), as long showers as well as very hot water can dry out and cause water loss/wrinkling of the skin.

Diagram of the Itch-Scratch Cycle Courtesy of The National Eczema Association http://nationaleczema.org/

3) Avoid scratching, as scratching can actually make itching worse.  This has been proven by scientific research. When a person has the urge to scratch often moisturizing the affected area and applying cold packs can serve as a more helpful alternative.

4) Avoid antimicrobial hand-sanitizers as much as possible (as these contain alcohol among other potential ingredients that can dry out and irritate the skin), and try to wash hands with gentle, unscented soaps and either lukewarm or cool water.

5) Moisturize often, especially after showering and washing hands, and for very dry skin, ointments often work better than creams.

Of course every person’s skin can have individual needs, and if the skin is very irritated, eczema or some of form of allergy may be driving irritation.  So please remember that these recommendations are simply a place to start, and that readers are encouraged to consult a dermatologists for more specific instructions and a for personalized skin care plan.

Best wishes for healthy skin this winter,

~ A.S.K.

References:

1) The National Eczema Association:  http://nationaleczema.org/

2) “Guidelines of care for the management of atopic dermatitis” from the American Academy of Dermatology:  https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&ved=0CC8QFjAD&url=https%3A%2F%2Fwww.aad.org%2FFile%2520Library%2FGlobal%2520navigation%2FEducation%2520and%2520quality%2520care%2FAD-part-2.pdf&ei=k4C9VL-QIYXQggSA04KABg&usg=AFQjCNG7rwxQuX5Ut68QA1V65SsxYSJHgg&sig2=h2vxQKOJWyN7pUAy4NYmUA&bvm=bv.83829542,d.eXY

3) Study sheds light on why scratching worsens an itch:  http://www.nursingtimes.net/nursing-practice/specialisms/dermatology/study-sheds-light-on-why-scratching-worsens-an-itch/5076342.article