Winter skin woes

If perpetually cold hands and feet weren't clear tip-offs that we're now in winter's grasp, perhaps a flurry of dry, flaky skin has driven it home.

Rough, itchy patches are nearly universal at this time of year. But you may not have braced yourself for other skin problems that can crop up — or get worse — when temperatures plunge.

On this undesirable list are eczema, which is marked by dry, red areas and painful cracks; psoriasis, which typically involves patches of thick, red skin coated with silvery scales; rosacea, most often characterized by facial flushing and redness and causing red bumps on the nose and cheeks; and seborrheic dermatitis, which is known as dandruff when it's on the scalp but can take the form of a scaly rash on other skin areas, particularly around the eyebrows and the corners of the nose and chin.

Even people whose skin has been remarkably unproblematic over the years often find they're facing new winter skin woes merely because they're getting older, says Dr. Rachel Reynolds, interim chair of dermatology at Harvard-affiliated Beth Israel Deaconess Medical Center. For women, the first five or so years after menopause may seem especially brutal, since diminishing estrogen levels translate into less skin moisture.

"As we age, our skin gets drier," Dr. Reynolds says. "So unless someone has already been dealing with a skin condition, they might not experience these weather-related changes until they get older."

Problematic behaviors

Why do all of these problems converge in winter? Simply put, winter wreaks havoc with our skin barrier — the top layer of skin, which contains substances such as cholesterol and fatty acids that help seal in moisture and protect against irritants.

Frosty temperatures and dry air are winter-weather characteristics that are particularly hard on skin. "Even heating systems create more dryness," Dr. Reynolds notes. "They take more humidity out of the environment, which extracts moisture from the skin."

Certain behaviors can aggravate the situation, including

• taking long, hot showers or washing hands frequently
• using harsh soaps, laundry detergents, fabric softener sheets, or heavily fragranced products
• spending a lot of time outdoors
• wearing wool, which can irritate sensitive skin.

Surprisingly, using alcohol-based hand sanitizer — which became a staple during the pandemic — isn't as drying as hand washing can be, Dr. Reynolds says. "Ironically, for someone who has to clean their hands frequently, soap and water exposure is more harsh on skin," she says.

Skin protection tips

Applying moisturizer is a go-to measure to ward off dry skin, as well as soothe problems such as eczema, psoriasis, rosacea, and seborrheic dermatitis. But Dr. Reynolds suggests taking a deeper dive on products and approaches you may not have considered:

• Opt for creams and ointments, since thinner lotions don't provide as much moisture.
• Coat cracked skin areas with petroleum jelly and cover with cotton gloves, plastic wrap, or another barrier to seal in moisture overnight.
• Use a humidifier to pump moisture into dry indoor air.
• Take only lukewarm showers, and shower no more than once a day — every other day if possible.
• Use moisturizing soaps and liquid body cleansers, which contain more skin-softening emollients than bar soap. "And try to avoid soap on areas you don't need it, like your arms and legs," she says.
• Pat yourself dry after bathing and apply moisturizer while skin is still damp, which traps the moisture.

However you respond to dry skin, don't ignore it — especially if you're at midlife or beyond, Dr. Reynolds warns. Untreated dry skin can develop into a type of eczema called nummular dermatitis, another version of the dry-skin eczema often seen on older people's legs. This itchy condition can predispose people to cellulitis, a potentially serious skin infection that can spread to the bloodstream.

"Everyone gets dry skin as they age, and the degree to which you get it varies from person to person," she says. "Anyone around 60 or older could be predisposed to this eczema, just based on age-related dry skin."

See your primary care doctor if you develop an itchy, red rash. "If it becomes more severe, your doctor may refer you to a dermatologist," Dr. Reynolds says.

One last caveat: drinking water isn't a cure-all to either avoid or treat dry skin. "Keeping up with normal fluid intake is a good idea, but the benefits of skin hydration from drinking water are sometimes overemphasized," Dr. Reynolds says. "A much more effective approach is hydrating your skin from the outside by practicing diligent skin care and moisturizing regularly."

Image: © John M Lund Photography Inc/Getty Images