Dec. 26, 2023 – “Eczema is my constant winter companion,” said Ali Zagat, 42, of Philadelphia. Once cold weather arrives, so do dry, red patches on her hands and painful cracks on her knuckles and fingertips. “I have sensitive skin and eczema in general, but when the air is dryer and it’s cold outside, it gets worse.”
There are clear reasons for this, said Julia Tzu, MD, a clinical assistant professor in the Department of Dermatology at New York University School of Medicine. “Our skin is constantly fluctuating with the environment. During wintertime in the Northern Hemisphere, the humidity drops sharply and the temperature goes down — it’s (an extreme drying) condition, so your skin is losing lots of water.”
All Kinds of Trouble
Zagat’s experience isn’t unusual — research has found that as the temperature dips, eczema patients seek treatment more often. And people who live in cold climates are much more likely to have it than those who live in warmer areas. More than 31 million Americans have eczema, also known as atopic dermatitis, in some form.
Other skin conditions tend to flare up in winter, too. Cold and wind can trigger the redness of rosacea, for instance. And seborrheic dermatitis, a scaly rash (called dandruff when it’s on your scalp), gets worse with cold. In one study of several thousand people with psoriasis, more than half had more trouble in colder months.
Amy Kelly, 44, lives on a farm on Vancouver Island, British Columbia. She’s had psoriasis since childhood and knows to expect the worst when the weather turns frosty.
“At its worst, my psoriasis gets so itchy, I wind up compulsively scratching to the point where it bleeds,” she said. “And when scratching breaks the skin, it stings, too.”
All these issues share a similar root: Winter wreaks havoc with your skin barrier.
“The skin barrier is essentially a fortress that seals your body,” Tzu said. As the top layer of your epidermis, the barrier includes waxy ceramides, cholesterol, and fatty acids, which help to seal in moisture and keep out environmental irritants. When the surrounding air is extremely dry, as often happens in winter, it can strip the skin barrier’s natural moisture.
What Makes It Worse?
Unfortunately, some of the things we do in response to winter weather can trigger more problems:
- Indoor heat, so necessary for comfort, sucks moisture out of the air, and eventually your skin.
- Hot water, which seems like a simple way to warm hands and body, has a drying effect. Think about how well hot water helps clean greasy dishes. On your body, that means dissolving part of the skin barrier.
- Rubbing vigorously with a towel dries you off quickly, but it also tears at your skin barrier.
- Hand sanitizer, so helpful for avoiding colds, the flu, and COVID-19 this time of year, contains at least 60% alcohol — which is very drying.
- Wool and synthetic fabrics provide warmth but can irritate sensitive skin. You may want to reconsider your favorite knit cap or the fuzzy mittens your grandma made.
Skin care products themselves are often a culprit. A lot of anti-aging products can be too harsh for winter skin.
“Generally avoid anything irritating,” Tzu says. “If you’re using a retinoid in summertime, cut the frequency in winter. Avoid or cut down on products with ingredients like vitamin C, glycolic acid, beta hydroxy or alpha hydroxy acids, and retinols, or even physical exfoliation.”
And it’s not just the active ingredients that can cause trouble. For many people, fragrance leads to flare-ups.
“It might smell good, it might feel good, but avoid fragrance, natural or not,” said Shilpi Khetarpal, MD, a dermatologist at the Cleveland Clinic. “Poison ivy is natural, and look what it does to our skin.”
What Makes It Better?
Once your skin is dry and flaky, it’s a short hop to itchy and burning. Here’s what you can do to relieve the discomfort:
- Focus on repairing your skin barrier. Look for products with ingredients like ceramides, cholesterol, colloidal oatmeal, glycerin, hyaluronic acid, and vitamin B5 (also known as panthenol), Tzu and Khetarpal said. You may want to skip thin lotions you dispense from a pump, and instead look for thicker creams and ointments that come in a tube or a tub. If you’re using a topical prescription medication, apply it first, then follow with moisturizer.
- For dried and cracked areas like heels or elbows, a petroleum-based product like Vaseline or Aquaphor can soften skin quickly. “But remember, oil and water repel each other,” Khetarpal said. “These products are fine to use, but you’re not going to get any permanent improvement in the skin barrier. It’s just going to be a lubricant that sits on top of the skin.”
- Those barrier-forming petroleum-based products can also soothe chapped, cracked lips. Apply frequently and try not to lick your lips – that bit of moisture may feel helpful at first, but as the water evaporates, it dries you out further.
- If you use scented skin care products, switch to unscented versions or products labeled for sensitive skin. “Free and clear” laundry detergent can also help.
- Wear layers with 100% cotton as the base and cover as much of your skin as possible when going outside. Less exposure equals less drying. At home, make sure your bedsheets are 100% cotton — just think how much time you spend with your skin touching that fabric.
- It helps to cover up indoors, too. Zagat relies on gloves when she’s washing dishes, and also for sleeping. Before bed each night, she applies her prescription cream and a layer of moisturizer to her hands, then dons 100% cotton gloves. In addition to sealing in the moisture, the soft fabric keeps her from scratching too hard in her sleep.
- Use a humidifier to add moisture to indoor air. It’s fine to run it only at night, Khetarpal said. “When you wake up in the morning, you’ll notice your skin doesn’t feel as dry.”
Don’t wait too long to seek help if your skin is making you uncomfortable. “If it’s just your skin, with no obvious rash, nothing else you’ve noticed, try moisturizing for a week,” Tzu said. “If it doesn’t go away, see a dermatologist.”
Stop Trouble Before It Starts
Even if you’ve never had problem skin in winter, issues can crop up. A few preventive measures can help you avoid discomfort in the first place:
- Wear sunscreen, every day. The sun’s UV rays aren’t as strong in winter as they are on a summer beach day, but they still reach your skin. Radiation passes through and damages skin cells. Khetarpal recommends UPF of 30 or higher, just like in summertime.
- On the other hand, some sunshine seems to be good for winter skin. That psoriasis study of thousands of people found that those who worked outdoors were less likely to report winter flare-ups. Small studies have found that vitamin D, which your body needs sunshine to make, plays a role in both eczema and psoriasis. If it’s too cold to spend time outdoors, speak to your doctor about taking a vitamin D supplement.
- Drink plenty of water, to hydrate your skin from the inside. “If you’re parched in the desert, a jar of moisturizer won’t help much,” Tzu said. “Most moisturizer only really works if you have moisture around.”
- While indoors, put on an extra layer rather than cranking up the heat.
- Bathe and wash your hands and face with lukewarm water. Pat your skin dry and leave it a little damp. Moisturize within 3 to 5 minutes to trap that moisture in the skin. Tzu recommended carrying a travel-size container in your bag, so you can apply some every time you wash your hands.
- Watch your stress levels — both eczema and psoriasis can be triggered by it.
Whether you’re trying to heal your skin or keep it healthy, it makes sense to take a multi-pronged approach. Amy Kelly, who has psoriasis, leaps into action as soon as the temperature begins to drop. In addition to covering up when she goes outside, she takes a vitamin D supplement and drinks plenty of water. “I also watch my sugar, alcohol, and stress — all those things combined make it worse,” she said. “If I can take other stressors out, the cold doesn’t have that much of an impact.”
