Putting the freeze on winter skin troubles

Do or dry in problem times

There’s much to love about winter – warm drinks by a toasty fire, cracking out the slow cooker for endless casseroles, and brisk walks without breaking a sweat, to name a few. But when it comes to skincare, winter can be a miserable time for those with sensitive skin.

The colder and drier wintertime weather can worsen many skin conditions say, Dr Anneliese Willems and Dr Sarah Adamson, Education and Research Fellows at the Skin Health Institute. Conditions particularly affected are where inflammation is triggered by impairment of the skin’s barrier function, such as eczema, psoriasis and rosacea.

“In eczema, the skin barrier has been damaged,” Dr Willems said.

“The lack of humidity in the winter air can cause the upper layers of the skin to lose moisture, consequently becoming dry and scaly. Additionally, heating systems may also contribute to this drying effect. This irritation causes inflammation, resulting in the development of itch, causing the person to scratch and further inflame the skin, creating an itch-scratch cycle.”

Similarly, psoriasis may also worsen in winter. As with eczema, the loss of moisture from the skin can lead to increased cracking and irritation from psoriasis plaques.

“Moreover, many people with psoriasis find that [at other times of the year] UV exposure improves their condition, resulting in a worsening in the months when there’s less exposure to sunlight,” Dr Adamson said.

Rosacea, a chronic skin condition characterised by a constellation of symptoms including flushing, facial erythema, papules and pustules, can also be worsened by exposure to common triggers in winter: temperature fluctuations, low temperature, icy winds and dry heat through heating systems.

“Stress and illness are also more common during wintertime,” Dr Willems said. “While fighting off an infection, the body’s inflammatory response is triggered, which can worsen or trigger inflammatory conditions.”

Pharmacist, medical student, TikTok influencer and LaCorium Health brand ambassador Mustafa Dhahir says some illnesses, such as strep throat, can trigger skin conditions, including guttate psoriasis with small, red, scaly patches breaking out.

“Therefore, it’s very important to try to implement protective measures for your skin during winter, like regularly moisturising and hygiene methods to reduce the risk of getting sick,” he said.

Breaking bad habits 

In many cases, it’s not winter itself that triggers flare-ups of skin conditions; it’s the common behaviour aimed at beating the cold, such as using heaters and having hot showers.

Common winter habits that worsen such conditions include dehydration, long hot showers followed by sudden exposure to a cold environment, dry air conditioning, and even wearing thick multiple layers that dehydrate the skin,” Mr Dhahir said.

“Simple ways to avoid this are to regularly moisturise the skin, keep drinking plenty of water, reduce the time spent in the hot showers, avoid dry heating – or, if you’re unable to avoid dry heating, you can try a humidifier in the house – and wearing lightweight layers that you can adjust while moving into different temperature environments.”

Those with eczema will need to be more cautious about encountering triggers during winter, says Dr Willems.

“For example, when looking for layers to keep warm, alternatives to wool will be needed for those in whom wool is a trigger,” she said.

“For those whose eczema is triggered by dust mites, caution should be taken with running heating systems that excessively blow dust around, and ensuring heating system filters are cleaned regularly.”

Cleanse and moisturise 

When it comes to keeping troubled skin clean and moisturised during winter, the best skin products are those that the patient will be able to use every day.

“In selecting a moisturiser, the customer should feel comfortable with the sensation of the product on their skin,” Dr Willems said.

“For those with dehydrated skin, this will ideally be a ‘greasier’ product, such as a cream. However, some people might not tolerate this, and it may need to have a lighter consistency, such as a lotion.”

Gentle, fragrance-free products are ideal, as many people with skin conditions find that fragrances or harsher irritants worsen symptoms. Rosacea patients should look for an oil-free, fragrance-free, gentle facial moisturiser.

Soap-free washes should be used when bathing or showering, says Dr Willems, because soaps strip the skin of oils, resulting in further dehydration, which can worsen many skin conditions.

“Cleansers should be gentle,” she said. “Particularly with rosacea, less is more when using a cleanser. Many will apply harsh chemicals to their skin in an effort to treat the inflammation, and ultimately find that these flare redness and irritation.”

Helping customers 

Dr Willems says the number one rule during winter is to increase hydration of the skin. This can be achieved by reducing water loss through the skin and protecting the skin barrier.

“To minimise loss, customers should be counselled to limit long hot showers and excessive exposure to hot, dry heating systems,” she said.

“To protect the skin barrier, they should be advised to apply regular moisturisers and avoid known skin irritants – for example, prickly clothing and dust mites.”

The Skin Health Institute also advocates for all its patients to have a well-balanced, healthy diet with plenty of fruit, vegetables and fibre.

“Drinking enough water is also important in hydrating the skin,” Dr Adamson said. “Heavily restrictive diets are not often indicated in the management of skin conditions unless the treating team suspects a food allergy.”

If skin conditions aren’t responding to these measures, then these customers need to be advised to consult with their treating medical professional.

This feature was originally published in the July issue of Retail Pharmacy Assistants e-magazine