Avoid 'winter itch' -- and know when to see a doctor

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Winter can be brutal for skin. For many people, it’s the season of the itch.

Some skin conditions need special treatment and care from a dermatologist, like me. But dry, itchy skin usually can be prevented and treated with these steps: 

1. Moisturize.

2. Moisturize.

3. Moisturize.

It just can’t be stressed enough. Even when your skin feels moisturized to you, place one more layer of cream or lotion on your skin.

Creams tend to be more hydrating, but lotions also can be effective. If you prefer ointments, that’s fine, too. Just rub them in well and apply often – even before your skin feels dry.

If dry, winter air outpaces your moisturizing efforts, your skin may crack, and the open wounds that follow can lead to infection. It’s a common problem for people with eczema, but even those with typical skin can encounter this without proper moisturizing.

What to avoid 

  • Hot showers – They can aggravate and dry out your skin. Downgrade to a warm shower, and when you get out, don’t dry off before applying moisturizer. (Some moisturizers I recommend for patients: petroleum jelly, coconut oil and creams by Cetaphil, Cerave, Aquaphor, Vanicream and Aveeno.)
  • Dry air – A humidifier can add moisture to the air in your home. Many people find that humidifiers not only help their skin, but they also prevent uncomfortable dryness in their nose, mouth and throat.
  • Exposure to cold air and wind – Gloves, scarves and other winter accessories are essential to reducing skin damage outdoors. 

What if it’s more than just dry skin?

Winter makes some skin conditions worse and more noticeable. Psoriasis and eczema, the most common of these conditions, could at first be mistaken for just dry skin.

Eczema is a group of conditions that make skin red, itchy and inflamed. It can have many causes, but dry, cold air can provoke flare-ups.

Psoriasis symptoms are similar to eczema, but psoriasis sufferers may have red patches that are also silvery and scaly, with thicker, more-inflamed skin.

These two conditions aren’t aggravated by cold temperatures, exactly – you can blame the lack of humidity that accompanies cold air.

When should I see a dermatologist?

No change in your skin is too minor to make an appointment with a dermatologist or primary care doctor, especially if it’s uncomfortable or worrisome to you.

If your skin is simply itchy and dry, you could first consider whether recent changes in your environment or bath products could be drying out your skin. Moisturizing more often or switching to a more hydrating soap could make a world of difference. (Mild soaps unlikely to irritate your skin include Dove for Sensitive Skin, Cetaphil cleanser, Cerave cleanser, Aquaphor Gentle Wash or Vanicream cleansing bars.)

If your skin doesn’t improve or it gets worse, it’s definitely worth seeing a healthcare provider.

If you’re diagnosed with eczema or psoriasis, a dermatologist can help you find the right treatments to reduce flare-ups. For some, the best treatments include prescription ointments or even special types of light therapy.

Less-common skin conditions that are worsened by cold temperatures:

  • Cold hives, or cold urticaria, can appear in cold temperatures as a rash of red, itchy welts that vary in severity.
  • Cryoglobulinemia is a condition that can cause proteins in the blood to clump together and make blood’s plasma thick, syrupy or clumpy in cold temperatures. Symptoms include Raynaud’s phenomenon, numbness, tingling and swollen ankles and legs.
  • Pernio, or chilblains, is a condition in which cold temperatures inflame small blood vessels in the skin, leading to red, itchy patches and sometimes swelling, blistering or burning sensations.
  • Raynaud’s phenomenon happens when cold temperatures affect circulation in fingers, toes or other extremities. Those areas might feel numb and turn white or blue, and they’ll feel prickly or painful when they return to warmth.

These issues, like many skin conditions, range from mild to severe. They could simply cause discomfort, or they could lead to infection, permanent tissue damage or other problems when not treated properly. That’s why it’s important to see a doctor if you experience these symptoms.

Desmond M. Shipp, MD, is an assistant professor of clinical dermatology at The Ohio State University and a dermatologist at The Ohio State University Wexner Medical Center's Dermatology East.

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