Winter Itch - Dry Skin EczemaCraig Kraffert, MD
As summer turns to fall and fall to winter, atmospheric humidity levels tend to drop, especially when cold weather requires heating of indoor spaces by forced air, as is typical in the continental United States. This low indoor humidity factor is often the 'straw that breaks the camel's back' of skin barrier integrity, which results in itchy, rash-prone skin.
Cause of Dry Skin Eczema
There are many factors in typical American life that predispose patients to dry skin and winter itch. As the years pass, natural skin oil production gradually decreases and results in an increasing tendency towards excessive dryness. Also, many popular soaps tend to strip this precious oil away without replacement. Extensive water immersion - especially hot water - further strips the skin of its vital natural oil. When skin oil levels decline too far, the epidermal skin barrier becomes easily compromised. Irritants are then able to illicit immune reactions within the dermis resulting in itch, rash and the incessant bother of dry skin eczema.
Treatment for Winter Itch
So what's a person to do to treat and/or prevent winter itch and dry skin eczema? There are three key principles for dealing with dry skin eczema. First, the skin must be kept moist at all times. Second, any active rash areas will clear up faster and better with medical treatment. Third, avoidance of irritation is essential to clear the skin, calm the itch and preserve 'the peace.'
Keep Skin Moist
Keeping skin moist is the most important component of winter itch control. Bathing should be done with care. Showering with warm rather than hot water is preferred and short showers are best -- less than ten minutes is optimum. To avoid stripping natural oils from the skin, using soap matters and super-fatted soaps is key. Dove Bar is one of the best soaps to help manage dry skin rash and winter itch. Lubrication with a moisturizer every day, at least once daily after bathing and towel drying is essential; twice daily moisturization is better. Cetaphil Restoraderm Lotion is suggested. Hot tub baths may feel great but they can precipitate dryness and irritation. Moisturization is especially important after hot tub therapy.
Medicate the Rash
Areas of active rash respond well to topical medicine. Cortisone-based products are prescribed most often but other immune-modulating products such as Protopic are also helpful. Medicated ointments outperform medicated creams in treatment of dry skin eczema. Cortisone ointments may contribute to thinning of the skin with prolonged or excessive use. They should only be applied to areas of active rash.
Oral antihistamines can also be considered to help manage itch. These medicines are optional but not for everyone. Consider OTC Claritin for daytime and Benadryl for bedtime, as directed. Prescription antihistamines are also available.
Irritation is always an issue with winter itch and dry skin eczema. Scratching must be avoided as it can damage skin and worsen irritation. Nails are sometimes best kept cut short until itching resolves. Fabric softener dryer sheets such as Bounce should be avoided as they contain sensitizing oils. Downy Liquid and other liquid fabric softeners are preferred. Irritating and drying skin care products such as rubbing alcohol, witch hazel and calamine should be avoided. Soft, non-abrasive fabrics like cotton are best; wool clothing on bare skin can be problematic.
So, there you have it, three key concepts for surviving and suppressing winter itch and dry skin eczema: Keep the skin moist. Medicate the rash. Avoid irritation.