It’s winter and that means cold, dry weather and dry, itchy skin. We asked Dr. David Pomerantz, of School Street Dermatology, in Pawtucket, for advice on how to combat this common complaint.
Dr. Pomerantz practices general dermatology for adults and children, as well as cosmetic dermatology. He’s been in practice for more than 20 years. He received a medical degree from the University of Maryland School of Medicine and was a dermatology resident at Brown University, where he is now an assistant clinical professor. While answering our questions, he emphasized that he doesn’t promote specific products or companies.
Here’s some of what Dr. Pomerantz told The Voice:
Q: Winter is dry in New England. How do you recommend people combat that dry, itchy skin problem that we all seem to have?
A: Dryness of the skin is certainly more common in the winter. The low humidity combined with long, hot showers contributes to dry skin. Dry skin is itchy skin.
For most people, simply using a daily moisturizer is enough to hydrate the skin and relieve the itch.
The best time to moisturize the skin is right after the shower, [on] wet or damp skin. Some people do not want to dry off and then get “goopy” with emollients so I tell them to put the moisturizer onto dripping wet skin while still in the shower and then towel dry. While the towel may take away excess moisturizer, the skin is still hydrated and clothes do not get sticky with moisturizer. If dryness continues to be a problem, moisturizers can be applied twice a day [to wet or dry skin].
There are several things that can contribute to dryness that should be avoided. We tend to take longer and hotter showers in the winter, which removes oil from the skin. I recommend taking quicker showers that are warm [comfortable] but not hot. Oils from the skin are also stripped away by soapy water. Soap is a detergent and can be very drying. Ivory, Dial, Irish Spring are soaps that leave your skin feeling tight and “clean,” which usually means the skin has been dried out. I recommend non-soap cleansers or cleansing bars which are made by companies like Cetaphil, CereVe, Neutrogena and LaRoche-Posay. These hydrating cleansers do not contain soap and are less likely to dry out the skin.
Homes that are heated with forced hot air or baseboard heat tend to have drier air than homes with radiators. A humidifier may be helpful in these cases.
Q: What about young versus old? Differences in skin care?
A: As skin ages, the sebaceous glands [oil glands] tend to secrete less oil. So dryness tends to be a problem as we age. In addition, sun exposure tends to damage oil production. A lifetime of sun will cause dryness later in life. Yes! Sun causes wrinkles, brown spots, skin cancers and dryness! My recommendation for everyone is to be careful in the sun, and the sooner you start protecting yourself from the sun, the better.
Q: Do we need to worry about sunscreen during the winter?
A: The amount of ultraviolet radiation is significantly less in the winter than the summer. However, if you are outside for longer periods of time, skiing, shoveling, sledding, you should be protecting your skin. In addition, sun may reflect off the snow, giving you even more UV damage. I recommend sunscreen along with several other strategies to limit sun exposure. Sun-protective measures include sunscreen, shade, choosing a time of day with less intense sun and covering areas with clothing or sunglasses.
Q: There’s a dizzying array of sunscreens. How do I choose the best one? Do I use the same one in the winter as in the summer?
A: I am generally happy if my patients use at least an SPF 30, but preferably 50. More important than the type of sunscreen is how much is applied and how often. Most people apply a thin layer of sunscreen and then expect it to work for hours. I recommend a thick layer and, if willing, a second layer 20 minutes later.
Sunscreens lose their effectiveness over hours after being applied and I recommend reapplying at least every two hours, if not sooner.
In addition, the active ingredients tend to degrade over time and in very cold weather. I would not keep sunscreen in the car during the winter and would discard it if it is more than a year old.
Q: Do I need a separate product for my face?
A: You do not need a separate product for your face. If you are happy with your moisturizer for your body, by all means use it on your face too. The companies that sell these products are more than happy to sell you an eye cream, a face cream, a body cream and a hand cream. But there is no need for four separate products. However, there are times when you may need to fine-tune your treatment. If hands are an issue, you may need a thicker, heavier cream that would be too thick for the face. Hands, feet and body tend to require and tolerate thicker emollients than the face, eyelids.
In addition, many facial products have extra anti-aging ingredients, including sunscreen, retinol, anti-oxidants, alpha-hydroxy acids and salicylic acid. These ingredients are not for hydration. If anti-aging is desired, than choosing a separate cream for the face is appropriate. But please be aware that these extra ingredients often irritate the skin, especially sensitive skin.
Q: I have really sensitive skin. What kind of products should I watch for?
A: Products designed for sensitive skin tend to have fewer chemicals and fewer ingredients. Avoid products with anti-aging ingredients that can cause redness and scale. Look for hypoallergenic, fragrance-free, preservative-free products. VaniCream is one such product with a line of shampoos, cleansers and moisturizing cream and sunscreen.
Q: Anything else?
A: Please be aware that this advice is aimed at those with dry skin only. There are several conditions that are exacerbated by dryness, such as eczema or atopic dermatitis. Patients often try to treat the dryness with emollients, but if a dermatitis [inflammation of the skin] exists, then the inflammation needs to be treated along with treating the dryness.
The same can be said for seborrhea, which is often mistaken for dry skin.
It is inflammation of the eyebrows, nasolabial folds [laugh lines from nose to around the corners of the mouth], ears, beards and hairline/scalp. There is redness and a waxy scale in these areas and moisturizing alone is not sufficient to treat it.
Lower legs are also extremely prone to dryness, especially if there is swelling of the legs, resulting in venous stasis dermatitis. Moisturizers alone are not enough. Blood-pressure control, compression stockings, a low-salt diet and leg elevation are needed.
Scaling of the feet may be due to a fungal infection, requiring an antifungal agent.
If the dryness is accompanied by redness and not responding to emollients alone, I recommend seeing a dermatologist.
FRAN OSTENDORF is the editor of The Voice.