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During the winter months, many people complain of having dry skin. Skin dryness occurs due to the breakdown of a skin protein called filaggrin, which is generally stimulated by the cold weather. The breakdown compromises the skin barrier function, which, when coupled with low humidity levels of the atmosphere, results in skin flakiness and dryness. (1)(2)
Skin dryness can be easily managed with proper skin care, but excessively dry skin, if not attended to, can lead to complications that require medical treatment.
Causes of Dry Skin in Winter
The following factors can contribute to the development of dry skin in the winter season:
- Low humidity
- Sun exposure (3)
- Contact with harsh chemicals such as those found in cosmetics and detergents
- Irritating clothing fibers
- Excessive use of indoor heaters
- Prolonged hot showers
- Lack of moisture due to limited water intake or not using moisturizers
- Repeated hand washing, especially with hot water
- Nutritional deficiencies (4)
- Medical conditions such as dermatitis, kidney disorders, diabetes, and thyroid problems (5)
- Medications including diuretics, cholesterol medications, isotretinoin (Accutane), tretinoin (Retin A)
- Contact with allergens
Symptoms Associated With Dry Skin
Dryness of the skin is most commonly associated with the following symptoms:
Medical Treatment for Dry Skin
If you have severely dry skin or associated complications, the doctor may recommend one or more of the following treatments:
1. Moisturizing and repairing creams
If the cause of dryness is solely the cold weather during winter, the doctor may recommend moisturizing and barrier-repairing creams that contain ceramide, glyceryl glucoside, or cortisone. (6)
2. Oral ceramides
Ceramides are a major component of the topmost layer of the skin, enabling it to perform its barrier function. These bioactive lipids have a waxy consistency that helps hold the skin together. They also form a protective layer over the skin to ward off external irritants and seal in moisture.
The best-quality moisturizers ideally have ceramides in them, but topical use may not allow these lipids to penetrate deep enough into the skin. Thus, extreme dryness is often treated with oral ceramides, which are derived from plants and are therefore referred to as phytoceramides.
Phytoceramides then prompt the body to produce its own ceramides, which are absorbed into the skin barrier, hydrating it from within.
3. 1% hydrocortisone creams
These help treat itchy skin when used once or twice a day.
4. Antibiotic ointment
If the doctor suspects an infection, ointments containing clindamycin may be prescribed.
5. Antihistamines and steroids
These are used to treat severe allergic reactions that cause skin dryness. (7)
Note: Make sure to follow the doctor’s instructions on where and when the medications should be used. For example, cortisone creams should only be applied to the affected area up to two times a day, unless otherwise instructed by the doctor. Follow this with an application of a moisturizer. Moreover, steroid creams shouldn’t be used for more than 2 weeks.
Diagnosing the Cause of Dry Skin
In mild cases of winter-associated dry skin, the doctor will conduct a physical examination to diagnose the cause. However, if you have more symptoms, the following tests may be required, depending on the degree of severity:
- Thorough physical exam
- Medical history
- Skin biopsy
- Allergy tests
- Test for contact dermatitis
- Prick test
Complications of an Untreated Dry Skin
Generally, dry skin in winter can easily be managed with home-based interventions. However, if left untreated, the following complications may occur:
- Skin infections, caused by constant scratching that disrupts the skin barrier, allowing the entry of bacteria and can increase the risk of sepsis
- Pus formation
- Atopic dermatitis
- Eczema (8)
- Leathery, hard skin
When to See a Doctor
Dry skin can be treated with simple measures such as the use of moisturizers and sunscreen. However, it is essential to consult a doctor if the following complications occur:
- Excessive scaling
- Severe pruritus
Dry skin results from insufficient moisture retention in the skin, generally caused by excessive bathing, use of harsh products, or even certain medical conditions. The chances of skin dryness increase multifold in the cold weather due to the low humidity in the air.
Multiple simple measures, such as the regular use of moisturizers, can help manage and prevent skin dryness. However, if ignored, skin dryness can cause complications that require medical attention.