Keeping Winter Skin at Its Best – A Discussion with Naomi Simon, MD

Men and women alike complain frequently about dry winter skin. Dr. Naomi Simon, board certified dermatologist, answers the following essential questions about how to achieve the best skin possible through the cold months.

Question: What are the main reasons most people find it difficult to keep skin looking good in the winter months?

Dr. Simon: I certainly hear this complaint in my office. There are individual reasons for the season being troublesome, but here are the four that impact most people fairly consistently:

1) Winter exposes us to a lot of dry heat indoors and cold, irritating weather outdoors. The dry environment leads to an increased loss of water resulting in dry, flaky, irritated skin. Once dryness appears, it sets off a “cascade” of molecules trying to “fix” the dryness. Left untreated the molecules can cause inflammation and redness and can lead to the development of eczema. Staying hydrated in the winter is important, too.

2) We are constantly washing our hands in winter to prevent colds, flu, etc. Many people also use hand sanitizers all winter to kill germs. Frequent washing and sanitizing strips natural moisture and lipids out of skin’s top layers leading to dry, cracked, flaky, irritated skin. I see a lot of “winter hand dermatitis” in the office during the colder months.

3) Limited sun exposure can be problematic. Many people become Vitamin D deficient in winter, especially people with darker skin tones. Summer offers better opportunity through 10-20 minutes of midday sun for Vitamin D production. Three days a week, on our face and hands is enough to make Vitamin D for most people. Winter UVB rays are weaker and there are many days we just stay indoors to avoid the cold, wet weather, putting us a risk for Vitamin D deficiency. If you are not taking a Vitamin D supplement, you probably should in the winter.

4) Products used in summer with ease may be problematic. Retinol for anti-aging on the face can become too irritating if you don’t combine it with a quality moisturizer. So, normal skincare regimens may need a “tweak” to remain effective without being too drying.

Question: Do we need to change the products we use in the winter?

Dr. Simon: Absolutely. When it comes to moisturizers, most people need to switch from a water-based lotion to an oil-based cream or ointment. I tell patients anything that “squirts” or “pumps” is too thin for the winter season. Look for moisturizers in a jar that you have to scoop out. Thick, greasy petroleum-based moisturizers are great this time of year. If you are using prescription medications for eczema, psoriasis, or acne you may need a doctor to change them to the thicker formulation to hydrate skin while treating it.

If you are dealing with acne, especially anyone using Retin-A, you may need a lower potency formula or a more creamy formula. Retinol cream for anti-aging on your face should be combined with a good moisturizer to avoid over-dry skin.

Question:  Are their lifestyle issues that impact skin we need to be particularly careful of this time of year?

Dr. Simon: Of course there are. Consider a few adjustments to routines to help keep skin looking good this season:

1) Mentioned previously, over-washing hands without reapplying a good moisturizer is a very common cause of winter hand dermatitis. Dry, irritated hands benefit from the following treatment:

• Wash your hands with a gentle cleanser every time. Cetaphil Body Wash or Dove Nutrium Bar are both good options to choose from.

• After EVERY hand washing, re-apply moisturizer to your hands. This can seem like a chore. Try keeping your moisturizer on your desk at work or home, or in your purse, to make it easier. If your hands are really dry, you may need to sleep with a “greasy” moisturizer such as Vasoline, Aveeno Healing Ointment, or coconut oil overnight to re-hydrate.

2) Really hot showers or baths and bathing for more than about 10 minutes can certainly over-dry skin. Consider lukewarm baths for 5-10 minutes a day followed by immediate application of a thick moisturizer while the skin is still damp. Cetaphil or CeraVe creams are great choices. It is key to apply moisturizers before drying off. If you air dry, you loose a significant amount of your moisture barrier to the air.

3) Keep up your sunscreen regimen. You can still sunburn in the winter! People who ski or snowboard should apply your sunscreen 30 minutes before going out, at least SPF 60, and re-apply every two to three hours. Think of the pictures you’ve seen of sunburned faces and “raccoon eyes” goggles. Sunscreen ensures a great family vacation photo.

Question: We’ve heard there are some “super-foods” that contribute to health. What are your thoughts about this?

Dr. Simon: The most important are the carotenoids and flavonoids. They are antioxidant molecules that protect us from UV damage and cancer. These are available in the rainbow of fruits and vegetables. Carrots, red bell peppers and tomatoes, watermelon, mangos, papaya, grapes, green leafy vegetables, and cabbage are great sources.

Dark chocolate is also on the list and rates as my personal favorite flavonoid provider. Green tea should make your list as well. One study showed people who drank a cup of green tea per day had fewer skin cancers, including melanoma (the most deadly form of skin cancer). Omega-3 fatty acids like salmon oil are very important, containing the anti-inflammatory molecules needed to reduce inflammation. People who are psoriasis or eczema-prone should be taking those. My general recommendation? “Eat the rainbow” of fruits and veggies, some cold-water fish, have a little dark chocolate for dessert, and wash it all down with a cup of green tea!

Question: Does a multi-vitamin help them at all?

Dr. Simon: Our diets often lack the complete nutrition our bodies need to function optimally. I take a multi-vitamin and believe most Americans benefit from them.

Question:  Are there other supplements that may help improve skin health?

Dr. Simon: Other vitamins include Vitamin D, mixed carotenoids, and salmon oil. There is also a special supplement called “heliocare, “ an antioxidant from a fern plant that protects you from UV damage to cells. I recommend that people who play outdoor sports, including Lake Norman boaters/swimmers, take a heliocare tablet before going out in the morning.

Question: When we think of skincare, we mostly think of hands and face. However, winter seems to make it harder to keep legs, arms, and feet feeling and looking great too. What suggestions do you have for total care?

Dr. Simon: Legs, arms, and feet, benefit from thick creams and ointments applied to damp skin immediately after bathing. Daily use is the trick. The skin on your feet is prone to become dry, thick and cracked in the winter. Ointments rather than lotions are best to combat this problem. The cheapest and most effective thing to do is sleep with a coating of Vaseline petroleum jelly on your heels/feet at night under socks and gloves. If you have painful cracks, you can fill them in with super-glue or liquid Band-Aid. This technique stops the hurt while they heal. Then apply an ointment over the top of the crack.

Question: What are your favorite care products to keep winter at bay?

Dr. Simon: I love the Cetaphil and CeraVE creams that come in a jar for total body conditioning. Cetaphil is a little thicker and works for people with eczema or easily irritated skin. If you want something that spreads more easily but still has the needed Ceramides, which help fill in the missing moisture, my favorite product is Cetaphil Restoraderm” a body wash and moisturizer. This is an amazing, over-the-counter product that keeps my driest patients comfortable at home rather than in my office.

Winter faces love Skin Medica moisturizer Dermal Repair Cream. It is like putting satin on your skin. Many of my patients mix this with retinol cream and tolerate the retinol very well allowing them to continue their anti-aging routine. My favorite tinted AM sunscreen is a product by Revision called “Intellishade.” Some of my patients switch from the matte version to the regular version in the winter because it is more hydrating.

Winter can be a nightmare for people with red, irritated scaly faces. I love a prescription hyaluronic acid product called “Bionect.” It hydrates, does not feel greasy, and gets rid of redness and irritation within a few days.

Question: Would you share your top three must-do’s for overall skin protection and health?

Dr. Simon: Wear sunscreen on your face and neck every morning, all-year-round. This has been proven in multiple studies to prevent aging and skin cancer, significantly more than if you only wear it when going out. Smear your skin with moisturizer after every bath or shower. I call this the “soak and smear” routine. If you moisturize just as the dryness, flakiness, or redness is getting started, you can often prevent it from turning into a full-blown eczema rash.

Check all of your moles and spots monthly for changes in shape, color, size, symmetry, bleeding, or recurrent itching. If you have a suspicious lesion, get it checked right away by your physician. Keeping winter at bay may require a few changes and adjustments, but there are a lot of tools to help keep your skin in great health year-round.

Naomi Simon, M.D.of Mooresville Dermatology Center is board certified by the American Board of Dermatology and a fellow of the American Academy of Dermatology and the American Society of Dermatologic Surgeons.

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