The British winter’s inevitable cold weather and biting winds can wreak havoc with our skin. What are the effects of winter on skin health, and what can be done to redress the balance?

Skin is the body’s largest organ and it works hard to keep us healthy, doing everything from acting as a barrier to infection to helping to regulate body temperature. But as winter arrives, bringing with it icy temperatures and biting winds, many people suffer from uncomfortable winter skin ailments including dryness, flakiness, redness, chapping and sensitivity.

“Many people, particularly those who spend a lot of time outside, notice that their skin becomes dry or even chapped as the temperature drops during the winter months,” explains Dr Bav Shergill, consultant dermatologist and trustee at the British Skin Foundation. “Strong winds and cold temperatures can strip away the skin’s natural moisture levels and prevent it from doing what it’s meant to do.”

All dried out

Dry skin is a condition in itself and develops when the balance between moisture content and natural moisturising factors, such as lipids, in the skin becomes compromised. Although dry skin can appear anywhere on the body, it’s commonest on the face, hands, arms and legs. An estimated 15 to 20 per cent of people suffer all year round, especially those younger than 10 years or over 60, although the severity of symptoms can vary greatly from person to person.Dry skin is also significantly more common in women than men.

The severity of the condition can vary from ‘problem dry skin’ – mild scaling; roughness; a feeling of tightness; and itching, to ‘extremely dry skin’ – roughness; chapping; callus formation or scaling; tendency to form cracks and fissures; and frequent itching.

Dry skin is often brought on by a combination of causes – internal factors such as hormonal imbalances, genetics and ageing, coupled with external elements including dry air from modern central heating systems and air conditioning, as well as UV exposure and contact with chemicals. All of these factors can reduce the skin’s moisture content, resulting in dry, rough and possibly cracked skin.

Dr Shergill also stresses the damage that damp clothing can do to the skin’s natural barrier function: “Wet, soggy clothing can chafe the skin, leaving it looking red and sore.”

Frequent temperature fluctuations can also play havoc with the skin’s appearance, adds Dr Shergill: “People may not realise just how often their skin is going from a hot to a cold environment in the winter – from warm buses and cars, to the cold outdoors, to centrally heated buildings, and so on. This can lead to the blood vessels in the skin rapidly changing size to account for the fluctuating temperatures, which can leave skin looking flushed and weather beaten.”

Dry hands are a particular concern. Winter winds strip hands of their moisture content, while at the same time, the peak cold and flu season encourages frequent hand washing to prevent the spread of germs and viruses. Dry hands are especially common in people who work outdoors, as well as those who are exposed to chemicals or repeatedly submerge their hands in water. Protection is key – with gloves whenever possible. During the cold and flu season, it’s important not to skimp on hygiene, even if suffering from chronic dry hands. However, customers should opt for warm rather than hot water to maintain their skin’s natural, protecting oils; avoid fragranced and foaming soaps; and moisturise after each hand wash.

For better or worse

Customers with pre-existing skin conditions such as eczema or psoriasis will probably suffer from dry skin all year round, but wet weather and a drop in temperature can exacerbate symptoms.

Both eczema and psoriasis vary in their severity, with many sufferers having periods of no or mild symptoms followed by flareups when their symptoms become more severe and require additional treatment.

Atopic eczema, also known as atopic dermatitis, is the most common form of eczema. It affects around one in five children in the UK, but can continue into adulthood. Eczema is a chronic inflammatory condition that causes the skin to become red, itchy, dry and cracked, commonly in the folds of skin, such as behind the knees, inside the elbows, on the side of the neck and around the eyes and ears. It occurs when an individual comes into contact with a particular substance such as an irritant or an allergen that affects the skin via the immune system. The exact cause of eczema is unknown. However, it often runs in families and occurs alongside other allergic conditions, such as asthma and hayfever. The main treatment options include the regular application of emollients or the use of topical corticosteroids in severe cases. Understanding eczema triggers can be important in preventing flare-ups.

Psoriasis is a chronic skin condition that produces red, flaky, crusty patches of skin covered with silvery scales. It affects around two per cent of people in the UK and most often develops in adults under 35 years old.

Psoriasis occurs when the production of skin cells speeds up to create a build up of cells on the skin’s surface. Why this occurs is not fully understood, but it may be related to the immune system. Although there is no cure, treatments include topical corticosteroids and vitamin D analogues, some of which can be purchased OTC. Phototherapy and systemic treatments are prescribed in severe cases.

“Eczema and psoriasis typically worsen over winter,” says Dr Shergill. “While temperature plays a part, it is worth remembering that sunlight improves both conditions and is in short supply between October and March.”

Strong winds and cold weather can strip away the skin’s natural moisture levels and prevent it from doing what it’s meant to do

Cold weather not only affects the moisture levels in the atmosphere, but also the blood flow to the skin and our clothing habits, which can aggravate skin that is already inflamed and lacking moisture. “Some people report that turning on the central heating leads to flare-ups, as the lower air humidity further dries the skin,” says Matthew Gass, spokesperson for the British Association of Dermatologists. “Heated rooms also encourage dust mites, which are a major cause of allergy related flare-ups.”

Although it may seem impossible, Dr Shergill recommends avoiding sudden changes in temperature: “Customers should protect their skin with warm clothing whilst outside and try to choose soft materials that won’t scratch or irritate their skin, especially if they suffer from a skin condition like eczema or psoriasis.”

Dr Shergill also advises:

  • Not turning the thermostat to the maximum setting
  • Avoiding long, hot baths
  • Shortening the time spent bathing
  • Washing with warm, rather than hot, water
  • Gently patting down skin after washing, rather than rubbing it.

 

Winter sores

Cold sores can be more prevalent during winter months. Caused by the herpes simplex virus, theses small, fluid-filled blisters usually develop on the lips or around the mouth. Outbreaks occur when a trigger such as cold weather, stress or hormonal changes activates the virus, which normally lies dormant. Prevalent winter ailments such as colds and flu can also leave sufferers feeling run down, which can cause an outbreak. The herpes simplex virus is highly contagious and can be easily passed on through direct contact, making infection difficult to avoid. During winter, customers should keep their lips hydrated with lip balms and, if suffering from a cold or flu, stay hydrated and get plenty of rest.

Fighting back

“One of the best and simplest ways to combat the winter effects on skin is to regularly apply moisturisers and lip salves,” says Dr Shergill. “All skin types benefit from a moisturiser, particularly skin that is regularly exposed to the elements, as this will help replenish the lost moisture from the skin.”

The benefits of moisturising include:

  • Making the skin more supple
  • Reducing irritation, including dryness and itching
  • Reducing scaling
  • Softening cracks
  • Forming a protective layer against the environment
  • Reducing the likelihood of flare-ups in existing conditions
  • Helping other emollients and treatments to be absorbed more easily into the skin
  • Improving skin appearance

The terms ‘emollient’ and ‘moisturiser’ may be used interchangeably. However, emollients are often non-cosmetic and the term frequently describes a single ingredient.

Emollients form a protective layer on the skin to help prevent moisture loss and facilitate the movement of water from deeper skin tissues to the surface. They are available as creams, lotions, ointments and sprays, as well as bath and shower products and soap substitutes. Considering the different formulations available, customers may have to try several products before they find a regimen that works for them.

The different types of emollients include:

  • Occlusive creams and ointments, which create a film over the skin to prevent moisture from evaporating
  • Humectant-containing creams and ointments, which contain additives such as urea glycerol to attract and hold water to the top layer of skin

 “No treatment works unless it is used properly,” says Dr Shergill. “It is best to apply a moisturiser to skin straight after a bath or shower, while the skin is still slightly damp. If the skin is slightly shiny after applying a moisturiser, the right amount has probably been used.”

Matthew adds: “The drier the skin, the more regularly moisturiser should be reapplied.”

A 2007 study revealed that of the 50 children with eczema who participated, only 20 per cent had been shown how to apply emollients correctly. Additionally, 24 per cent of parents were either confusing emollient creams with steroids or applying them sparingly instead of liberally. Caroline Fredj, senior brand manager for Oilatum, says: “Providing information on how to apply an emollient cream or ointment correctly will help the customer to get the most out of their treatment.”

Emollients should be applied in downward strokes, following the direction of hair growth. After applying, customers should leave 30 minutes before using topical corticosteroids or other topical treatments to avoid diluting their effects or spreading them to areas that do not require treatment and increasing the risk of side effects on normal skin.

Everyday use of soaps and cleansing products can remove the surface layer of natural oils on the skin, which can make skin dry and aggravate pre-existing conditions. To avoid this, emollient wash products can be added to lukewarm water to prevent moisture loss from the skin and, although they don’t typically produce foam, many users find them to be just as effective at cleansing as conventional wash products. Using both an emollient soap substitute plus an emollient to moisturise skin is known as ‘complete emollient therapy’.

It is best to apply a moisturiser to skin straight after a bath or shower, while the skin is still slightly damp

 

Top tips

Pass these top tips on to customers suffering from eczema:

  • Apply an emollient at least twice a day in downward strokes, preferably after bathing. NHS Choices recommends an average of 600g a week for most adults and 250g for children
  • Use soap substitutes – soap is drying and can worsen existing conditions
  • Avoid harsh alcohol-based cleansers, soaps and toiletries
  • Limit exfoliation
  • Introduce a complete skincare regimen – including emollientrich shower and bath products, plus a cream, ointment or lotion. Use these daily to lock in moisture
  • Avoid fragranced products, which may aggravate the skin l Choose cotton or silk clothing and bedding
  • Avoid contact with irritating man-made fabrics and wool
  • Wear cotton mittens at night to reduce the impact of scratching, particularly in children
  • Use non-biological washing powder
  • Wash bedclothes and vacuum beds and carpets frequently to control house dust mites
  • Do not allow pets in the bedroom. Fur and feathers can irritate the skin
  • The sun can still be strong during the winter months – apply a broad-spectrum UVA/UVB high protection sunscreen.

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