Winter can be brutal on exposed skin — the cold, dry air zaps your skin of moisture. Add wild winds, damp cold rain or snow, and dry indoor heat to the equation, and exposed skin can develop dry, itchy, scaly patches and chap to the point of cracking, peeling and bleeding — all also symptoms of chronic skin conditions like eczema and psoriasis.
Cold, brutal, wet weather can strip the skin's protective barrier and further aggravate sensitive skin and skin conditions — and it doesn’t help that our hands are being stripped of moisture by constant hand-washing and the alcohol content in the hand sanitizers we use to protect ourselves against COVID-19.
When your skin is in rough shape, it can be a challenge to determine whether your issue is seriously chapped hands or something else, even for dermatologists like Samer Jaber, MD, founder of Washington Square Dermatology in New York City.
“Dry, cracked, winter hands and hand eczema can look very similar,” Jaber explained. “The difference is the cause. Dry, winter hands are due to winter dryness. Eczema is a genetic condition. Dry, cracked winter hands are a type of dermatitis.”
Both Jaber and Rosemarie Ingleton, MD, founder of Ingleton Dermatology in New York City, told TODAY Health that dermatitis is a term used interchangeably within the dermatology community to describe what happens when inflammatory cells rush into an area of the skin, causing inflammation.
“The way it manifests is you see more redness and a bit of swelling,” Ingleton explained. “You see a lot of flaking. You could see cracks.” She said this level of redness, which can be difficult to discern sometimes with darker skin, is a sign your skin needs help, stat.
Is it dry skin or a more serious skin condition?
Skin conditions, like eczema and psoriasis, involve your immune system. According to the National Institute of Allergies and Infectious Diseases, eczema, or atopic dermatitis, is an inflammatory skin condition that often affects children and adolescents, and can reoccur later in life. Thought to be connected to the immune system, people with eczema can also be susceptible to bacterial, viral and fungal skin infections. Jaber describes the symptoms of eczema as rough, inflamed, irritated and itchy skin. “You can also have scaling, cracks or blisters and it can hurt when washing your hands. In severe cases, the fissures can bleed or ooze,” he said.
Ingleton said that people with childhood eczema can have it over various periods in their lives, so dermatologists take a patient’s history into account when determining whether or not their painful skin issue is eczema. “They're going to be more susceptible to hand eczema later on,” she explained.
The National Psoriasis Foundation describes psoriasis as an immune-mediated disease characterized by plaques, or scales, on the skin, caused by an “overactive immune system that speeds up skin cell growth.” Normal skin cells shed within a month, but with psoriasis, this happens in three-to-four days. The cells don’t shed but pile up into “plaques” that itch, burn and sting. These plaques are most commonly found on the elbows, knees and scalp.
“Psoriasis looks a bit different than eczema in that the rash is much thicker and tends to have a thick white coat on the outside, almost a helmet of dry white skin, and is a bit thicker in its appearance,” said Ingleton. “It tends to be over the knuckles, as opposed to being over the back of the hand. It can be on the palms. You have some clues that somebody has psoriasis because you can look at their scalp, their elbows and knees and see it, so it makes sense that they have on their hands as well.”
When to see a dermatologist
How can we tell if we have severely dry, cracked, winter skin or a condition that might require the help of a dermatologist?
Whether you’re having a bout of eczema or your hands are just beat up, Jaber said the first line of defence is to moisturize, moisturize, moisturize. Ingleton explained that if your dry, cracked skin doesn’t respond to repeat applications of thick, rich moisturizers over the span of three-to-four days, you should consider visiting a dermatologist to determine the culprit.
“If you're not getting a response, there's probably dermatitis or eczema going on. There could even be an infection that would require more than just moisturizer. You would need some kind of prescription grade anti-inflammatory product, or an antibiotic if there's an infection,” she said.
https://www.today.com/health/chapped-winter-hands-it-dry-skin-or-something-else-t208822
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