Winter skin woes

From health.harvard.edu

Frosty temperatures can do a number on our skin, especially as we get older

If perpetually cold hands and feet weren't clear tip-offs that we're now in winter's grasp, perhaps a flurry of dry, flaky skin has driven it home.

Rough, itchy patches are nearly universal at this time of year. But you may not have braced yourself for other skin problems that can crop up — or get worse — when temperatures plunge.

On this undesirable list are eczema, which is marked by dry, red areas and painful cracks; psoriasis, which typically involves patches of thick, red skin coated with silvery scales; rosacea, most often characterized by facial flushing and redness and causing red bumps on the nose and cheeks; and seborrheic dermatitis, which is known as dandruff when it's on the scalp but can take the form of a scaly rash on other skin areas, particularly around the eyebrows and the corners of the nose and chin.

Even people whose skin has been remarkably unproblematic over the years often find they're facing new winter skin woes merely because they're getting older, says Dr. Rachel Reynolds, interim chair of dermatology at Harvard-affiliated Beth Israel Deaconess Medical Centre. For women, the first five or so years after menopause may seem especially brutal, since diminishing oestrogen levels translate into less skin moisture.

"As we age, our skin gets drier," Dr. Reynolds says. "So unless someone has already been dealing with a skin condition, they might not experience these weather-related changes until they get older."

Problematic behaviours

Why do all of these problems converge in winter? Simply put, winter wreaks havoc with our skin barrier — the top layer of skin, which contains substances such as cholesterol and fatty acids that help seal in moisture and protect against irritants.

Frosty temperatures and dry air are winter-weather characteristics that are particularly hard on skin. "Even heating systems create more dryness," Dr. Reynolds notes. "They take more humidity out of the environment, which extracts moisture from the skin."

Certain behaviours can aggravate the situation, including

• taking long, hot showers or washing hands frequently
• using harsh soaps, laundry detergents, fabric softener sheets, or heavily fragranced products
• spending a lot of time outdoors
• wearing wool, which can irritate sensitive skin.

Surprisingly, using alcohol-based hand sanitizer — which became a staple during the pandemic — isn't as drying as hand washing can be, Dr. Reynolds says. "Ironically, for someone who has to clean their hands frequently, soap and water exposure is more harsh on skin," she says.

Skin protection tips

Applying moisturizer is a go-to measure to ward off dry skin, as well as soothe problems such as eczema, psoriasis, rosacea, and seborrheic dermatitis. But Dr. Reynolds suggests taking a deeper dive on products and approaches you may not have considered:

• Opt for creams and ointments, since thinner lotions don't provide as much moisture.
• Coat cracked skin areas with petroleum jelly and cover with cotton gloves, plastic wrap, or another barrier to seal in moisture overnight.
• Use a humidifier to pump moisture into dry indoor air.
• Take only lukewarm showers, and shower no more than once a day — every other day if possible.
• Use moisturizing soaps and liquid body cleansers, which contain more skin-softening emollients than bar soap. "And try to avoid soap on areas you don't need it, like your arms and legs," she says.
• Pat yourself dry after bathing and apply moisturizer while skin is still damp, which traps the moisture.

However you respond to dry skin, don't ignore it — especially if you're at midlife or beyond, Dr. Reynolds warns. Untreated dry skin can develop into a type of eczema called nummular dermatitis, another version of the dry-skin eczema often seen on older people's legs. This itchy condition can predispose people to cellulitis, a potentially serious skin infection that can spread to the bloodstream.

"Everyone gets dry skin as they age, and the degree to which you get it varies from person to person," she says. "Anyone around 60 or older could be predisposed to this eczema, just based on age-related dry skin."

See your primary care doctor if you develop an itchy, red rash. "If it becomes more severe, your doctor may refer you to a dermatologist," Dr. Reynolds says.

One last caveat: drinking water isn't a cure-all to either avoid or treat dry skin. "Keeping up with normal fluid intake is a good idea, but the benefits of skin hydration from drinking water are sometimes overemphasized," Dr. Reynolds says. "A much more effective approach is hydrating your skin from the outside by practicing diligent skin care and moisturizing regularly."

https://www.health.harvard.edu/staying-healthy/winter-skin-woes 

How to Care for Cracked and Bleeding Psoriasis Skin

From blackdoctor.org

Psoriasis is a chronic skin condition that affects millions of people worldwide. It can cause patches of red, dry, itchy skin, known as plaques, which can become itchy, flaky, and sometimes even crack and bleed if not well managed. If you’re dealing with these symptoms, it’s important to know how to care for your skin properly to prevent further discomfort and reduce the risk of infection.

Understanding the Causes

Before we dive into the tips for managing cracked and bleeding skin caused by psoriasis, let’s understand why it happens. According to Dr. Saakshi Khattri, an associate professor of dermatology at Mount Sinai Hospital in New York City, dryness is the primary culprit behind skin cracking and subsequent bleeding. The more parched your skin, the more likely it is to develop cracks and open sores.

First-Aid Care for Cracked Skin

If you find yourself dealing with cracked or bleeding skin due to psoriasis, here are some first-aid tips to help you manage the situation:

1. Clean your hands: Before touching your skin, wash your hands thoroughly with warm, soapy water to reduce the risk of infection.
2. Stop the bleeding: Apply gentle pressure to the fissure with a clean bandage or cloth until the bleeding stops.
3. Clean the wound: Rinse the wound under running tap water and clean the surrounding area with soap. Remove any dirt, lint, or debris from the wound gently.
4. Apply a protective ointment: Petroleum jelly is an effective over-the-counter option for protecting injured skin and promoting healing.
5. Watch for signs of infection: Keep an eye out for pus, tenderness, worsening redness, or systemic symptoms like fevers or muscle pain, which could indicate an infection. If you notice any of these signs, consult your doctor promptly.

Preventing Skin Cracks and Bleeding

Prevention is key when it comes to managing psoriasis-related skin issues. Here are some tips to help you prevent skin cracking and bleeding:

1. Keep your skin moisturized: Moisturize your skin regularly, especially after bathing or washing your hands, to prevent dryness.
2. Remove scales gently: Use over-the-counter lotions and creams with salicylic acid to reduce scale build-up, but be gentle to avoid causing further damage.
3. Be gentle with your skin: Avoid using abrasive products or aggressive measures that could worsen skin damage.
4. Identify and avoid triggers: Understand your psoriasis triggers and take steps to avoid them, which can help prevent plaques from forming.

Consulting Your Doctor

Lastly, if you find that your psoriasis symptoms, including skin cracking and bleeding, are persistent or severe, it’s essential to consult your doctor. They can help you develop a treatment plan tailored to your needs, which may include medicated topical treatments or systemic therapies like biologics. Working closely with your doctor can help you effectively manage your psoriasis and improve your quality of life.

Treatment Options for Psoriasis

In addition to self-care strategies, there are various treatment options available for managing psoriasis. These treatments aim to reduce inflammation, control skin cell growth, and alleviate symptoms. Here are some common treatment options your doctor may recommend:

1. Topical treatments: These are applied directly to the skin and include corticosteroids, vitamin D analogs, retinoids, and coal tar. They help reduce inflammation and slow down skin cell growth.
2. Phototherapy: Also known as light therapy, this treatment involves exposing the skin to ultraviolet light under medical supervision. It can help reduce inflammation and improve skin appearance.
3. Systemic medications: These are taken orally or by injection and work throughout the body to control the immune system’s response. Biologics, methotrexate, and cyclosporine are examples of systemic medications used to treat psoriasis.
4. Oral medications: In some cases, oral medications like apremilast may be prescribed to help control psoriasis symptoms.
5. Combination therapies: Your doctor may recommend a combination of treatments to effectively manage your psoriasis, especially if one treatment alone isn’t providing sufficient relief.

Developing a Personalised Treatment Plan

The effectiveness of psoriasis treatment can vary from person to person, so it’s essential to work closely with your doctor to develop a personalized treatment plan that addresses your specific needs and concerns. Your doctor will consider factors such as the severity of your psoriasis, the location of your plaques, your overall health, and any other medications you may be taking.

It’s important to follow your treatment plan as prescribed by your doctor and attend regular follow-up appointments to monitor your progress.

If you experience any side effects or have concerns about your treatment, don’t hesitate to discuss them with your doctor. Open communication is key to ensuring that you receive the most effective and appropriate care for your psoriasis.

The Importance of Self-Care

In addition to medical treatments, self-care plays a crucial role in managing psoriasis. Here are some self-care tips to help you manage your condition:

1. Maintain a healthy lifestyle: Eating a balanced diet, getting regular exercise, and managing stress can help improve your overall health, which may in turn benefit your psoriasis.
2. Avoid triggers: Identify and avoid triggers that exacerbate your psoriasis symptoms, such as certain foods, stress, or environmental factors.
3. Protect your skin: Use gentle skincare products, avoid hot water and harsh soaps, and protect your skin from extreme temperatures and sun exposure.
4. Stay informed: Stay up-to-date with the latest research and developments in psoriasis treatment and management. Knowledge is power, and being informed can help you make informed decisions about your care.
5. Seek support: Living with psoriasis can be challenging, so don’t hesitate to seek support from friends, family, or support groups. Talking to others who understand what you’re going through can be incredibly helpful.

Final Thoughts

Living with psoriasis can be challenging, especially when dealing with symptoms like cracked and bleeding skin. However, with the right care and treatment, it is possible to manage the condition effectively and improve your quality of life. By following the tips outlined in this article and working closely with your doctor, you can take control of your psoriasis and enjoy healthier, more comfortable skin.

https://blackdoctor.org/how-to-care-for-cracked-and-bleeding-psoriasis-skin/ 

Psoriasis: How to Deal with Cracked, Bleeding Skin

From everydayhealth.com

Take these steps to heal your skin and avoid future fissures

Psoriasis is a chronic skin condition that causes patches of red, dry, itchy skin, called plaques. When these plaques are not well treated, they can get itchy and flaky and then sometimes crack and bleed, according to research published in September 2017 in the Journal of Patient-Reported Outcomes. People with psoriasis tend to notice bleeding if they scratch plaques too much, rub cracked skin against their clothes, or put pressure on their skin while sitting or bending their limbs, the study showed.

The more parched your skin, the more likely it is to develop cracks, or fissures, and open sores on the skin. “The dryness is what causes the plaques to crack and subsequently bleed,” says Saakshi Khattri, MD, an assistant professor of dermatology at Mount Sinai Hospital in New York City. Psoriasis on the scalp is often particularly dry, leading to cracking and bleeding, suggests a study review published in 2018 in the journal Reumatologia.

Unfortunately, cracks in your skin are uncomfortable and could increase your risk of infection. Here’s how to prevent and manage skin cracking and bleeding.

First-Aid Care for Cracked Skin

If you develop cracks or fissures in your skin, it’s important to take steps to treat the wound and reduce your risk of infection. Follow these tips.

Wash your hands. Use warm, soapy water to wash your hands before touching your skin.

Stop the bleeding. Apply gentle pressure to the fissure with a clean bandage or cloth until the bleeding stops.

Clean the cut. Rinse the wound under running tap water and clean the surrounding area with soap. Gently remove any dirt, lint, or other debris from the wound.

Apply a protective ointment. The best over-the-counter first aid is petroleum jelly, says Dr. Khattri, “but eventually the goal should be to treat underlying psoriasis.” Petroleum jelly can strengthen your skin and bolster your skin’s immune response, suggests research published in April 2016 in The Journal of Allergy and Clinical Immunology. 

Watch for infection Generally, psoriasis plaques don’t get infected, but if they’re cracked or open, they could, says Khattri. Watch for pus or yellow discharge, tenderness to the touch, worsening redness on or around the lesion, or any systemic problems such as fevers or muscle pain, as these can be signs of infection, she adds. Talk to your doctor if you notice any of these or if the wound isn’t healing.

How to Prevent Skin Cracks and Bleeding

Following your psoriasis management and treatment plan can help reduce your risk of developing fissures, as can practicing self-care habits to protect your skin.

Keep your skin moisturized. Dry skin is more likely to crack and bleed. Avoid long showers or baths, which can dry out skin, and apply cream or ointment after you shower, take a bath, or wash your hands to help lock in moisture.

Remove scales. Over-the-counter lotions and creams with salicylic acid can help decrease the buildup of scales, says Khattri. Plain old moisturizer has its place, too. “A good moisturizer that helps with dryness and skin healing can be a helpful [addition],” she adds.

Be gentle on your skin. If you use an abrasive product, such as a pumice stone, to remove scaly skin, you could be doing more harm than good. “There is a possibility that such aggressive measures could result in bleeding,” notes Khattri.

Avoid your triggers. Knowing your psoriasis triggers and taking steps to avoid them can help prevent plaques from developing in the first place. Common triggers include stress, smoking, cold weather, and injuries to the skin.

Talk to Your Doctor About Your Psoriasis Treatment Plan 

Look at your psoriasis symptoms as part of the bigger picture, says Khattri. If your skin is frequently cracking and bleeding, it may be a sign that your condition isn’t well controlled and you need to discuss options with your doctor to better manage it. See a dermatologist if your skin continues to bleed and crack, is breaking over a large area of your body, or impairs your quality of life, advises Khattri.

There are many treatment options for psoriasis, including medicated topical treatments that are mostly available by prescription, as well as 1 percent hydrocortisone, which is available over the counter, says Khattri.

Your doctor may recommend a variety of treatments of differing potencies, depending on the severity of your psoriasis, your preferences, your age, and the location of your plaques, according to a study review published in February 2021 in the Journal of the American Academy of Dermatology. For example, people with chronically dry, thick plaques might need the strongest class of steroids, the researchers say.

While topical treatments come in many forms, many patients prefer foams, solutions, and lotions, as they are less messy than other formulations, suggests research published in October 2019 in the Journal of Dermatological Treatment. 

If topical treatments aren’t enough to manage your psoriasis, you doctor may recommend systemic therapies, such as biologics. Unlike topicals, which are applied directly to the skin, systemic medications are taken orally or injected and alter the immune system to help control the underlying inflammation that causes psoriasis. Work with your doctor to find a treatment plan that will help keep your psoriasis symptoms under control.

https://www.everydayhealth.com/psoriasis/managing-skin-cracks-bleeding/

Prevent common dry skin conditions during the wintertime

From craigdailypress.com

MRH board-certified dermatologist Dr. Laurie Good explains how to keep your skin healthy in the upcoming winter months

Sponsored content by Memorial Regional Health

Colorado winters aren’t easy on the skin.

The air outside is cold, dry and lacking in humidity, which can cause skin irritation and dehydration. People also tend to do things to stay warm inside, such as run the heat in their homes or crank up the hot water in the shower. The natural elements and our reactions to them can contribute to dry skin conditions, which are more frequent in the wintertime.  

Dr. Laurie Good, board-certified dermatologist at Memorial Regional Health, said it’s just as important in Colorado’s dry climate to use a daily moisturizing cream from head-to-toe as it is to drink water.

“The older you are, the more important that is because we become less adept at retaining moisture with age,” she said.

Dry skin conditions

Skin that becomes abnormally dry, itchy and cracked is called asteatotic eczema, a condition that patients experience more frequently during the wintertime. Asteatotic eczema can also include little dry pink bumps, sometimes with a dry riverbed appearance, Dr. Good said. This most commonly occurs on the back, flank and lower legs or ankles.

When the seasons change, seborrheic dermatitis, which is the medical term for dandruff, is another condition that can warrant a patient visit. Dandruff usually presents with a greasy, yellow scale and sometimes itching on the scalp and central face.

“Seborrheic dermatitis typically presents with an itchy, flaky scalp, but it also commonly occurs between the eyebrows, the sides of the nose and in the ears,” Dr. Good said. “The change in temperature, humidity and bathing habits can all contribute to flare of ‘seb derm.’”

Other skin conditions that arise during the winter include chapped lips, acne, eczema, psoriasis and rosacea.

Remember, even though winter days are shorter and darker, putting on sunscreen is just as important as it is during the summer. UVB rays can damage skin all year long, especially at high altitudes and on reflective surfaces such as snow or ice. According to the Skin Cancer Foundation, snow reflects up to 80 percent of the sun’s UV light, which can increase the risk of skin cancer and premature aging.

Treatment

If you have asteatotic eczema, scheduling an appointment with a dermatologist could be beneficial if the itchy skin doesn’t resolve or significantly improve after reducing shower temperature and applying daily moisturizing cream. It’s also time to visit the doctor if the condition appears to truly be a rash and not just marks from scratching, or if there are any other symptoms or locations associated with the itching, Dr. Good said.

If you have typical scalp or facial dandruff, Dr. Good said alternating over-the-counter shampoos like Clinical Strength Head and Shoulders and Neutrogena T/Sal can be very effective.

“If it does not resolve with showering three times weekly with one or the other of these shampoos, seeing a dermatologist is a reasonable next step,” she said.

Per sunscreen recommendations, apply a broad-spectrum sunscreen with an SPF of 15 or higher to all exposed areas of your skin, especially on days when you hit the slopes or explore the outdoors. Don’t forget to cover frequently missed spots such as ears, neck, hairline and around the eyes.

Other tips to help avoid common dry skin conditions during winter months include:

• Moisturize daily with a fragrance-free cream or ointment.
• Use warm, but not hot, water in the shower.
• Try a humidifier if you are eczema-prone to add moisture to the air.
• Use gentle cleansers that don’t deplete moisture from skin.

https://www.craigdailypress.com/news/prevent-common-dry-skin-conditions-during-the-wintertime/

Causes and treatments for cracked skin on hands and feet

From medicalnewstoday.com

For many people, cracked skin appears or gets worse during the winter, when dry air can lead to dryness on the hands, lips, or feet.

Sometimes cracked skin occurs due to a skin condition, such as eczema or psoriasis, or because the skin came into contact with an irritating substance.
Cracked skin can also be a symptom of an underlying medical condition. For example, people living with diabetes may notice cracked skin on their soles.

In this article, we will cover some common causes of cracked skin on hands, feet, and lips plus treatments and home remedies that may help.

What is cracked skin?

According to the American Association of Dermatology (AAD), the fissures, or cuts, that mark cracked skin typically occur when a person’s skin is dry or irritated. Dry and cracked skin can:

• itch
• flake
• bleed

Some people may feel unpleasant sensations when applying any product to cracked skin. Their skin may also feel more sensitive to water temperature and household cleaning products.
Cracked skin can appear on any part of the body, but it is especially noticeable on exposed areas, such as the hands.

Causes

Cracked skin on the hands, feet, and lips can develop for a variety of reasons.

Dry skin

The AAD note that harsh winter temperatures and wind can irritate the skin. When air humidity drops, the skin can become dry and start to crack.
In cold or dry weather, many people also develop dry and cracked lips. Licking, biting, and picking can make cracked lips worse.

Contact dermatitis

Contact dermatitis is an itchy, dry skin rash that develops when a person comes into contact with a specific substance. This may occur because a person has an allergy, or because the substance is toxic or irritating.

For example, someone with a latex allergy may develop contact dermatitis while wearing latex gloves. During the flu season, frequent hand washing can also cause dryness, itchiness, or cracking. This also applies to hand washing during the COVID-19 pandemic.

Eczema

People with eczema, or atopic dermatitis, have dry and itchy skin. The skin may look red and inflamed. Often, scratching will make the rash worse.

Eczema occurs when the skin barrier allows too much moisture to escape. The lack of moisture leads to dryness and, sometimes, cracked skin. It is not always clear what causes eczema, but it can run in families.

Psoriasis

Psoriasis is an autoimmune condition that affects the skin. People with psoriasis have patches of extremely dry skin, typically on the scalp, trunk, and around the joints. However, patches can appear anywhere on the body. Some people with psoriasis also experience pain.

Athlete’s foot

Athlete's foot, or tinea pedis, is an infection of the feet caused by ringworm. Ringworm is a type of fungus. Symptoms of athlete’s foot include:

• itchiness
• a rash between the toes
• skin peeling
• cracking of the skin

People are more likely to get athlete’s foot if they spend a lot of time in water, sweat a lot, or wear shoes that do not allow the skin to breathe.

Diabetic neuropathy

People living with diabetes may develop problems with their feet. This includes dry or cracked skin.
Due to changes in their nervous system, people with diabetes have feet that sweat less. While too much moisture is a risk factor for athlete’s foot, too little can make the skin dry, causing fissures.

As some people cannot see the soles of their feet, they must rely on a partner or their doctor to check them. Cracked skin on the feet can go unnoticed until the person develops an infection or a painful skin ulcer.

Treatment

The treatment a person tries will depend on the cause and location of their cracked skin.
For cracking that occurs in cold weather or as a result of frequent hand washing, The AAD recommend keeping the skin hydrated. A person can do this by applying fragrance- and dye-free hand cream or ointment immediately after washing the hands.

When choosing a moisturizer for cracked skin, people should look for these beneficial ingredients:

• olive oil
• jojoba oil
• shea butter
• lactic acid
• urea
• dimethicone
• hyaluronic acid
• glycerin
• lanolin
• mineral oil

As alcohol-based hand sanitizers can also cause dryness, dermatologists also recommend applying moisturizer after using them.

People with eczema and psoriasis also benefit from moisturizers to prevent flare-ups and protect the skin. However, they may require additional treatments to control flare-ups. This can include:

• corticosteroid creams
• calcineurin inhibitors
• medications
• UV light therapy

If the skin has become infected, a doctor may also prescribe antibiotic ointment or tablets.

According to one article, people with athlete’s foot may need to change their footwear or apply talc to prevent sweating. They may also need to use antifungal products to treat ringworm.

An article in the International Journal of Nursing Studies suggests that a lack of blood flow in the feet can contribute to cracked skin in people with diabetes. Managing blood flow to the feet by wearing compression stockings may help.

Home remedies

To prevent cracked skin from getting worse, people should avoid washing their hands with hot water. Hot baths and showers can worsen dry or cracked skin. Dermatologists recommend:

• using warm rather than hot water
• closing the door of the bathroom to lock in moisture
• limiting time in the shower to a maximum of 10 minutes
• washing with a small quantity of a gentle fragrance-free cleanser
• drying the skin by blotting, not rubbing
• applying moisturizer immediately after blotting

Doctors also recommend that people wear gloves to protect their hands when:

• going outside in the winter
• performing tasks that get the hands wet
• using harsh chemicals, degreasers, and other substances

Some dermatologists recommend using a humidifier in the house if the air is dry. According to the AAD, humidifiers may also help to treat dry lips.

Lip balms can also help soothe dry or cracked lips. However, some lip balms may cause burning or stinging due to their ingredients. It is important to choose a non-irritating lip balm if you have cracked lips.

Certain fabrics can irritate dry skin. It may help to wear smooth, breathable fabrics, such as cotton or silk, and to avoid textured materials, such as wool. Using hypoallergenic laundry detergents and fabric softeners may also help to reduce irritation.

Complications

People with cracked skin are more prone to infections because the skin barrier is broken. Bacteria and other germs can get inside the skin and cause an infection.
People who notice pain, redness, inflammation or pus at the site of the fissure must see a doctor. Fissures can also start to bleed.

People living with diabetes have poor circulation in their feet and may have dysfunctions in their nervous system. These conditions can cause dry skin and cracks that are slow to heal.
Sometimes fissures on the soles of the feet can develop into painful ulcers, which can make it challenging for people to stand or walk. According to one article, some people with diabetes may require amputation if their ulcers become severe.

When to see a doctor

If moisturizing frequently and avoiding behaviours that cause cracked skin do not help, a person should speak with a doctor. The doctor can check for any underlying conditions.
A pharmacist can help a person choose an appropriate cream or ointment to soothe cracked hands and feet.
People who have signs of complications from cracked skin must also speak with a doctor. These signs include skin that is:

• red
• inflamed
• painful
• hot

People with diabetes should see a doctor if they develop ulcers from cracked skin on the soles of the feet. Ulcers can make it difficult to walk and require medical attention.

Summary

Cracked skin on hands and feet is common in winter, but can also occur with certain skin conditions, such as eczema and athlete’s foot. To prevent cracked skin, people should avoid using hot water and harsh chemicals, and moisturize after washing.

People with skin conditions that lead to cracked skin may require medication to treat the underlying cause. If moisturizing frequently and avoiding triggers does not help, a person should speak to their doctor.

https://www.medicalnewstoday.com/articles/cracked-skin#summary