Photo by: Kelly Sikkema on Unsplash
Our Skin: a Quick Overview
The skin is our largest organ and plays a very important protective role. To better understand dry skin and the “winter itch”, let’s start with a quick review of skin anatomy. The skin is comprised of three distinct layers, the hypodermis, the dermis, and the epidermis. The Hypodermis is the deepest layer and contains primarily subcutaneous fat which provides structure and fullness to the skin, acts as a shock absorber, provides insulation to the body, as well as, acting as an energy store for skin cells. Next, comes the dermis which houses blood vessels, nerves, sweat glands, oil glands, and hair follicles. Finally, the epidermis forms the outermost layer. This layer functions as a protective barrier and is comprised of several layers of skin cells. The lower levels contain the younger living cells, which are pushed to the surface as they mature and die and are eventually sloughed off. This process takes about one month and allows us to continually renew and replenish this protective layer of the skin. The outer layers of the epidermis are kept hydrated by a lipid-rich (fat-rich) substance called sebum, which allows the outer layers of the skin to remain smooth and soft. Dry skin occurs when the epidermis is unable to retain enough moisture and these outer layers of the epidermis start to curl and lift like shingles on a roof might. This can lead to several problems including:
The winter itch: Dry skin will often itch from the extra tension and the small cracks that form in its surface. In some cases, this is felt more as a burning sensation or even a combination of itching and burning.
Thickened rough patches: Dry skin can start to accumulate leading to this familiar and often unsightly issue.
Cracking: When the dryness becomes bad enough it can lead to cracking and even bleeding of the skin.
Exacerbation of other conditions: Eczema, psoriasis and dermatitis are often worse when the skin is dryer.
Infection: When the integrity of the skin is compromised by dryness, and, especially in when cracks form, this can allow access to bacteria than may cause an infection.
What Causes Dry Skin?
Dry skin can be caused by a lack of humidity in the environment. We Canadians know this all too well, as the cold winter months bring with it the incredible dryness. Further, as we age, our skin commonly begins to thin, meaning we don’t have as thick of protective layer to keep the moisture in. To add insult to injury, the production of sebum also slows with age; this is especially prominent in women after menopause. Finally, dry skin can also be caused using harsh and drying compounds on the skin pulling moisture and stripping the nourishing sebum from the outer surface layers.
How do we beat the Itch?
There are several ways to address dry and itchy skin. I will discuss a few tips and tricks below then review some recipes you can make at home to help beat the winter itch.
Tips and Tricks
Cover up in the cold
In extreme temperatures, the cold pulls moisture out of the air, which in turn, means it is pulled from your skin. Keeping skin covered in the cold not only serves to keep you toasty warm, it also protects from the drying effects of the cold. This means not just jackets and footwear; be sure to wear gloves, scarves, and something to cover your head. If you will be out in the cold for extended periods, covering the exposed skin on your face with a thicker cream can also help protect these areas.
Avoid long hot showers
As much as a nice, hot shower is exactly what we all dream of when it is cold outside, hot showers, especially long ones, will strip the natural oils from the skin and leave it in worse condition than before. Try instead to keep the temperature on the warmer side instead of hot, and limit shower to 5-8 min.
Add oils or herbs to your bath … Carefully!
If you are avoiding the indulgence of a hot shower, what about a steaming hot bath?? Unfortunately, the same principle applies here. Keeping the temperature on the warmer side instead of hot and not staying in for too long, will help prevent precious moisture loss from your skin. One way to combat moisture loss is by adding oils to the bath. Oils are hydrophilic, meaning they will look for other oils to bind to, like those on your skin. Oils that you might consider include sweet almond, apricot kernel, jojoba, sunflower. My generally rule of thumb is, if you wouldn’t eat it, don’t use it on your skin! To further enhance your indulgence, you could add essential oils as well. Some of my favorites are rose, lavender, chamomile or bergamot. Be sure to test any oils on a small patch of skin first to make sure you will not have a reaction. When using essential oils, you need to use caution as some can burn the skin causing blistering. Be sure to do your research so that you know which are safe to use. Avoid body wash or bubble bath in your bath as they will pull the oils off your skin. Exercise EXTREME CAUTION! Using oils in your tub will make it very slippery! Do not use oils without a bathmat and use extreme caution getting out of the tub. Ensure the oil residue is cleaned from the tub afterward so others don’t slip.
Some of my other favorite bath additives are oats, rose petals, chamomile flowers and/ marigold petals. These herbs have fantastic healing, soothing and anti-itch properties. They can be used fresh or dried, alone or in combination. If you are adding dried herbs give them a quick pulse in a blender before adding them to the bath. Adding these herbs to your bath turns it into a healing tea for your skin. There are 2 options for adding herbs to your bath. You can tie your herb(s) in cheese cloth before adding them. This makes for easy removal. Or, if you have a drain catcher with a fine weave you can add the herbs directly to your bath and allow your drain catcher to sieve out your herbs for removal.
Choose your self-care products wisely
Products with harsh chemicals and perfumes can not only be drying but, can further irritate skin that is already struggling. Do your best to choose products that contain natural ingredients without scents. Stay tuned for another blog on which chemicals to avoid in everyday products. The following are substances known to dry the skin.
Alcohol is in many skin care products but is very drying and should be avoided.
Detergents such as sodium lauryl sulphate and its relatives (such as sodium laureth sulphate and ammonium lauryl sulphate) pull moisture from the skin and should be avoided for several reasons.
Clay based products draw oils from the skin and while they are a favorite of teens everywhere for acne they should be avoided when you are trying to combat dry skin.
Salicylic acid is another common favorite for acne due to its drying properties, watch for this ingredient in your skin care products.
Any “soap” (including body wash, hand wash, shampoo etc.) will be somewhat drying by nature. Choose the gentlest versions you can find. It is also recommended that you use them sparingly. Only wash the areas of your body that get smelly with soap and use just water for other areas. Wash your hair every 2-4 days instead of daily and use only a ¼ pump of hand soap instead of a full pump.
Moisturize, but not too much
Choosing whether to apply lotions or creams can be tricky. When the skin is very dry, added moisture is needed to prevent damage to the skin, but the skin will respond by producing less of its own natural oils. Apply creams and lotions as needed but take breaks to encourage your skins’ own natural oil/ sebum production. An easy way to incorporate this into your skin routine is to use a facial moisturizer in the morning to protect your skin from the elements during the day but leave it out most nights to encourage your skin to hydrate on its own.
If you choose to apply lotion, it is best to do so after a bath or shower, before you skin is completely dry. This helps to lock in the moisture and prevent excessive drying of the outer layers before it starts.
In cases of extreme dry skin or specific skin conditions, such as, eczema or psoriasis, it is important to keep moisture in the skin. Using creams containing occluding substances such as lanolin, bees wax or shea butter to form a barrier over the skin can be helpful. However, in these cases it is important to consult your health care provider (ND or MD) for advice on how best to manage your condition.
To scrub or not to scrub?
This can be a difficult question. Gentle exfoliation can be helpful for mild dry skin if it is not over done. Exfoliation can help remove some of the drier dead layers that are flaking and causing the rough feeling to your skin by exposing the softer, smoother skin underneath. Rough skin can catch on the fabric you are wearing which can be irritating and painful. But don’t overdo it! Over exfoliating can cause irritation and inflammation which will set you back further. It is important to choose the right exfoliant for the skin you are treating. Delicate skin like that on the face should be matched to very delicate exfoliants, whereas slightly coarser exfoliants can be used for less delicate skin like the arms and legs. Always use a mix with natural ingredients and a moisturizing rather than drying base. If you have any skin conditions always consult your health care provider (ND or MD) before using an exfoliant.
Try not to scratch…
“Of course,” you say… “you try not to scratch” you say… This is certainly easier said than done. Often, we find ourselves itching and we don’t even know we are doing it! One trick to preventing yourself from scratching is keeping your skin covered in long sleeves, and pants and you might consider wearing gloves. A thin pair of cotton gloves can be helpful to keep yourself from scratching especially at night.
If you will be wearing gloves to bed as it is, you could take advantage and take it one step further. For dry skin or for the occasional super moisture boost, you could cover your hands in a thicker cream or salve before donning your bedtime gloves. This same principle can be applied to other areas of dry skin as well.
Use a humidifier at night
To help combat the dry air we experience in the winter months, adding a humidifier or 2 to your home can be helpful. The most important room to humidify is the bedroom as you spend most of your time here. You want to ensure the room does not become too saturated as this can lead to damage of your home and possibly mold growth. It is critical that your humidifier is regularly maintained and cleaned to prevent the growth of any pathogens within the device. Some humidifiers have filters or other mechanisms to prevent pathogenic growth, do your research!
Choose your fabrics wisely
Some fabrics tend to be more irritating to dry skin than others. See below for a quick reference to fabrics to avoid or choose while you are getting your dry skin under control.
Fabrics to avoid with dry skin:
Safe for dry skin fabrics:
Drink more water, drink less coffee and alcohol
We hear this all the time! “Drink more water”. Well here it is again! Water is important not only for the obvious hydration, but also because it allows us to excrete toxins through our kidneys improving our overall health. Avoiding diuretics (substances that make us lose more water), such as alcohol, coffee, and green or black tea, helps maintain a positive fluid balance.
Eat more healthy fat
Our body needs the healthy fats in our diet to produce the sebum which naturally moisturizes the skin. Some of the same oils you might consider using to moisturize your skin (see below) are also great for moisturizing from the inside out. These include olive oil, avocado oil or coconut oil. Omega 3 oils, as well as, evening primrose or borage oil supplements can also be helpful for the skin. For more specific supplements that can help with skin health, consult your ND.
There are a few conditions that can lead to chronic dry skin such as thyroid disease, kidney disease, lymphoma, eczema, psoriasis, atopic dermatitis etc. and in some cases, you may need more help. If you feel that your dry skin is more than a case of the annual Alberta winter dryness or is not improving, consult your ND or MD for further work up and treatment.
Stay tuned next week for a number of recipes you will love to help beat that winter itch!