Skin Care during Winter (cont.)

RODAN:
You can apply aloe-based moisturizer and that might help alleviate the problem. One important point to make is don't forget the sunscreen in the winter. Most people don't think they're receiving ultraviolet light, a big dose, when it's cold or rainy or snowy outside, but guess what? You are. So sunscreen will act as not only environmental protection against that UV-UVB light, it will also provide much needed moisturizing agents.

MEMBER QUESTION:
I was wondering about a "winter skin" problem. I have what seems to be dry and itchy skin on my upper inner thigh and on my upper inner forearms. I have been controlling it with Johnson and Johnson's Baby Cream and also applying a thin layer of Curad Liquid Bandage. It seems to help for a few days but it then recurs, looking for a "solution." I have not had this problem before this year. I'm 32 years old and have hot water baseboard heat.

FIELDS:
The rash you're describing is most likely eczema, but it is unusual in its presentation. There may be an irritant reaction to perhaps fabric such as pantyhose that are making these areas more susceptible to barrier breakdown, rash and itch. Over the counter hydrocortisone cream, 1 percent applied once a day for a week followed by moisturizer may rapidly improve this condition. If you are not better, see your local dermatologist.

MEMBER QUESTION:
We just got a whole-house humidifier. Will this help our skin (and our dog's coat)?

RODAN:
You bet. I recommend that all the time to my patients, because adding moisture, increasing the humidity of your environment will keep your skin moister. Don't forget the other measures we've described in this chat. For example, limiting your frequency of bathing and hand washing, applying moisturizer after cleansing or showering to damp skin; using a heavier moisturizer while you sleep at night and a lighter one which will be more comfortable, by day.

MEMBER QUESTION:
Will a vaporizer do the same as a humidifier. Will it help if only used at night?

FIELDS:
In general, when you put moisture into the air, you will be helping your skin, and it's a good idea. Just make sure the vaporizer is cleaned regularly so that bacteria do not build up in the unit.

MEMBER QUESTION:
Are there specific ingredients we should look for in a winter sunscreen?

RODAN:
Yes. The most important sunscreen agents are zinc oxide or benzone, also known as parsol, 1789. Either of these agents block out UVA light. UVA light is the aging ray, and is present 365 days a year from sunup to sundown, 100 times greater in amount than UVB. All sunscreens provide UVB protection, as reflected by the SPF number. In selecting a sunscreen, I advise my patients to not only pay attention to the SPF number, 15 and above, but also look on the back of the bottle where the ingredient list is and make sure under active ingredients, your product contains either zinc oxide or avobenzone.

Many patients wonder if they need to use a moisturizer in addition to their sunscreen. For people with normal to oily skin, a moisturizer is unnecessary, because sunscreens, by themselves, will provide significant moisture. Finally, don't forget to reapply your sunscreen often if you are outdoors. A single application in the morning will not last throughout the day.

MEMBER QUESTION:
Our 6 month old son has had, since 3 months old, a large area of dry skin on his forehead. His pediatrician attributed it only to "winter skin" and said it was not serious. However, over the past few weeks it has begun spreading to his cheeks and has become very itchy and he is very uncomfortable. We've made an appointment for a dermatologist next week, but in the meantime, can you recommend anything to make him more comfortable? OTC eczema creams don't seem to help. Thank you.

FIELDS:
Basically, childhood eczema can look like many different things. The environment has a huge impact on delicate baby skin. Consider a short course of over-the-counter hydrocortisone cream, 1% to the affected areas only, twice a day for 3 to 5 days until you see your doctor. Long term use of a steroid is not indicated. We also advocate the use of Cetaphil lotion, for hydration, over the medicine. Use lavishly.

MEMBER QUESTION:
I have a 7-month-old baby girl who seems to have dry raised circles on different parts of her body. I've seen them on her belly, arms and legs. The doctor said to mix hand cream and hydrocortisone cream together and put it on the spots. It doesn't seem to be doing anything to stop the patches. Any advice? It's mostly on her arms and belly. Is it OK to put hydrocortisone on her baby skin on her face?

RODAN:
We can't diagnose a skin condition without seeing the patient. What you may be describing is eczema, also known as atopic dermatitis. This condition affects approximately 20% of children in the first year of life. I tell my patients it is the itch that rashes, not the rash that itches. Parents may not realize that their child is scratching at their skin because this often occurs at night. The itching may be relieved with Benadryl, an over-the-counter antihistamine taken orally, not topically, mild topical steroid, or newer creams, such as Elidel or Protopic.

In addition, limited bathing is critical. In America, we have a hygiene fetish and believe we have to give our babies nice long baths every night. Water alone is very drying for the skin. When the skin is dry it's going to itch more, which is going to start this cycle of itching, scratching and eczema. Therefore, in place of daily bathing, use Cetaphil, soap free cleanser, over the entire body, wipe it off and wash key areas like the diaper area, as needed. You can do this every other night. As always, if the rash is not responding quickly, within a matter of days, please see your dermatologist, as many other conditions, including ringworm and psoriasis, may mimic eczema.