Winter Skin Care-- Brandith Irwin, MD-- 12/18/03

By Brandith Irwin
WebMD Live Events Transcript

Is red, chapped, and dry skin making this cold weather season a miserable one already? Before you spend big bucks on another skin care product or cosmetic procedure, check out this advice from dermatologist Brandith Irwin, MD, author of Your Best Face: Looking Your Best Without Plastic Surgery.

The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Member question: My skin gets so bad in the winter that I can't even shower every day otherwise I itch so bad it hurts and bleeds. I drink plenty of water and no cream seems to help. Are there any other suggestions other than scratching myself into one big scab?

Irwin: First of all, you may have more than just dry skin; you may have atopic dermatitis, which is a type of eczema, and I think you should probably see a dermatologist.

In the meantime, take only lukewarm, short showers and use Dove soap for sensitive skin only on your face and in your armpits and groin area. Don't soap all over. When you get out of the shower, get some Cetaphil cream -- not the lotion -- or Vanicream and apply that all over your body in a thick layer. That should help until you can get in to see your doctor.

It's OK to take over-the-counter Benadryl an hour before bed if you're having trouble sleeping due to the itching.

Member question: I would like to know what to do about dry, itchy skin on my belly and backside in the winter since I am pregnant. Cocoa butter and shea butter do nothing for me.

Irwin: Do you have a rash or are you just itching?

Member: I have a small rash under my breasts, which my OB said is not PUPPP, but to use Benadryl (I'm allergic) or cortisone, but they aren't working. Otherwise, it's just dry/scaly and itchy.

Irwin: I would recommend trying no soap in the area with a little over-the-counter hydrocortisone 1% cream, along with Cetaphil cream three times a day for a week. If it's not gone after a week, you should see a dermatologist.

Member question: Is Cetaphil cream an OTC?

Irwin: Yes, Cetaphil is just over the counter.

Moderator: Would the clothes she is wearing have any bearing or effect?

Irwin: If you're itching it's helpful to use All Free or Tide Free detergent for your clothing, and don't use any fabric softeners, even the ones that say they're OK, because they leave little irritating fibers all over your clothes.

Member question: Also, is it safe to use an oatmeal bath or oils while pregnant to combat dry skin in the winter months?

Irwin: Yes, as long as the bath is short and not too hot and you apply cream right after you get out of the bath.

Member question: I have dry skin but I think it's getting worse since the winter started. I'm 25 now, but I've had this problem since I was a kid. I get dry skin all over my face around my nose and the cheeks as well. I also get very dry skin in and around my scalp. Help!

Irwin: This is a tough one to do without seeing you. You could even have psoriasis or seborrhea or a type of facial eczema, or a combination of those three. I really think you need a dermatologist for this one. In the meantime, use Nizoral shampoo (it's over the counter) on your scalp, and a little hydrocortisone .5% together with a lot of Cetaphil cream until you can get in to be seen.

Member question: Where can I see a dermatologist with no insurance?

Irwin: The best place is to find the nearest county hospital. Most county hospitals have dermatologists on staff and a payment program for people with reduced or low incomes.

Member question: I have Raynaud's disease, as well as heart and lung disease. I'm always cold and out of breath and being all huffy and puffy leads to dry lips, not to mention the Raynaud's keeps them chilly. I've tried everything from Carmex to Vaseline to gloss and nothing works on my lips. What can I do?

Irwin: First of all, if you live in a cold area it's really important to keep your hands and your face warm. So I hope you're wearing a scarf around your lower face or a ski face mask for your lower face most of the time, because nothing substitutes for keeping this area warm if you have Raynaud's. Also make sure your core temperature is kept high.

You might try the shea butter and apply it 10 times a day to your lips. You can find the shea butter at L'Occitane. I think they have an online site. They have pure shea butter in tins.

Moderator: Does using normal face lotion on the lips help keep them moist, or do we need to use specific lip stuff on them?

Irwin: You can use just a good moisturizer, but you'll need to apply it many times a day. Most of the lip products have things in them that keep it on longer.

Member question: I recently heard something about lip moisturizers being addictive and actually drying to your lips. What do you think about this?

Irwin: An old wives' tale. The thing that dries your lips out the most is licking them.

Member question: My hands look as though I scrub floors for a living. They continually crack, split and peel ... NOT just in the cold weather, either. This is unsightly and quite painful. I get relief from painful splits in my skin with Vicks salve, but I can't go around with that during my workday. I also use aloe gel topically and drink aloe juice and OPC-3 to treat from inside out. Someone told me this condition is due to going through menopause. I had never heard that skin problems were considered a menopause symptom. What do you think?

Irwin: I think you need a dermatologist, but in the meantime, until you can get in:

  • Wash your hands only with Cetaphil lotion cleanser. That means no commercial soaps ever, including at movies, your workplace, etc.
  • Wear vinyl gloves when you wash dishes or have any prolonged contact with water.
  • Use Cetaphil cream every time after your hands are wet, especially after washing your hands. So put your Cetaphil cleanser and cream by every sink in your house so it will be convenient to use.
  • Get inexpensive cotton gloves at the drug store, apply the Cetaphil thickly right before bed and sleep with the gloves on.
  • Stop the aloe gel (too drying) and stop Vick's (has irritants in it).
  • Make sure you're getting plenty of good oils, like olive oil and fish oils. These are better than taking aloe internally for this problem.

Member question: When your skin breaks and bleed from extreme itching, should you treat it as a wound, and heal it before using any lotion again? Is lotion bad on broken skin?

Irwin: No, using lots of Cetaphil cream is good for it. The moister you can keep it, the better. Keeping fissures clean with a Band-Aid is fine.

Member question: Does topical vitamin C really work?

Irwin: I assume you're talking about using it for sun damage, so yes, but it should be in a serum form (don't buy the creams) and look for ones that are about 20% concentration. They should have a pH of 3.5. Try the Skinceuticals vitamin C and E.

Moderator: We are almost out of time. Before we wrap up for today, do you have any final comments for us, Dr. Irwin?

Irwin: Just this: Use only mild soaps, like Dove or Cetaphil, and lots of lube! Think lube, lube, lube!

Moderator: Thanks to Brandith Irwin, MD, for answering our questions. For more information on Dr. Irwin's approach to skin care, pick up her book, Your Best Face: Looking Your Best Without Plastic Surgery.



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