As the temperatures outside drop and the humidity decreases, the winter season is inevitably associated with skin inflammation. Exposure to cold, dry air can cause irritation to the skin barrier, leading to cracks and fissures.[1,2] This type of irritation, asteatotic eczema, occurs in dehydrated skin areas from a poorly functioning skin barrier.
The Normal Skin Barrier
Skin is comprised of multiple layers: the epidermis, the dermis, and the hypodermis. The top layer of the epidermis, the stratum corneum, consists of dead cells that slough off and are replaced by new cells from the deeper layer. This layer contains many fat molecules, known as lipids, that help form the skin-water barrier and maintain skin moisture. In a comparison of skin on the face and arms, the facial skin was more sensitive to changes in the environment, particularly in the winter months. The study suggested that the stratum corneum layer of the epidermis had a higher turnover rate during winter, particularly on the exposed facial cheek areas, leading to poorer skin barrier function and greater water loss through the skin.
Winter Skin Damage
Protein damage and loss of fat cells can damage the skin, leading to tightness, dryness, irritation, and itching. Most often, the damage to the barrier leads to dehydration of the skin and resulting pain and inflammation. In a study examining how easily the skin is irritated, participants noticed seasonal differences between the summer and winter. In another study examining environmental irritating factors, low temperature and low relative humidity were risk factors for developing dry, irritated skin on hands. Often the dry skin irritation can occur with increasing age as well due to decreased activity of the skin’s oil glands that help maintain the stratum corneum layer of the epidermis.[11,12] Dry skin and asteatotic eczema have decreased levels of lipids (oils) in the cells of the water-skin barrier.
Soap and Water can Further Irritate Skin
While environmental changes in the temperature and dryness can strip the skin of moisture, contact with soaps and other materials can further worsen skin irritation. Frequent hand washing with soap or even water alone can irritate the skin. Initially, the skin damage is not easily visible, but over time, the skin will begin to appear as scaly, red, irritated skin and may have burning sensations.[15,16] Skin cleansers can alter the skin barrier and selection of a gentle wash can be beneficial in reducing skin irritation.
Table 1 – Triggers for Dry Skin
Frequent handwashing with warm water
Use hand lotion or cream after washing to reduce further moisture loss.
Irritating hand soap
Alcohol-based hand sanitizers can help reduce dryness and inflammation. In skin that is broken, alcohol can be irritating and it is important to use seek medical attention of your hands are cracked, painful, or draining pus.
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