Dermatologists reveal what really works for dry winter skin

Stacey Burling
Philadelphia Inquirer

Your skin doesn’t like winter.

The combination of cold air outside and heated air inside often leads to dry, itchy, scaly skin.

There’s plenty of advice on the web about what to do and plenty of heavily marketed products that claim they’ll solve this seasonal problem, often at a hefty price. But how many of us have tried a watery lotion that made big promises and stopped working by the time we got from home to the office? How many have tried one that made the itching worse? And, really, how exactly are we supposed to slather slippery concoctions on skin still wet from a shower when everyone knows that oil and water don’t mix?

In the interest of cutting through the noise and possibly solving our own dry-skin problems, we asked three dermatologists – Jules Lipoff of Penn Medicine, Gopal Patel of Aesthetic Dermatology Associates in Media and Paoli, and Nazanin Saedi, director of the Jefferson Laser Surgery and Cosmetic Dermatology Center – for advice. Here’s what they said.

The combination of cold air outside and heated air inside often leads to dry, itchy, scaly skin.

Q: Are there medical reasons to worry about dry skin?

A: Usually not. If you neglect it and let your skin crack, you could be at higher risk of infection. In some cases, dry skin can be a symptom of underactive thyroid, Saedi said. It is more common in people with allergies, eczema or atopic dermatitis, and asthma. Patients with neuropathy, a nerve problem common in people with diabetes, may not realize their skin is dry and may wait too long to use moisturizers, Patel said. Dry skin may also be a sign of autoimmune conditions such as Sjogren’s disease or of certain cancers, he said.

Q: Is it more common in older people?

A: Yes. Older skin becomes less efficient at attracting moisture to itself. However, Saedi said she has teenage patients with dry skin. Their faces may still be oily, but they have dry knees, ankles, and elbows.

Q: Do men and women or people of different races have different rates of dry skin?

A: Mostly not. However, dryness may be more visible on darker skin. And oil gland activity declines earlier in older women than in older men, Patel said.

Q: Will drinking more water or eating certain foods make skin less dry?

A: No. “For the average person, there’s nothing you could consume that would make your skin better,” Lipoff said.

Q: Is using a loofah or washcloth to rub dry skin during showers a good idea?

A: No. You want to be gentle to dry skin. Exfoliating “just makes it worse,” Saedi said.

Q: What about showers?

A: Sadly, these doctors want to take all the joy out of showers. Hot, steamy showers may feel good for your muscles and your sinuses and your soul, but they dry out skin. The doctors want you to take lukewarm showers that last five to 10 minutes. (Trust us, 10 minutes is a long time in lukewarm water unless you keep your house really toasty, and you’re not supposed to do that, either.)

There’s no need to lather all over. Unless you are covered in dust or mud, you only really need to soap the smelly parts.

Q: What soap should I use during my short, chilly shower?

A: Doctors like simple, unscented bar soaps with added moisturizers. Lipoff says people tend to overuse the liquid soaps. If you must use a liquid, Saedi says, go with one that is fragrance-free and says it’s for sensitive skin. Patel likes cleansers from Vanicream and Cetaphil.

Steer clear, the doctors said, of strongly scented soaps such as Irish Spring and Zest because they can irritate skin.

Q: Should I wash my face differently?

A: Yes. You only need to wash it once a day, in the evening. You can just rinse in the morning. You don’t necessarily need a different cleanser for face and body.

Q: Do I really have to put lotion on while I’m wet from the shower?

A: The doctors agree this is better, but they don’t mean dripping wet. Pat yourself down with a towel, but leave a little moisture. Immediately rub on some lotion to trap the moisture against your skin.

Q: What kind of moisturizer should I use?

A: There’s no need to spend a fortune on what Patel called “Hollywood” skin creams. The fancy stuff sometimes contains scents and additives that are irritating.

“You have to understand that most of the skin-care industry is marketing,” Lipoff said.

The doctors had different favorite products, but they agreed on one of them: petroleum jelly. You can’t beat it for value, they said. It’s great for your lips, but probably not what you want for the rest of your face. There, you’re looking for products that are noncomedogenic, which means they don’t clog pores.

Because it can feel a little thick and greasy, it may be best to apply petroleum jelly to your body at night.

The doctors also agreed that thicker is better, which generally means you want products sold in jars, not tubes. “When in doubt, just look for the cheapest thing you can get in a jar,” Patel said, adding that he prefers “established brands.”

Lipoff suggests starting with inexpensive products and working your way up until you find something that works for you.

Saedi and Patel tend to like products you can get at the drugstore, but not at the lowest price points.

Saedi looks for thick creams that contain ceramides and hyaluronic acid. She likes Neutrogena Hydro Boost and Neutrogena Norwegian Formula hand cream.

Patel recommends Aquafor, Aveeno, CeraVe, and Eucerin products.

For skin that is more seriously dry and cracked, patients can try “acid-based” creams such as Amlactin and CeraVe SA. For the face, he said products by Vanicream, CeraVe, and Cetaphil are good.

The doctors did not recommend oils and said that a lot of people find lanolin, a key ingredient in some products, irritating.

Q: How often should I use skin cream?

A: Twice a day.

Q: What if my scalp feels dry, too?

A: Patel said this is probably seborrheic dermatitis or dandruff, not dry skin. Rubbing oil into your scalp won’t help that. Use a dandruff shampoo.

Q: Will a humidifier help?

A: Yes. Patel said 40% humidity is ideal at home and at work. The bedroom is a good location because that’s where you spend the most time at home.

Q: What mistakes are patients making?

A: Patel has patients who like to rub their skin with alcohol and peroxide. That is very drying. Noxzema is too harsh for most people, he said, and back scratchers can break fragile skin. The doctors agreed that trendy tea tree oil can be problematic. Allergic reactions to it have been increasing.