health

Cold weather brings itchy, irritated, dry and scaly skin – here's how to treat eczema

11 Comments
By Sonal Choudhary and Jeffrey Chen

In many parts of the U.S., the winter months bring frigid temperatures and drier conditions that can wreak havoc on the skin.

The primary role of the skin, as the largest organ in the body, is to act as a physical barrier to the external environment. When your skin is healthy, it helps protect you from allergens and infections. But in winter, when the outside temperature and humidity drop, skin can become especially irritated.

We are a dermatologist and a medical student who study a broad range of common skin conditions and the effects of the environment on skin health.

Heading into the winter months, a handful of common dermatological conditions can develop or worsen in response to the cold. These include eczema, chilblains, Raynaud’s phenomenon, cold urticaria and cold panniculitis. All are conditions that can be irritating and uncomfortable, and some are harder to treat than others. So it’s helpful to know when to manage these conditions on your own and when to see a dermatologist.

Eczema

Eczema is an inflammatory skin condition that causes dry and itchy skin and may be triggered by soaps and detergents, environmental or food allergens, hormonal changes and skin infections. There are numerous types of eczema, which often have overlapping symptoms.

Asteatotic eczema, also known as winter itch, is common in older adults. During the winter months, skin can become drier and, in some instances, cracked, fissured and inflamed.

Severe dryness may lead to itchiness and scratching. In turn, this can create open wounds that may allow allergens and bacteria to penetrate the skin and cause a rash or an infection.

This type of eczema typically occurs on the lower legs, but eruptions can occur anywhere on the skin, such as the trunk, arms and hands.

Keeping the skin hydrated is the primary treatment. Water-based lotions may worsen skin drying, so applying moisturizers with a high oil content – like petroleum jelly, mineral oil or Vaseline – on wet or damp skin is recommended. Hypoallergenic and anti-itch moisturizers designed specifically for eczema are also available.

Other tips include replacing long hot baths with quick warm showers, switching to a milder soap, and using a room humidifier if the climate is dry. If itchiness and dryness persist, seek care from a dermatologist, who may prescribe a topical steroid.

Hand eczema may also worsen in the winter as your hands are frequently exposed to cold, dry air. Scaling, fissuring and bleeding on the hands is common. Minimizing exposure to hard or antibacterial soaps, along with using gentle cleansing products followed by applying a petroleum-based unscented moisturizer can improve symptoms.

Chilblains

Chilblains, also known as pernio, are small, itchy patches that can occur when the skin is exposed to cold and damp weather, resulting in swollen and painful bumps that affect the fingers, toes, ears and face. Poor circulation, blood vessel constriction, a history of autoimmune disease and being underweight may predispose people to chilblains.

Afflicted areas are painful, itchy, swollen and usually have a blueish to purple hue. In severe cases, blisters and ulcers may occur. But for most people, the condition tends to spontaneously resolve within one to three weeks.

Until that happens, it’s important to keep affected areas protected from the cold. If the sensitive area starts to blister, or if fevers, muscle aches and chills develop, it’s best to see a dermatologist or physician.

Pseudo-chilblains, also known as “COVID toes,” can be caused by COVID-19 infection. Chilblains associated with COVID-19 resemble the rash in chilblains – painful red to blue-colored nodules on the toes – but it is not specific to winter.

Raynaud’s phenomenon

Like chilblains, Raynaud’s phenomenon is a skin condition characterized by an significant constriction of blood vessels in the fingers and toes in response to cold exposure. The digits may turn red or blue, but they quickly flush red upon rewarming. Afflicted areas may also be numb or painful, and when severe, may develop ulcers.

To treat Raynaud’s phenomenon, it’s necessary to avoid cold-weather exposure. Ideally patients with Raynaud’s should dress for the cold in layers. At a minimum, make sure to wear gloves and insulated footwear. Avoid tobacco, caffeine and decongestants; they may cause blood vessels to constrict more. If symptoms don’t improve quickly – Raynaud’s due to cold typically gets better after only a few minutes – see a dermatologist or your physician, as Raynaud’s phenomenon can also be a manifestation of a more serious systemic disease, including cancer, infections and/or trauma.

Cold urticaria

Cold urticaria is a skin rash believed to be triggered by an autoimmune response, which leads to the release of inflammatory molecules, including histamine.

Soon after the skin is exposed to sudden drops in temperature, wheals – also known as hives – may develop. These are reddish, itchy and swollen areas of skin. Such episodes can last for approximately two hours. Occasionally, other symptoms accompany the outbreak, including headache, chills, shortness of breath, abdominal pain and diarrhea.

People can test for cold urticaria using the ice cube test. This is done simply by placing an ice cube on an area of skin for five minutes; if you have cold urticaria, the skin will raise and itch within five to 15 minutes. Treatment involves avoiding cold exposure and using over-the-counter antihistamines.

For those who have experienced cold urticaria, swimming in cold water can be dangerous, as it can lead to loss of consciousness and drowning.

Cold panniculitis

Cold panniculitis – which appears as enlarged, red and painful nodules on the skin – develops 12 to 72 hours after cold exposure.

Cases of cold panniculitis have been documented in children eating Popsicles and in adults undergoing whole-body cryotherapy, which is often used as treatment for chronic inflammatory conditions such as rheumatoid arthritis, or for improving post-exercise recovery.

Cold panniculitis is more common during childhood and usually resolves on its own by avoiding cold exposure and direct contact with frozen products.

Symptoms from winter skin conditions are often self-limiting and resolve on their own with adequate protection from the cold. But if symptoms do not resolve, you should see a licensed dermatologist, as cold-induced rashes may be a sign of a more concerning underlying health condition.

If visiting your dermatologist in person proves difficult, you may consider seeing a dermatologist virtually, as many academic medical centers and private practices now offer telehealth dermatology.

Sonal Choudhary**, MD, is a dermatopathologist at the University of Pittsburgh Health Sciences. Jeffrey Chen is a medical student**University of Pittsburgh Health Sciences.

The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.

© The Conversation

©2023 GPlusMedia Inc.

11 Comments
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Goats milk

1 ( +2 / -1 )

Dryness causes me an itchy back and I also get chilblains on my toes. Use creams on my back and rub cream on my toes or a hot patch on my socks. Use a Drop water humidifier in the main room.

1 ( +1 / -0 )

A common joke between dermatologists (that fortunately is changing in recent times) is that this medical specialty has to deal with thousands of problems relying mostly in only half a dozen things to solve them. I remembered this joke while reading the article and seeing moisturizers, steroids, antihistamines and antibiotics as the recommended medical treatments.

For good or for bad many of the dermatological problems are treated more easily with changes in lifestyle than with drugs, so this article can be very useful to people so they can try the simple methods recommended here first before visiting their doctors.

3 ( +6 / -3 )

If your skin cracks, particularly on the knuckles/joints, in cold weather, wear a pair of disposable plastic gloves at night. Your skin will soften as if you were using moisturiser. Turn the gloves inside out, clean and dry them, and re-use them the next night. A pair will last you some time.

Dry skin on your chin may be razor burn. Apply an OTC hydrocortisone cream several times a day.

2 ( +2 / -0 )

Good to see some cold weather coming through with all the climate change propaganda floating around.

A common joke between dermatologists (that fortunately is changing in recent times) is that this medical specialty has to deal with thousands of problems relying mostly in only half a dozen things to solve them.

No such joke exists in the Western world with dermatologists.

What is your source on which you are relying for this story?

-6 ( +1 / -7 )

Good to see some cold weather coming through with all the climate change propaganda floating around.

You seem to realize that we have two separate words, "weather" and "climate". A possible next step would be to look up the difference between the two.

Saying "ooh, it's snowing, see, there's no global warming" is a bit like saying there's no global food shortage because you just had a good breakfast.

3 ( +4 / -1 )

Roy SophveasonToday  03:01 pm JST

You seem to realize that we have two separate words, "weather" and "climate". A possible next step would be to look up the difference between the two.

Saying "ooh, it's snowing, see, there's no global warming" is a bit like saying there's no global food shortage because you just had a good breakfast.

Is that your perception? Lots of leaps of logic in there!

So another article here says "ooh, greenland is getting warmer"; according to you that would be like saying there is a global food shortage because I just had breakfast.,

https://japantoday.com/category/features/environment/new-ice-core-analysis-shows-sharp-greenland-warming-spike

-6 ( +1 / -7 )

So another article here says "ooh, greenland is getting warmer"; according to you that would be like saying there is a global food shortage because I just had breakfast.,

I am genuinely curious as to whether that sentence even made sense in your own mind, logically or semantically.

5 ( +6 / -1 )

No such joke exists in the Western world with dermatologists.

According to what? your authority? claiming to know all conversations between dermatologists in the world (necessary to say this joke does not exists) is terribly irrational and unbelievable, what evidence or on whose authority can you support this claim?

What is your source on which you are relying for this story?

Conversations with dermatologists, you can always claim not to believe this, but since you claim is that this does not exist that means you require evidence for this.

So another article here says "ooh, greenland is getting warmer"; according to you that would be like saying there is a global food shortage because I just had breakfast.,

You keep making nonsensical comparisons that have nothing to do with the topic being discussed, same as with your claims of knowing all the conversations in the world you need to support your claims with actual arguments and sources, specially about the topic being discussed in the article.

6 ( +7 / -1 )

We are a dermatologist and a medical student who study a broad range of common skin conditions and the effects of the environment on skin health.

Sounds like a small pool.

I talked to some dermatologists once and they told me some serious information, and there were no inside jokes.

-4 ( +0 / -4 )

I talked to some dermatologists once and they told me some serious information, and there were no inside jokes.

And that is the source you use to say this joke do not exist anywhere in the world? that would be a much better example of an invalid source.

It is understandable that no inside jokes are used when the participants are not "inside" the ingroup. That does not prove in any way that those can be used (an they may be even common) in other contexts.

0 ( +0 / -0 )

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