In the fall and winter I start to see a lot more patients with dry, itchy skin so I though I would share some tips for keeping your skin healthy this time of year.

Dry skin equals Itchy skin

When the skin dries out it we become itchy.  Nerve fibers are more easily activated and the skin itself becomes a lot more prone to irritation.  This all leads to a dramatic increase in itching.  One of the single most important things in preventing itch is ensuring that the skin is well moisturized.  Once the skin becomes itchy, it is almost impossible to relieve the itch on a long term basis unless the skin is well hydrated.

Hot showers dry the skin out

Hot showers, especially the kind that feel really good on these chilly mornings we have been having open up all the pores in your skin.  This leads to a rapid loss of moisture in your skin.    Certainly, hot showers tend to relieve itching for a few minutes, but in the long term they make the problem worse because it takes about a day for the skin to recover this moisture.  If you find that your upper back is really itchy, its very likely that hot showers are a big part of the problem.

Most soaps dry the skin out

Soap is designed to remove dirt and emulsify oils.  So, while soaps make you very clean, they also strip all the protective oils from your skin.  Many soaps are also filled with a variety of irritants that can exacerbate dry skin.  Fragrance (Irish Spring, the entire Axe line, everything Bath and Body works has ever made) is often irritating.  Anti-bacterial agents are also often very irritating.

If you have visible dirt to remove, then you need soap.  However, most of the time most people really only need soap to clean their armpits and groin area.

My favorite soap for dry skin is no soap.

My second favorite soap for dry skin is Eucerin Calming Wash.  This stuff is quite inexpensive, has no fragrance, and contains omegas and other natural lipids to help moisturize the skin.

For kids, I really like Aquaphor Baby Wash.  This is also fragrance free and very gentle. Most importantly, its tear-free.  I’ve had a very hard time finding a good baby cleanser that is also tear free, so I was very happy when this came along.  I’ve been using it on both of my kids for years now.  I must also admit I like that it can be used to wash their hair and body.

Baths can help out a ton

There is a misconception that taking a bath will dry your skin out more.  Hot showers will, but baths usually do not.  But, if you put a bath oil into the tub like Robathol into the tub and soak, it will actually put moisture back into your skin.

The best time to moisturize is right after bathing

Right after you get out of the shower or finish your bath, pat dry and apply moisturizer.  Your skin is very receptive to moisturization at that moment, so whatever you apply then will have the greatest impact.

The best moisturizers are the simplest

In terms of sheer moisturizing power, nothing has ever beaten plain vaseline in any head to head study.  Its dirt cheap, bland, but certainly a bit messy.  But it still has a role:

• Vaseline on the feet can be awesome for dry cracked feet.
• Itchy calves can be relieved with vaseline at night covered up with long tube socks.
• Little kids don’t mind it.  Itchy babies can be made better overnight by coating them in vaseline and stuffing them into pajamas overnight.  It might take two people to do it, but the next day their skin will be like butter.

Most people will prefer a cream based moisturizer instead of vaseline.  The key here is to avoid ones that have all kinds of extra additives.  Most of the extra junk that manufacturers put into creams are more likely to be irritating than helpful.  Good choices:

• Vanicream.  This was developed at Mayo as part of a quest to create the perfect moisturizer for people with sensitive skin.  All of the top allergens have been eliminated from it.  Its one of the simplest cream based moisturizers ever made, one of the best tolerated, and one of the most effective.  However, its still made in Rochester MN and the further you are from there, the harder it is to find.  Medical Center Pharmacy in Issaquah stocks it.
• Cerave.  Research suggests that fatty acids called ceramides that our body makes these naturally are important for skin health.  It seems that applying them topically is also helpful and Cerave is one of the best products out there that uses this approach.