By Talia Abbas-Self
For all of winter’s much-anticipated seasonal joys, like hot chocolate by the fire, there’s always a downside. For many of us, it’s dry, itchy skin. The cold outdoor climate and bursts of dry indoor heat often exacerbate dry skin conditions like eczema and put a damper on the season.
During the winter, eczema mainly stems from transepidermal water loss, or dehydration of skin cells, and a compromised skin barrier from lack of skin lipids. However, there are many different types of eczema, and a dermatologist can diagnose which specific type you are experiencing. The most well-known is atopic dermatitis, which experts refer to as “classic” eczema because it can make skin super dry, itchy, and inflamed. Atopic dermatitis can also present as small bumps filled with fluid which break when scratched—and lead to painful infections.
Shasa Hu, M.D., dermatologist at the University of Miami Health System, tells SELF she sees many people come in the office with a special type of eczema, called asteatotic eczema, during the cold winter months. Asteatotic eczema gives a fish scale-like appearance to the skin, particularly in lower legs, which makes it look rough and ashy. In more severe cases, Hu says, people can have itchy, red areas where the skin surface is broken, giving the skin a cracked look similar to cracked porcelain. (Asteatotic eczema is also known as eczema craquelé).
The treatments for both types of eczema require gentle skin-care and frequent moisturization. However, Hu says atopic eczema appears year-round, and is usually genetic or exacerbated with environmental allergies. Asteatotic eczema, on the other hand, is more seasonal, and fall and winter are the most common times that people experience eczema flare-ups.
If you’re experiencing eczema this winter, there’s still time to adapt your skin-care routine to manage the itching and pain with this expert advice.
- Use a humidifier.
Drier air means drier skin. Therefore, experts recommend adding moisture to the air with a humidifier in your bedroom. Hu recommends the Crane Ultrasonic Cool Mist Humidifier, $43, since she prefers cool mist over warm mist for safety reasons.
- Minimize long showers.
Everybody enjoys a long, relaxing shower. It’s an OG form of self-care, right? But showering for too long—especially with hot water during the winter—strips the natural oils from your skin and causes it to dry it out even more, Lily Talakoub, M.D., dermatologist at McLean Dermatology and Skincare Center in Virginia, tells SELF. Instead, she recommends patients with eczema shower for less than five minutes and use lukewarm water. Additionally, a high mineral content in tap water can dry out the skin and make eczema worse, she says.
- Moisturize twice a day with a thick cream or ointment.
“Eczema is a sign of skin sensitivity, and that sensitivity often stems from damage to skin barrier, which then leads to increased exposure to environmental allergens, chemicals and irritants,” Hu explains. When the skin barrier is compromised, a host of cellular reactions—like the red, dry, and blotchy skin—can occur. Dermatologists we spoke with agreed that you have to moisturize with a thick cream twice a day, as it takes at least four weeks of consistent application to manage the symptoms of eczema.
The formulations for over-the-counter moisturizing products all differ. (A quick skin-care primer: Gels are mostly formulated with water and alcohol, while lotions are a combination of some oil and a lot water. Creams contain equal percentage amounts of oil and water, while ointments are mostly oil-based, meaning they are the most emollient.) In general, experts recommend opting for creams and ointments over gels and lotions, as they have more amounts of oil and are thus more nourishing. Ointments generally stay on the skin longer than creams and gels, and experts recommend plain Vaseline, $5, or Aquaphor, $7, as two good ointments for eczema-prone skin.
As an alternative for those who don’t like the greasy texture of an ointment, Hu also recommends Curel Hydra Therapy Wet Skin Moisturizer for Dry and Extra-Dry Skin, $9. It has a water-activated formula that allows nourishing ingredients like ceramides and shea butter to penetrate deeper and stay longer on the skin. Also, like Vaseline and Aquaphor, it is fragrance-free, which is safe for even the most sensitive skin, she says. Experts say that as long as you are ok with greasy skin, the thicker the cream or ointment, the better, since they hold moisture in the skin for longer.
- Gravitate towards natural fabrics.
Cold weather usually means piling on the layers, but clothes that are made of synthetic fabrics can trigger eczema for people with sensitive skin, Hu explains. Check the labels of your favorite knits and look for 100% pure cold-weather fabrics like cotton, silk, and cashmere. Wool and polyester may keep you warm, but can cause skin to become irritated and red. Saint Haven’s Second Skin Legging, $88, is hypoallergenic and antimicrobial, and the brand makes other loungewear for adults and children with sensitive skin concerns.
Sleeping on cotton sheets can also make a difference, Talakoub says, noting that polyester blends can be irritating for people with eczema. We recommend Gryphon’s Comfort Washed Sheet Set, $140, which is made of 100% pure Supima cotton.
- Look for moisture-retaining ingredients in your skin-care.
When shopping for facial moisturizers, look for hyaluronic acid, squalene, dimethicone, and ceramides, as these hydrating ingredients hold moisture in the skin. Talakoub recommends Peter Thomas Roth Water Drench Hyaluronic Cloud Cream, $52, and Hu likes Dr. Brandt Skincare Hydro Biotic Recovery Sleeping Mask, $52, which is an overnight leave-on gel moisturizer.
A trick Hu recommends for both severely dry and eczema prone skin is to “double hydrate”—apply a cream-based moisturizer first, then “seal” the cream in with an ointment-based product to prevent or minimize skin’s water loss. Bear in mind that for eczema patches on your body, where skin is often thicker, more frequent application is needed than on the face.
- Avoid known irritants in cleansers.
The skin on our face can be more sensitive to chemicals and temperature changes because it is the most exposed part of our body, Hu explains. Therefore, when cleansing any facial patches of eczema, make sure your products contain the least amount of known irritants, such as added fragrances, preservatives, and surfactants. All skin with eczema should be considered “sensitive skin” and you should be cautious about the ingredients in the products you use. “Once that immune system is sensitized, any exposure to chemicals or an impaired barrier from over-drying of the skin will trigger the skin immune system to react, resulting in flare-ups,” Hu explains. Additionally, foaming cleansers, gels, and shaving creams can also exacerbate dryness, so stick to cleansers that hydrate.
- Skip antioxidant gels, but do use antioxidant serums.
While most summertime skin-care products get swapped during the winter, you can continue to use your favorite serums all year long. Talakoub says people can still use their antioxidant serums during the winter, but advises them to avoid antioxidant gels, which can sometimes be drying to patients with eczema. The reason? Gels are alcohol-based, which is better if you have oily or acne-prone skin, while most serums are oil-based. Although gels containing alcohol tend to be less greasy, they can be irritating to dry, sensitive skin. For patients with eczema, she recommends iS Clinical Pro-Heal Serum Advance Plus, $148, which contains the powerful antioxidant vitamin C. Apply the serum as a first layer in the morning, before layering on heavier products.
- Light exfoliation is OK but don’t overdo it.
Gentle exfoliation once or twice a week is important to care for dry skin, as it allows for better penetration of your moisturizer, Hu says. For people with eczema-prone skin, she recommends a soft wash cloth or honey-based sugar scrub for exfoliation. Avoid more aggressive body scrubs for exfoliation, as they can further irritate dry, cracked skin, Talakoub says.
You should also avoid harsh peels or overuse of retinol treatment, as these are stronger exfoliants that can cause extra dryness during the winter and irritate eczema. We recommend Kate Somerville’s ExfoliKate Gentle Exfoliating Treatment, $65, which contains Vitamin E, aloe vera, and lactic acid.
- Oils are your friends.
Products formulated with natural oils like argan or sunflower are recommended, as they contain fatty acids that keep skin hydrated. Talakoub prefers oil-based cleansers for all skin types, including eczema-prone ones. “They remove dirt and makeup without stripping the natural oils and skin barrier of the skin,” she says. Talakoub likes Bioderma Atoderm Cleansing Oil, $6, which is gentle cleansing oil for the face. We recommend Avene XeraCalm A.D Lipid-Replenishing Cleansing Oil, $31, which is formulated for people with eczema, and Bioderma Atoderm Shower Oil, $20, which is a cleansing oil made for dry skin.
- Cut back on other sneaky irritants in your life.
If you are taking short, lukewarm showers, using a humidifier, and coating your skin with nourishing creams, but still experience irritated skin, then you’ll need to look elsewhere in your environment to find out what’s wrong. Experts recommend eliminating perfumes, which have the potential to be irritating regardless if they’re made in a lab or are derived from a natural plant oil. Choose laundry detergents wisely as well, opting for fragrance- and dye-free detergents, like Dropps HE Sensitive Skin Laundry Detergent Pacs, $30. Avoid dry cleaning your clothes as much as possible, as chemicals used in the process can trigger eczema.
- Know when it’s time to seek medical treatment.
When you can’t break the “itch and scratch” cycle no matter how much moisturizer or anti-itch cream you apply, experts recommend seeking medical treatment from a board-certified dermatologist. Some warning signs to look out for: persistent itch, trouble sleeping, or redness and inflammation with yellow crusting, as this could be a sign of infection. In general, topical prescription medications are anti-inflammatory and will help to speed up the healing of eczema patches, Hu says.