It’s the most wonderful time of the year. Yep, winter is here, and hopefully you are in full holiday mode. What could be better than watching “It's A Wonderful Life” for the 32nd time, drinking wassail or eggnog lattes (yum!), breaking out those exceptionally UGLY sweaters (you know who you are) and hoping to wake up on Christmas morning to fresh powder and that awesome new North Face jacket you have been eyeing...
FIRST, THE POSITIVE.
On one hand, you have all the things that make getting in the holiday spirit so memorable:
The lights. Those beautiful, twinkling and brilliantly colored Christmas glow bulbs. And for those of you who go full-on Griswold's with your lights or decorating technique, I LOVE driving by to look at your "illumination mastery." ;)
The Perfect tree. Fat vs thin, real vs artificial, Blue Spruce vs Fraser firs---finding that perfect tree (tall and thin Charlie Brown style is my fav) and decorating it with my family, (Christmas music jamming on the day after Thanksgiving usually) is something I truly look forward to All. Year. Long.
That Holiday Food. Turkey, Ham, Stuffing, Pumpkin or Gingerbread anything, Sugar cookies with creamy frosting, need I say more?
Your Friends and Family. As the year finishes up, I especially enjoy spending quality time with friends and family...whether we are playing games (Monopoly anyone?), heading to a concert or play, or just getting together for a little low-key madness and mayhem!
"Oh the weather outside is frightful..." Aww yeah- sing it to me Bing Crosby! You are so speaking my language. Because when the weather changes into the colder, drier conditions known to all Coloradans as "arctic winter weather," I start seeing more patients with this simple complaint: "Itchy/Scratchy/Lizard-like Skin." Enough to make you wanna scream BAH HUMBUG, right??
Dry, itchy skin is a problem everywhere, but it is even more prevalent in the more arid western states like Colorado. The high altitude (5280 feet above sea level in Denver, 9000+ here in Summit County) coupled with particularly low humidity makes for extremely unhappy, negative conditions for your skin anytime of year, even in the summer months. But then add colder temperatures to the mix during this winter/holiday season and the majority of us find we have real skin concerns if we are not preventative and on top of this early on.
Dry, flaky skin. Whether you notice the constant itching EVERYWHERE, the initially small cracks on your hands, feet and elbows that seem to get larger and more ugly as time progresses throughout the winter months, and oh my goodness, EVERYTHING HURTS.
Yikes! I don't care how tough you think you are or claim to be....this will ruin ANYONE's holiday spirit. :(
THAT SLIPPERY SLOPE OF DRY SKIN SIGNS & SYMPTOMS
We just talked about how having dry skin is a real pain in the, well, you know. Literally. You know that feeling you get when it doesn't matter what you do, no amount of cream or lotion seems to keep your skin soft and silky smooth? You try to put on your gloves and the dry skin flakes seem to catch on the lining and rip your skin open further? Or the lizard-like texture on your feet sounds like sandpaper scratching against your sheets or blankets when you slip into bed for a little much-needed rest?
You may be asking "How am I supposed to enjoy the holidays like this?" If not properly managed at this phase, the next phases of progression can bring you to a whole new level of misery.
Your skin begins to crack. Maybe it started as just a small cut on your knuckle or elbow. And then it grew into this enormous crack that is painful every time you move. And WOW, now you can't even put your skin under hot water without supreme levels of torture-OUCH!
That darn red nose. And no- we’re not talking about redness on the outside like Rudolph. If you're like me, you get that super duper inconvenient bloody nose at just the wrong time...well, you probably know the scene well since many of my readers also live in Colorado. It’s right at Christmas dinner in front of Aunt Tilda and Uncle Roscoe. Yep, I'm pretty sure I will never get ANY type of invite to their house again. Or you go to take that holiday office photo with the boss and BAM! You look like an alternate actor for Texas Chainsaw Massacre! Ugh, why now nose? This is the worst, so embarrasing! No one will want to do Secret Santa with me now. Yes, a bloody nose can be a life changer or at the very least, an unwelcome guest at the party.
WATCH THIS VIDEO -
And of course, everyone's favorite winter and holiday ailment - CHAPPED LIPS. Most noticeable right when I am going to kiss my wonderful hubby under the mistletoe...Perfect!
Are you kidding me? I was just out in the cold for 5 minutes getting some firewood and I come back in and yep, I must have grimaced too widely with my wonderfully chapped lips and now I am tasting the blood from one of the cracks I have angered. Now where is my tub of thick and therapeutic Vaseline or Aquaphor to douse these lips with? Must deal with this STAT, it's already pretty painful within the first few seconds of rearing it's ugly head.
Have you ever experienced anything like this? Your scene may have been different, but the side effects and feelings were likely similar.
Now we are definitely not talking about life-threatening conditions like some of my previous blogs have (as in wondering if a strange and rapidly growing brown spot or mole is a form of Melanoma skin cancer or if an infection turns into a dangerous, potentially fatal problem like sepsis). But rather, having dry and itchy skin can be a real "fun ruiner," especially during this festive time of year.
READ MY BLOG ON BROWN SPOTS HERE
READ MY BLOG ON THE DANGER OF SEPSIS HERE
KELLY, I USE LOTION ALL THE TIME, WHY IS MY SKIN STILL SO DRY?
Well, not knowing your exact lifestyle at home, work or play, I can tell you what many of the men, women, and even children I have met over the years are struggling with.
Now most people outside of the medical field are usually clueless to this, but one of the main culprits for dry hands is, wait for it.... WASHING YOUR HANDS (OR ANY REPETITIVE EXPOSURE TO WATER). I know, I know, we are taught and have built up our habits to wash our hands constantly. Isn't that how we keep disease and infection away?
Yes, yes it is. But it's this very clean habit that can cause our skin so many problems. Like dry and itchy skin. You see, every time you wash your hands in water, and hopefully you are using soap, that exercise in cleanliness robs your skin of it's natural protective barrier and vital natural oils. And just like it suggests, when you “DRY” your hands, guess what you are doing? Yep, you are drying out your skin and further disrupting the protective skin layer.
Now, if you or someone you know is either a worker in the restaurant or hospitality industry, an auto repair technician, a health care worker, nurse, doctor, dermatologist, or even a mother with children who are seemingly into everything or need regular diaper changes, you are probably washing your hands with more than average frequency.
In fact, some professionals may wash their hands or get their hands wet (washing dishes, cleaning, rinsing and prepping food, etc) HUNDREDS of times in any given day. Ugh, no wonder their hands are so sad!
But let's take a moment to seriously address this condition that has been a daily battle for thousands of my patients over the past 20 years I have been in medicine. This type of excessive chronic exposure to water isn't just robbing their skin of precious moisture and oils, but it can also cause long-term discomfort, increased risk of infection when the barrier is consistently broken down, and a steady stream of self-consciousness or embarrassment over the unsightly appearance of the skin.
This sounds great, sign me up for a double dose of that, right? No way. This is something I would not even wish on my worst enemy. Having to think about what someone else is going to think with the simple act of shaking hands? Not wanting to even touch others because our skin is so rough and may be interpreted as an attack instead of an act of affection? Believe me, when I first started working in the Emergency Room and was washing my hands >100 times per 12-hour shift, this WAS my reality. And it wasn't fun or pretty. Which is why I can speak to this topic personally and with the compassion I wish my co-workers and attending docs had for me at that time. Thankfully for all of you who are past or future patients, saying "Buck up and just DEAL WITH IT" simply does not fit in my "I will do everything in my power to help you" wheelhouse. Just stay with me for a few more paragraphs and I promise I will disclose helpful tips to prevent this.
KELLY, MY HANDS AND FEET HAVE CRACKS AND CREVICES IN THEM THAT ARE SOOOOO PAINFUL.
If your skin begins to show signs of extreme dryness and irritation, and if you do not properly address it, of course it will go from bad to downright evil.
Your skin may initially develop cracks and fissures that may expose underlying tissue. Then you may start to experience bleeding, swelling and even signs of an infection.
In many cases, even before you notice a crack in the protective barrier of your skin, it has been damaged and exposed to the point where bacteria and other organisms may enter. If you are unaware an infection is developing or if you are not given proper treatment for the organism causing the infection, this can cause even more complications such as severe pain, fever, red streaking on the skin symbolizing spread of infection, and possible amputation or even death in worst case scenarios. (See Sepsis link above)
For those of you who are visual/literal learners (like me!), let me illustrate this point with an analogy. Think of the wood used on your patio, deck, or even the exterior of your home. This wood, when exposed to the elements over time, goes through aging and drying. If you don't continually apply primer, paint, oil, or varnish with the right level of protection, then that wood will succumb to cracks, chipping, peeling, and even structural failure. Think of your skin in the same way.
Now put that same home and its wood elements into harsher conditions like G-force winds, severely cold temperatures, high altitude, and a low moisture environment. Yep, all of those consequences I listed above are rapidly accelerated (for both the wood as well as your precious skin).
HOW TO KNOW IF I HAVE SOMETHING MORE CHRONIC THAN JUST DRY SKIN.
If you are referring to Eczema, you may definitely have more challenges than just trying to prevent and recover from your average Coloradan's winter-induced dry, itchy skin. Read on...
What is Eczema?
The National Eczema Association (NEA) states that “Eczema is the name for a group of conditions that cause the skin to become red, itchy and swollen or inflamed. There are eight types of eczema: atopic dermatitis, contact dermatitis, dyshidrotic eczema, hand eczema, lichen simplex chronicus, nummular eczema, seborrheic dermatitis and stasis dermatitis.”
According to the NEA, the actual cause of Eczema is not known but researchers have concluded that both environmental factors and genetics play a role. Individuals who have a more sensitive immune system may suffer from "eczema triggers" like stress, dryness of their skin or contact with irritants (cigarette smoke, chemicals, certain fabrics or fragrances) due to other types of allergic reactions.
For example, Atopic dermatitis is the most common form of eczema that usually begins in infancy or early childhood and is thought to be due to an overactive immune system, genetics and environmental triggers. While many think you just outgrow it, statistics show that 17.8 MILLION Americans are suffering with this condition every day.
Symptoms of Eczema include:
Dry, super-sensitive skin
Leathery looking patches
Swelling or inflamed areas
Oozing or infected cuts or nicks
But you have to know you have a problem before you can effectively treat and manage it. If you have any of the above signs or symptoms (or even any not mentioned that pertain to your skin), please visit your favorite dermatology provider as soon as possible.
SO WHAT ARE THE BEST REMEDIES FOR MY NON-MERRY, NON-FESTIVE DRY SKIN?
Well, I’m not going let the dry skin Grinch steal all of your holiday spirit. Nope. Here are some of the best ways to combat your specific problem...
HELP YOUR DRY SKIN COMPETE WITH THE FABULOUS COLORADO WINTER WEATHER
Limit your water exposure. If you get your hands wet or wash your hands often, think about wearing protective water-proof gloves up to your elbows. This prevents your protective barrier and natural oils getting robbed from the soap, water and drying action.
Limit your environmental exposure. Cover up as much as possible when you go outdoors, leaving as little skin as you can exposed. This means scarves, buffs or neck gaiters, hats, thick gloves, and a proper coat. And if you are going to be working around chemicals, fragrances, or other potential irritant, wear the same type of gloves discussed above for water exposure.
Hydrate. I suggest drinking 3-4 liters of water a day when living/working/playing in a high altitude environment like Summit County, especially if you are not used to high altitude or are only here for a brief visit. But, in all honesty, studies show this most likely has no effect on your dry skin. However, this may support you not getting altitude sickness which is much worse than dry skin. Your welcome.
Keep Vaseline or Aquaphor on hand. The thick, sticky stuff. Both come in little portable tubes and are, in my experience, the best way to keep moisture in. I tell my patients to put this on a MINIMUM of 4 times a day (after each meal and before bedtime) and more often as needed. Remember, over-exposed elements are always more prone to dry out, so you need a barrier on consistently to prevent dry, cracked and chapped lips. And, if you are not a fan of either Vaseline or Aquaphor, check out this list of moisturizers that have received the National Eczema Seal of Acceptance:
That ill-timed, oh-so-humiliating bloody nose can be managed by keeping the membrane inside the nose moisturized. And no, your snot and mucus doesn't count as effective moisturizer for most residents in Colorado. If you are prone to nose bleeds, apply the same moisturizer you like on your lips to the inside of your nose on both sides. Simplify your life and just moisturize both areas at the same time. I would do my lips first for obvious reasons. ;)
CUTS AND NICKS
If you experience cracks and open areas in your skin due to dry skin, it is time to get professional help. Especially if you are concerned for infection developing. Your dermatology provider can not only support you in preventing future outbreaks but can also come up with a treatment and management plan to stop further damage to your skin.
THE BOTTOM LINE - I AM HERE TO INCREASE YOUR HOLIDAY SPIRIT
For years, my patients have been asking my staff "What do you give her every day for her to be this happy and positive?" The secret is....I truly LOVE what I do and feel so blessed to be able to serve the Summit County community with this Derm-Nerd passion. And, I am all for creating ways to capture more holiday spirit for everyone...whether it is changing someone's life by teaching them how to control their unruly skin or removing a potentially dangerous skin cancer. Same amount of "good juju" in my eyes. And if you have been dealing with dry, itchy, red skin for too long, well, consider this an early Christmas gift from me to you. Forgive me for not including my signature big red bow. :)
I hope you found this blog article informative and if you know someone who is also suffering from any of the symptoms referenced in this article, please don't be stingy. SHARE IT!
As we get closer to Christmas and deeper into the winter months, it will be more crucial for you to think about what the harsh Colorado elements do to your skin and how the play and work preventative measures listed above can contribute to having a very merry life (during the holidays and beyond).
As you know, I love Colorado and pretty much everything that goes along with living here. This is why I choose to live, work and play here in Summit County. I look forward to seeing all of you in this wonderful area of the world in the upcoming months. I'll be hitting the slopes and strolling through downtown Frisco, Colorado this holiday season...see you there?
WANT MORE TIPS ON TAKING CARE OF YOUR SKIN? DOWNLOAD MY FREE WHITEPAPER
Kelly Ballou, PA-C
Co-Founder Renew Dermatology
Frisco, Colorado (Summit County)
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