Every winter, I sense the need to adjust how I care for my skin. Freezing cold night temperatures give way to cold, shortened days. My wife likes to turn up the heater, as do my workplace and the stores I frequent. I enjoy a hot shower too. But I know that my psoriasis and eczema don’t necessarily take well to dry, heated air and long, hot showers.
It could be the stress of the holidays, it might be because my medications have lost their effectiveness, or it could just be winter. Whatever the cause, I’m needing to take extra measures to make sure my skin is well managed and cared for.
When I last visited my dermatologist, Dr. Emanual Maverakis of the University of California, Davis Health System, I wondered what winter skincare tips he and his resident Dr. Tatyana Petukhova might have for those of us living with psoriasis and eczema.
My years of experience have helped me develop ways to manage any inevitable winter flare-ups. Here are my five recommendations with a few of my doctors’ thoughts peppered in.
1. Be Sure to Moisturize and Humidify
Without a doubt, this tip to moisturize is the one my dermatologists recommended first. Dr. Maverakis noted that using heaters in the winter dries out the skin, so more moisturizing is needed. That’s my experience as well.
I took a couple of climatology classes in college. One professor used the analogy of two different-sized buckets to explain relative humidity. If you have a small bucket, and it’s 80 percent full of water, then you would say it’s quite full. But if you put that same amount of water in a big bucket, it might only be 20 percent full.
Cold air is like the small bucket, and hot air is like the large bucket. When cold air is heated up, as it often is indoors in the winter, the relative humidity drops. Unless water is added back into the air, such as with a humidifier, the dry air will dry out your skin.
I’ve noticed my skin is like a hygrometer, a device that measures humidity. I can tell when my skin is dry and needs more moisturizer. Plus, dry skin will easily become itchy and irritated. In the winter, it seems to dry out even faster than usual.
When moisturizing, I start with a layer of a lotion with ceramides (mainly for eczema) to add moisture, then lock in the moisture with a thicker, petroleum-based cream. If I am moisturizing after a bath or shower, I moisturize within a couple of minutes of getting out to trap the moisture in my skin. It took me some time experimenting with different moisturizers, and talking with my doctors, before I settled on a regimen that works for me.
Having a humidifier in the living room, bedroom, and the office helps too — especially during those cold and dry times. Dr. Petukhova also recommended using humidifiers, noting the need to “clean them regularly” and use a humidity level “that feels comfortable.”
2. Avoid Long Hot Baths or Showers
Simply put, hot water dries out your skin, and that’s generally not good for psoriasis or eczema. My dermatologists noted this tip as second important after moisturizing. But I confess I like to bathe in hot water in the winter. When it’s cold outside, or even cool, doesn’t everyone enjoy a hot shower or bath? After seeing Dr. Maverakis, I turned back the temperature of my shower and cut down the time.
I also will take 10- to 15-minute soothing baths. I sprinkle an over-the-counter oatmeal bath packet into the water as the bath is being drawn, then I add some moisturizing oil. When I get out of the tub, I put on extra layers of moisturizer. This system seems to be working well so far, but it’s hard to give up the hot water.
3. Don’t Get Sick
Staying healthy is a key strategy for my winter psoriasis care. Because I take immune-suppression drugs for psoriasis (such as cyclosporine), I easily catch viruses or get bacterial infections. The last time I had the flu (influenza A, according to the viral panel test), my skin exploded with psoriasis and eczema. To make matters worse, I couldn’t take some of my psoriasis medications since they affected my immune system. It took weeks to get my skin back under control.
This year I’m focusing on prevention. I got my flu shot early. When I feel like I am about to catch a cold, I go to bed early, stay hydrated, and minimize my workload. I wash my hands regularly, especially after I’ve shaken someone’s hand. Prevention has become more and more of my strategy to stay healthy.
Right now, two of my children have colds. At church, I see people sniffling, coughing, and sneezing. I can’t completely avoid the illness around me, but awareness of what an infection will do to my skin keeps me vigilant.
4. Take Time to Relax and Exercise
I’m one of those people who wishes they didn’t need to sleep so they could get more done. I enjoy my work, but it’s never-ending and therefore easy to take home. I have tasks around the house, writing projects, family time, and other interests and hobbies I enjoy. With my type-A personality, it’s hard to relax and rest. However, if I don’t relax my stress builds and shows up on my skin.
One important way for me to find relaxation is through exercise. I often don’t feel like moving in the winter, much less getting out to exercise in the cold or windy weather. Of course, when the weather is especially inclement, I can work out indoors on my rowing or elliptical machine. To further motivate me, over Black Friday weekend I bought a fitness tracking watch for the first time. So far so good.
As a geek at heart, I find the new watch gets me going to reach my goals. It also gives me data and stats on my runs, walks, and elliptical machine workouts that show me how well I’m doing.
Ultimately, my hope is that with less stress, better sleep, and a cleared-out mind through relaxation and exercise, my skin will follow in good health.
5. Manage Your Moods
Each winter brings its challenges. My skin becomes more challenging, and work at church ramps up around the holidays. This year brought an additional crisis: my daughter had a health emergency that led to a two-week hospitalization. I had been doing well with everything else in life, but I began to feel down within a couple days of her hospital admission.
Predictably, my skin followed with increased infections (folliculitis), eczema rashes all over my face, scalp psoriasis flares, and general break-outs. Dr. Maverakis immediately noticed how much worse my skin became during this time. I told him my psoriasis didn’t respond as well to my long-standing treatments.
About a week into my daughter’s hospital stay, I made the decision to address my feelings in a positive way, such as taking walks, praying and meditating, and sharing my feelings with my wife and friends. I didn’t want to burden others, but what happened to my daughter felt so overwhelming. Just acknowledging how I felt gave me strength to keep moving forward.
It took longer than I expected, but my daughter’s conditioned improved. A couple of weeks later, my skin began to respond to my treatments again. The skin-emotion connection is still being researched, but it’s clear that they are related. If you’d like to read further, you can find my thoughts on psoriasis and depression here.
It often takes experimentation and consultation with medical professionals to find out how to best manage winter psoriasis. I’ve shared a few of my strategies — which ones work for you?