Laura J. Martin, MD
Winter is brutal on our hands. Smooth, supple, and soft in September, hands can turn red, chapped, and rough by February.
The main culprit? Lack of moisture.
During the winter months, the humidity in the outside air plunges. Inside, things are even more arid, with indoor heating creating desert-like conditions in our home and office. What's more, follow the advice of health care experts to wash your hands frequently to avoid catching a cold or the flu and you'll sap whatever natural oils are left in your skin.
The effect -- hands so dehydrated they may crack, peel, bleed, and become painful -- can be alarming.
"People will have fissures in their hands and they'll come to see me saying they can't figure out what's happening," says New York City dermatologist Ellen Marmur, MD, author of Simple Skin Beauty: Every Woman's Guide to a Lifetime of Healthy, Gorgeous Skin. "It's just extremely dry skin."
The good news, Marmur says, "is once you recognize that, you're halfway on your way to fixing the problem."
Here's what you need to know to help your hands weather winter.
Just how well our hands can withstand winter's harsh conditions has a lot to do with the strength of our skin barrier, says Charles Crutchfield III, MD, a dermatology professor at the University of Minnesota Medical School. A combination of proteins, lipids, and oils, the skin barrier is what protects our skin from assault, and just how good a job it does is largely genetically determined.
If you have a weak barrier, you're more prone to symptoms of sensitive skin, like itching, inflammation, and eczema. You're also more likely to experience excessively dry hands in winter.
The bottom line: If you suffered from chapped hands last year, you can count on that happening again this season and every winter.
To treat parched, scaly hands, you need to replace the moisture that your thirsty skin is missing. Drinking water, experts point out, won't do that.
"It's the moisturizer applied directly to the skin that will keep water from evaporating and give your skin a healthy, dewy appearance," says dermatologist Amy Wechsler, MD, author of The Mind-Beauty Connection: 9 Days to Reverse Stress, Aging and Reveal More Youthful, Beautiful Skin.
For effective treatment, apply moisturizer early and often. "The best prevention is to begin using a moisturizer before your hands show signs of dryness," Marmur says.
Putting moisturizer on just once a day is inadequate. "That's probably enough protection for about five minutes," Marmur says.
With more frequent application, however, the effects of a moisturizer last longer. Five or six applications a day, Marmur says, will provide round-the-clock protection.
To reach that goal, Marmur suggests practicing what she calls "good product placement." Along with keeping a big jar or tube of your favorite over-the-counter moisturizer in your bathroom, stow smaller sizes in your purse, gym bag and on your desk so application becomes a habit.
And remember to rub the hand cream or lotion over your cuticles and nails. "Nails can become dry, just like the skin of the hands," Crutchfield says.
You'll find a dizzying array of hand creams and body lotions on your drugstore shelves. Wechsler says to cut through the clutter by remembering that just two types of ingredients do most of the work when it comes to keeping your skin soft and hydrated: emollients and humectants.
Emollients act as lubricants on the surface on the skin. They fill the crevices between cells that are ready to be shed and help the loose edges of the dead skin cells that are left behind adhere together.
"The slippery feeling you get after applying a moisturizer is most likely coming from emollients," Wechsler says. "They help keep the skin soft, smooth, and pliable." Look for ingredients such as lanolin, jojoba oil, isopropyl palmitate, propylene glycol linoleate, squalene, and glycerol stearate.
Humectants draw moisture from the environment to the skin's surface, increasing the water content of the skin's outer layer. Scan the ingredients label for common humectants such as glycerin, hyaluronic acid, sorbitol, propylene glycerol, urea, and lactic acid.
When your hands go from being merely dry and rough to having little cracks, or fissures, and are tender or bleeding, it's time to move on to more therapeutic moisturizers.
Petroleum jelly is a reliable standby. Or choose a thick, rich moisturizer in a formula that contains heavier ingredients such as dimethicone, cocoa or shea butter, or beeswax.
Slather on at bedtime, slip on a pair of cotton gloves or socks, and keep on overnight.
To protect your hands while you're protecting your health with frequent hand washing, choose a mild soap, use warm not hot water, pat your hands dry and apply a moisturizer right away.
If you've got severely dry hands or you wash your hands a dozen or more times a day, substitute a hand-sanitizing gel or wipes for some of the soap-and-water sessions.
"These alcohol-based sanitizers do dry the skin," Marmur says, "but for people who do a ton of hand washing -- whether they're doctors, moms, or dog-walkers -- it's actually a bit gentler on the skin than soap and water."
You can't do anything about the weather, but you can add moisture to your home or office with a humidifier.
The higher humidity levels will not only salve your super dry hands, they'll help ease dry itchy skin all over your body, including chapped lips, and soothe a stuffed up nose.
Just be sure to maintain the appliance regularly or you could end up releasing bacteria or mold into the air, Marmur says.
Remember the advice your mom gave you: Wear gloves or mittens if you're going to be outdoors for longer than a dash to a car on cold days. Dry your hands after a snowball fight (then apply moisturizer, of course).
And if redness, peeling, and tenderness persist, see a dermatologist. He or she can prescribe a strong topical steroid cream to help fight inflammation, and also investigate the possibility that your dry hands may be caused by a skin condition like eczema or psoriasis.
But barring that, there's no reason to wring your hands over winter's wrath. Just resist the urge to warm up in hot water, keep simple and effective remedies on hand, and bundle up until the seasons turn toward the sun.
SOURCES:Ellen Marmur, MD, associate professor and chief of dermatologic and cosmetic surgery, The Mount Sinai Medical Center; author, Simple Skin Beauty: Every Woman's Guide to a Lifetime of Healthy, Gorgeous Skin,Simon & Schuster, 2009.Charles E. Crutchfield III, MD, clinical associate professor of dermatology, University of Minnesota Medical School; director, Crutchfield Dermatology.Amy Wechsler, MD, adjunct assistant clinical professor in psychiatry, Weill Cornell Medical College; assistant clinical professor in dermatology, SUNY Downstate Medical Center; author, The Mind-Body Connection: 9 Days to Reverse Stress Aging and Reveal More Youthful, Beautiful Skin,Simon & Schuster, 2008.
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