Scaly Skin
Prevent chapped flaky skin with a few precautions
By Karen Uhlenhuth
Knight Ridder Newspapers

Think of yourself as a humidifier — a chapped, flaking, scaly, itching humidifier. Because in effect, come January and cold temperatures and forced-air heat, that’s what you become.

Consider the physics. Your body is 60 percent water, more or less. The humidity of indoor winter air tends to hover closer to 30, and easily can plummet into the single digits, depending on how cold it is outside and where you set your thermostat.

You see the problem. Your body has too much water, the air doesn’t have nearly enough ... and you can almost hear that giant sucking sound as nature tries to achieve equilibrium by snatching water molecules from the backs of your hands, the edges of your red and raw nostrils. Ouch!

Although you can’t do much about the laws of physics, there are some tactics you can employ to hang on to a little more of your body’s H2O. One is to change the humidity in your room by using a humidifier. A setting somewhere between 35 percent and 60 percent is generally recommended for maximum comfort.

“It’s very important for humidity to be reasonably high in both home and workplace,” said Jennifer Ashby, a Kansas City area dermatologist.

You also can stop doing things that exacerbate your body’s loss of moisture. Hot showers, for one, strip the natural oils from your skin. Try taking fewer showers, and making them shorter and cooler.

Soaking in a tub of water can help, especially if you add one-third to one-half cup of common kitchen salt to it. That “increases the osmotic pressure of the skin,” and draws water from the capillaries to the skin’s surface, according to J. Matthew Knight, a dermatology resident at the University of Kansas Medical Center.

Soap is another important factor in drying skin. You might try lathering up very selectively — in only your underarms and groin area, for example.

Ashby advises using “a gentle cleanser instead of a strong soap,” and recommends Dove and Oil of Olay in particular. Knight added Cetaphil and Lever 2000 to the list.

In general, soaps that are “superfatted,” or that contain glycerin, are preferable when dry skin is a problem, according to the Mayo Clinic Health Letter.

And when you’re done bathing, do not rub yourself vigorously with a towel. Pat or blot your skin, leaving some moisture on the surface.

Moisturize. That’s right. “The key point in winter is to combat drying forces by using lots of moisturizers,” Knight said.

People tend to misunderstand the function of moisturizers, he said. “Some people think moisturizers add moisture. What they do mostly is protect your body’s natural water from drying out.”

In other words, they put a barrier on the surface of your skin. And that, Knight said, is why good old petroleum jelly is the most effective moisturizer, bar none.

“A lot of people walk into our clinic with dry skin, and walk out using Vaseline and doing well,” Knight said.

The only problem, of course, is that petroleum jelly is close kin to the gunk they pack around the ball bearings in the wheels of your automobile. And don’t you just want to coat yourself with that crud?

“Medically it’s fine,” Ashby said. “But it’s messy and can clog your pores. I would never use it. None of my patients use Vaseline on their skin. You can use Crisco too, but I don’t recommend it.”

She advocates instead looking for lotions or creams that contain an alpha hydroxy acid or a poly hydroxy acid. On product labels, they’re generally referred to as AHA or PHA. Those compounds improve the skin’s ability to act as a barrier by stimulating cell turnover and helping slough off dry dead skin, she said.

“If you get new fresh skin from underneath, it’s moister,” she said. “So anything that stimulates cell turnover helps the barrier. If your barrier is good, you don’t lose as much water.”

Another ingredient that makes for a more effective moisturizer is what’s known as a humectant. This is a class of compounds that attracts water to the skin. One that Knight recommends is vitamin B-5.

Hands and feet, which are more prone to drying, need a heavier product than the rest of the body, Ashby said. Moisturizers generally are formulated as oil-in-water products, or water-in-oil products. Water-in-oil products are heavier and therefore better suited to hands and feet. Creams generally are heavier than lotions.

Among the heavier preparations recommended by the Mayo Clinic are Cetaphil cream, Eucerin, Advanced Therapy Lubriderm, Moisturel and Vanicream.

Although moisturizing compounds are helpful any time, they are most effective when applied to damp skin, directly after showering or washing your hands.

You also can address dry skin problems from the inside-out, Ashby said. She emphasizes drinking lots of water, although she prefers not to prescribe any set amount.

“It depends how much you sweat, how hot the environment is,” she said.

Eating oil, especially the oils found in fish, also helps to lubricate the skin, Ashby said.

Dry skin in most cases is a matter of comfort and aesthetics, although extremely dry skin can lead to health problems, Knight said. Skin that has dried to the point of cracking provides pathogens with an entryway into the body.

“It’s not common, but it can happen, especially in people who are diabetic or have any kind of disease that would decrease immune function,” he said.

For most of us, however, it just makes the winter months a little easier to bear.

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