Question of the Week

February 12, 2007


In much of the nation, the heaters have been working overtime this month. With the cold weather, low humidity, and increased heater use, many people can see the damage that has been done (or is being done) to their skin.

"The skin – the largest organ of the body – is made up of a thin outer layer (called the epidermis) and a thicker outer layer (called the dermis). Below the dermis is the subcutaneous tissue, which contains fat. Buried in the skin are nerves that sense cold, heat, pain, pressure, and touch. Sebaceous glands secrete a lubricating substance called sebum. Deep within the skin are your sweat glands, which produce perspiration when you are too hot."
American Medical Association
(A detailed drawing that shows a cross section of the skin is available at the above site.)

While dry skin may not seem like a big deal to some, it could be argued that the one organ that it is the easiest to see and monitor should also be the easiest to care for.

"Dry skin is common. It happens more often in the winter when cold air outside and heated air inside cause low humidity. Forced-air furnaces make skin even drier. The skin loses moisture and may crack and peel, or become irritated and inflamed. Bathing too frequently, especially with harsh soaps, may contribute to dry skin. Eczema may cause dry skin."

While not all dry skin is caused by eczema, eczema can cause dry skin, and those with eczema may have a more difficult time managing their condition during the dry months of winter.

"Eczema is a general term for rash-like skin conditions. The most common type of eczema is called atopic dermatitis, which is an allergic reaction. Eczema is often very itchy and when you scratch it, the skin becomes red and inflamed. As many as 15 million people in the United States have some form of eczema. It occurs in adults and children, but most often appears on babies. You are more likely to have eczema if you have a family history of the condition. Although the exact cause is unknown, eczema is not contagious. Eczema can't be cured, but it can be managed, and you can learn to avoid the things that trigger it.

"The most common type of eczema is called atopic dermatitis..."

"The word 'dermatitis' means inflammation of the skin. 'Atopic' refers to a group of diseases where there is often an inherited tendency to develop other allergic conditions, such as asthma and hay fever. In atopic dermatitis, the skin becomes extremely itchy. ... In most cases, there are periods of time when the disease is worse (called exacerbations or flares) followed by periods when the skin improves or clears up entirely (called remissions). As some children with atopic dermatitis grow older, their skin disease improves or disappears altogether, although their skin often remains dry and easily irritated. In others, atopic dermatitis continues to be a significant problem in adulthood."

While those with eczema may see it flare during the winter months, even those without the condition can find themselves suffering from uncomfortably dry skin as the humidity drops and the colder weather outside is paired with increased heater usage.

"The low humidity common in many parts of the United States during winter can cause dry, irritated skin. When skin becomes dry and irritated, eczema can flare. Here are some tips to help skin feel more comfortable during winter or anytime the air is dry:

  1. Use a humidifier. With the heat on and the windows closed, the air inside can become very dry in the winter, making the dryness and itching of eczema even worse....
  2. Switch to an oil-based moisturizer and moisturize frequently....
  3. Before Going Outside in Winter:
    * Apply a heavy layer of moisturizing broad-spectrum sunscreen with an SPF of 15 or higher to the face, hands, and any other skin that may be exposed....
    * Grab those gloves. Protecting hands from the cold air and low humidity plays an important role in preventing flare-ups....
  4. Dress in layers. The most common triggers of the scratch/itch cycle are sweating and overheating....
  5. Shed wet clothes and shoes immediately. These can irritate the skin and cause a flare-up."

When caring for the skin, don't forget that the lips are covered in skin and can require special care.

"Lips may become chapped for a variety of reasons. These include:
  * Exposure to wind, sun, and cold, dry air
  * Obstructed breathing, such as in allergic rhinitis, which can force you to breathe through your mouth
  * Contact dermatitis due to irritants or allergens in cosmetics or skin-care products
  * Certain medications, such as those used to treat acne
  * A habit of frequently licking your lips
  * Dehydration
To treat or prevent chapped lips, consider these tips:
  * Use an oil-based lubricating cream...
  * Apply lip cream, balm or lipstick before going out in cold, dry weather. ...
  * Choose a lip cream or balm that contains sunscreen. Sun exposure contributes to chapped lips.
  * Avoid licking your lips. Saliva evaporates quickly, leaving lips drier than before you licked them.
  * Avoid using a flavored lip balm, which can tempt you to lick your lips.
  * Stay hydrated by drinking plenty of fluids. Dehydration can contribute to chapped lips.
  * Use a humidifier at home to keep air moist.
If chapping is severe and self-care measures don't seem to help, consult your doctor. Rarely, persistent chapped lips may indicate an underlying problem, such as dermatitis."

Caring for the skin from the outside is helpful, but (as mentioned previously with issues pertaining to hydration), proper nutrition can help keep all of the body's organs at their best.

For example:

"* Vitamin A...
Essential for: antioxidant properties, which help ... fight and prevent infection; growth and repair of cells, tissues and skin; relieving allergy symptoms
When lacking, can cause: dryness, itching and loss of skin elasticity
* B Complex Vitamins...
Essential for: relieving dryness and itchiness...
When lacking, can cause: dry, flaky, sensitive skin; eye disorders...
* Vitamin C...
Essential for: antioxidant properties; antihistamine effects; fighting skin infections and healing wounds; producing collagen and elastin for firm skin; healthy gums and firm capillaries
When lacking, can cause: scurvy; loose teeth and swollen gums; excess bleeding; wounds that won�t heal
* Vitamin E...
Essential for: antioxidant properties; reducing risk of disease; fighting free-radical damage...
* Sodium (salt)
Essential for: regulating fluids and blood pressure
* Zinc...
Essential for: healing and overall skin health; working with vitamin A to maintain and repair skin; providing strength, elasticity and firmness to skin; promoting tissue growth...
When lacking, can cause: reduced resistance to infection...
* Carbohydrates...
Essential for: energy, fiber and B vitamins
* Protein...
Essential for: energy and repair of body tissues and cells...
* Fats (essential fatty acids linoleic acid and alpha linolenic acid...
Essential for: maintaining healthy, hydrated skin
When lacking: dry, scaly and flaky skin; hair loss
* Water...
Essential for: proper hydration of cells; regulating body temperature; carrying nutrients to cells and wastes away from cells
When lacking, can cause: dehydration"
Cleveland Clinic
(The above link includes good foods that can help people incorporate the listed nutrients into their daily diets.)

Please note: Moderation is key. While having some a necessary nutrient is beneficial, more is not always better. Too much of a good thing can become unhealthy.

"Too much niacin, typically as a result of supplements, can cause flushed skin, rashes and liver damage. ... Nearly everyone gets enough salt. Large amounts of sodium are found in highly processed foods (fast food, canned products, frozen dinners). These foods should be eaten infrequently, because an excess of sodium causes fluid retention and swelling and may contribute to other health problems." Cleveland Clinic

Most dry skin can be treated at home, but, as with any condition: If symptoms persist or worsen, be sure to see a health care professional. Doctors and registered nurses can offer further advice, and check to make sure that a more serious problem does not exist.

Questions of the Week:
Why is it important for you, your peers, and those in your family, to know about the proper care of dry skin? What can you do to prevent dry skin? What can you do to heal existing dry skin, and help prevent a recurrence? How does the care of dry skin vary for people with differing needs (for example: those of various ages or with other pre-existing health conditions)? How could/ should this affect how they care for their skin? What factors affect how you care for your skin? What factors can/ should you take into consideration that you may have previously overlooked?

Please email me with any ideas or suggestions. Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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