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Dermatologist tips for healthier skin this winter

The girl uses cream. Winter hand skin care.
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The winter months bring fun activities for those willing to brave the outdoors, but time outside in the dry and cold air can be tough on our skin.

Q: What unique challenges does our skin face in the winter?

Our skin is our interface with the environment. As temperatures and humidity levels drop, one of the first places we experience this is on our skin — particularly in places like Minnesota where it gets very cold and dry.

A number of studies have looked at measures of skin (and even fingernail) moisture content in winter versus summer, and unsurprisingly, it’s much lower.

When our skin dries out, its barrier function is compromised and we become more susceptible to external allergens, irritants and even infections. The effects of cold can range from being a nuisance to quite dangerous. Frostbite can occur when the skin temperature gets to 28 degrees — this only takes about 30 minutes when the thermometer reads 0 degrees. Our skin isn’t physiologically equipped for unprotected, prolonged exposure to these temperatures, so be sure to put on a warm coat and hat when you’re going outside.

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Q: What common skin issues do you see during the winter?

We see lots of dry skin, even incidentally in people who come in for other skin concerns.

Winter is often a more difficult time for people with eczema — especially on their hands — as well as other areas on the body.

We also see many irritant reactions, such as from frequent tissue use during respiratory virus season or lip licker’s rashes.

In my area of specialization in autoimmune connective tissue diseases, I see a lot of Raynaud’s and pernio (chilblains). Raynaud’s is the rapid onset of white or blue discoloration of the fingers and/or toes from cold exposure due to constriction of blood vessels. Pernio is the delayed onset of tender pink bumps on the fingers and toes 1-2 days after cold exposure.

Q: What are your go-to recommendations for those suffering from dry winter skin?

Moisturize, moisturize, moisturize! It’s pretty intuitive, but it bears repeating.

The environment treats our skin differently in the winter, and that means we may have to change our behaviors to acclimate. I generally recommend a thick moisturizing cream that you have to scoop out of a jar or squeeze out of a tube over those with a pump handle, which tend to be thinner.

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I don’t like a lot of additives, perfumes, scents, etc. — keep it simple.

Ceramides may be helpful in restoring the skin barrier, so those can be a good ingredient to look for. There’s some data suggesting humidifiers can be helpful in certain circumstances, but probably less so than moisturizers.

I also recommend a gentle soap that doesn’t have perfumes or scents either, as these can be irritating to the skin.

Q: Should people still wear sunscreen/SPF in the winter?

In short, yes. Getting into a routine with sunscreen improves consistency of use, so I often recommend working in a combined moisturizer/SPF product every day.

The long answer is a little more nuanced. In Minnesota, our UV index — a measure of how much ultraviolet light reaches us — is pretty low in the winter. People’s skin is usually covered up in the winter, but there’s actually a fair amount of reflection of UV light from the snow. Prolonged exposure through outdoor activities (or long drives) can add up. If you’re lucky enough to travel south or upwards in elevation, I would definitely recommend applying sunscreen like you would during the summer months.

Q: What are you doing to advance research in the dermatology field? 

As the director of the Autoimmune Connective Tissue Diseases Specialty Clinic, my clinical and research interests are focused around lupus, dermatomyositis, scleroderma, morphea and vasculitis, among others.

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Our group is involved in a number of industry-sponsored clinical trials aimed at developing new and better therapies for these diseases. Unfortunately, many of these diseases have limited treatment options right now and can be devastating to people who suffer from them. We hope to address this unmet need.

I’m also particularly interested in environmental triggers of these skin diseases. I’m working with Drs. Michael McAlpine and Tianhong Cui, both in the Department of Mechanical Engineering, on a few translational projects where we are developing novel, skin-interfaced sensors. Like many autoimmune diseases, the conditions I study are characterized by periods of both increased and decreased activity, and we still have a lot to learn about why and when flares will happen.

Dr. David Pearson is an assistant professor of dermatology at the University of Minnesota Medical School, a dermatologist with M Health Fairview and the director of the Autoimmune Connective Tissue Diseases Specialty Clinic.

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