By Dr Rob Ayoup ND; Naturopathic Doctor – MediSeen, www.NaturopathicAesthetics.ca
Gingerbread, candy canes, festive holidays…snow shovelling, shivering at the bus stop, and dealing with layers and layers of clothing. People tend to fall into two camps, they are either itching for winter, or are frustratingly itching because of winter! No matter which side you prefer, your skin will feel the effects of the season either way. The aptly named, ‘Winter Itch,’ refers to the experience of dry skin, medically known as xerosis, during the winter months. The prevalence during the winter is owing to the relatively low humidity, combined with dry indoor heat, which occurs during this time. The greatest frequency occurs within the elderly population, as the winter weather change is the most common cause of dry skin in this group (1). Although dry, scaly and itchy skin can occur anywhere, the shins of the lower leg are commonly affected owing to their naturally lower density of sebum-producing sebaceous glands (2). For the purposes of our discussion we will focus on simple dryness of skin during the winter months, however, dry skin can also be caused by various dermatological/medical concerns such as diabetes, hypothyroidism, atopic eczema, as well as be triggered by certain medications such as diuretics (2). We will review key moisturizing ingredients to consider in the management of winter dry skin. The information can then be discussed with your healthcare provider to confirm its appropriateness in your case.
Most effective moisturizers tend to contain a blend of moisturizing ingredients which fall under three main categories: occlusive, humectant, and emollient.
- Occlusive moisturizers act to form a barrier overtop the skin, helping to trap and prevent water evaporation from the skins’ surface. Examples include petrolatum and mineral oil.
- Humectants work to draw moisture from the deeper skin up toward the surface layers. Glycerin (glycerol) and Panthenol (provitamin B5) are good examples of humectants.
- Emollients, which provide a fast-acting smoothness to the skin, work by interspersing in between the uppermost skin cells which are in the process of shedding. Dimethicone, Cyclomethicone, and Cetyl Stearate are good examples of commonly used emollients.
Although the above ingredients can support skin hydration, research is now showing that products which help replenish our skins’ lipid matrix barrier can be an efficient method by which we can re-establish our skins’ own ability to lock moisture in, and may help manage various skin diseases such as atopic eczema. It has also been theorized by researchers that overdependence on occlusive moisturizers may interfere with the skins’ own ability to optimally replenish the lipids needed to maintain and repair the skin barrier (3)
Much like the bricks and mortar protecting the outer layer of a house, the skin barrier is comprised of non-dividing cells called corneocytes (the bricks), and a lipid matrix helping to bind the corneocytes together (the mortar). This matrix is made up of ceramides, fatty acids and cholesterol. What better way to repair the barrier than by ‘re-stocking’ it with these very raw materials itself? Enter the world of ceramide-containing skincare products. Now found in more than just moisturizers, ceramides are now featured across a variety of skincare products, including cleansing bars, liquid cleansers for body and face, and even make-up removing liquids and wipes.
Many ceramide-based moisturizing products contain a combination of fatty acids (such as palmitic or stearic acid) and cholesterol, which is key since all three are important for matrix repair. Your dermatologist and/or skin specialist may recommend a ceramide-containing product designed to contain a specific ratio of any of these three components, depending on your skincare needs. Taken together, ceramides provide us with a unique and clinically effective skin moisturizer, which acts differently from most other moisturizers on the market. However, to simply call ceramides a great moisturizer would be short-changing its role. Due to its ability to directly replenish the lipid matrix, ceramide-containing products help strengthen the physiological integrity of our skin barrier. This is where the floodgates open regarding its applicability, as a strong barrier is essential in reducing skin sensitivity to environmental, and other, triggering factors. This allows ceramides to be helpful in the management of various skin concerns, such as: redness/blotchiness (4), eczema (5), psoriasis (5), skin aging/wrinkles, rosacea, and acne (6).
Talk to your skin care provider about ceramide-containing moisturizers and other ceramide-containing products…your winter-triggered dry skin will definitely thank you!
Disclaimer: The information presented in this article is for general information purposes only and does not constitute medical advice. Please first review with your personal healthcare provider(s) what therapeutic approaches and products would be best for your case.
- Pacheco T.R. Approaching the pruritic patient; In Fitzpatrick, J. & Morelli, J. (Eds.) Dermatology Secrets Plus, 5th Ed; Philadelphia:Elsevier, 2016. Chap. 68, 594-599.
- Ferri F.F. Diseases and Disorders; In Ferri F.F. et al. (Eds.) Ferri’s fast facts in Dermatology : a practical guide to skin diseases and disorders, 2nd ed; Philadelphia:Elsevier, 2019. Chapter 3, 37-403
- McCusker, M.M. & Grant-Kels, J.M. “Healing fats of the skin: the structural and immunologic roles of the w-6 and w-3 fatty acids”. Clinics in Dermatology (2010) 28, 440-451
- Bissett, D.L. Common Cosmeceuticals. Clinics in Dermatology. 2009; 27: 435-445
- Meckfessel M.H. & Brandt S. The structure, function and importance of ceramides in skin and their use as a therapeutic agent in skin-care products. Journal of the American Academy of Dermatology. 2014; 71 (1): 177-184
- Apostolos P. et al. Skin lipids in acne – seasonal changes and effect on the epidermal barrier. Journal of the American Academy of Dermatology. 2016; 74(5): p. AB9