FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

LESS BATHING, USING MOISTURIZER CAN CURE WINTER ITCH

Question: Every winter I have a problem with dry itching skin, particularly on my legs and arms. My doctor has told me I have "winter itch." This year, it has been worse than ever. Even though winter will be over soon, I'd like to have some pointers on how to avoid this problem next year.

Answer: Winter itch, also called "xeroderma" in unintelligible doctor language, is a common winter affliction of many who live in the northeastern part of our country. It is particularly common in people who have "atopy" -- a type of sensitive and easily irritated skin. About 10 percent of the general population has this condition.

In winter itch the skin becomes excessively dry and rather rough or scaly. This drying causes itching and the resultant scratching produces a rash. It's the opposite of many conditions, such as poison ivy, where the rash is what causes the itching. Winter itch is more common in the Northeast because of the climate and central heating that lowers the relative humidity of the indoor air. The low humidity promotes the drying of skin.

Winter itch is made worse by bathing, particularly with hot water and ample amounts of soap. This treatment removes dirt, but it also removes the natural skin oils that help smooth the skin and control water loss through the top layer of cells. The skin on the lower portions of the arms and legs produce less of the natural skin oils and, therefore, are more susceptible to these drying problems. This is why you have troubles with your arms and legs, but others with this condition can have the same itching and rash on other areas of their bodies.

One of the most important ways that you can help stave off winter itch next year is to avoid unnecessary bathing -- especially the areas where your skin is the driest. Our society encourages daily bathing, but this is often not necessary to be clean. Wash your "stinky" parts (face, underarms, crotch) daily, but bathe the rest of your body less frequently. Use tepid water instead of hot. Use a mild moisturizing soap or emollient cleanser and follow this by patting dry instead of vigorously rubbing with a towel because the rubbing stimulates the itch sensation.

Immediately after bathing, apply a lotion or cream to help smooth and soothe the skin while retaining moisture. Petroleum jelly is probably one of the most effective products for this purpose, but its greasy residue is often objectionable. I often recommend Aveeno cream for this purpose because my patients have found it significantly more effective.

Raising the humidity within the home is also beneficial in reducing the amount of skin drying. A vaporizer or humidifier in the bedroom is a good method of adding moisture to the air in your inside environment. It is also helpful to avoid wool clothing that scratches the already irritated skin. There are many other natural and synthetic fibers that are attractive and comfortable without being scratchy. In my experience, however, it seems that cotton is often the best fabric to use until the xeroderma is under fair control.

And one additional reminder: Even though the "winter itch" itches, don't scratch. Scratching will only make it worse. Rub on another dab of lotion or cream instead.

"Family Medicine" is a weekly column.

To submit questions, write to: John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.