TROUBLE ZONES
Lips If you are planning on getting kissed under the mistletoe or have upcoming New Year’s or Valentine’s plans, better get those lips in shape now! A maintenance approach is key here. Don’t just soften them up and forget about them, pamper them throughout the winter season. You’ll be happy you did. Lip balms are great and have their place, but only to help prevent lips from drying out. Waxes simply do not have the ability to rejuvenate or replenish lost moisture. Soften lips with an AHA nightly for a therapeutic remedy. Simply slathering on a heavy moisturizer won’t treat the underlying problem or get rid of unwanted peeling skin. Try using Ideas Lip Refine AHA Exfoliating Cream nightly. Then, during the day, use their Ideas Lip Solution Hydrating Lip Gel frequently. I have found that not only does using Ideas Lip Solution Hydrating Lip Gel help make your lipstick go on smoother, you can always apply it on top of lipstick or gloss if desired. It helps seal in the moisture as well as creates a shimmer look to the lips. On Accutane or other medications that are creating dry lips? It’s still OK to use the above regimen. Other options include carrying around Aquaphor Healing Ointment for extra heavy sealing. In worse case scenarios, your dermatologist may have to prescribe 2 ½ % hydrocortisone ointment to help resolve the issue or get you through your Accutane regimen. This should be used for a finite period of time. It’s not something to use indefinitely.

Hands/Fingers
This is a huge concern this time of year, especially for anyone who contacts a lot of water or chemicals in their home or workplace. Exposure to water actually dehydrates the skin as the air evaporates the bath water, it takes moisture from the skin along with it. Seal your hands after gently patting them dry with a towel immediately! The same applies for full body protection after bathing. This simple practice goes a long way to preventing winter itch, something that is more likely to occur each year we get a little older. Hands and fingers take a beating because of their constant contact with the elements. I would break down treatment into 2 categories; simple bland creams that help act as protection against the environment while restoring important moisture and therapeutic options once you’re in trouble.
Environmental Protection:
This includes good bland moisturizing creams. Notice I said creams, not lotions. I cannot tell you how many of my patients tell me that they don’t understand why their hands (or bodies) are dry, because they frequently apply a hand or body lotion. While this is certainly better than nothing, particularly in dry winter weather, the lotion is quickly absorbed into the skin and there is nothing left on the surface to protect the skin. Switch to a cream or ointment base this time of year! Most people understandably do not like ointments as they leave behind a tacky, sticky texture, but they seal the skin well. Try a cream like Vanicream Moisturizing Skin Care Cream, or Cetaphil Moisturizing Cream. Keep some at your work place, some at home by the kitchen as well as the bathroom sinks. You’ll find yourself more likely to use it if you don’t have to hunt for it. And by all means, apply it frequently.
Therapeutic Options:
So now you already are experiencing painful little cracks around the fingertips, hard dry skin on the hands and nothing seems to help. There are some simple things that go a long way to help heal the skin. First of all, if you already know you have this problem yearly, start out with a therapeutic moisturizing agent early on, before you have fissures. "Active" ingredients include glycolic acid M.D. Forte Hand & Body Cream, lactic acid AmLactin 12 % Moisturizing Cream and urea Carmol 20. There are also a few prescription options here such as LacHydrin 12% Cream and Carmol 30 or 40. These products are great hand softeners but beware, keep them out of already formed cracks, they are acidic and will cause some stinging.
Treat cracks with antibiotic ointment like Polysporin Ointment at least 2-3 times a day. Apply Epilyt Lotion around the fissured areas nightly. Epilyt Lotion is oily and while I love it, (works like a charm) you probably do not want to use it during the day unless you’re desperate to heal the areas more quickly. Bear in mind you may leave an oily residue behind on papers!
Nothing says you cannot mix and match the above agents. While I would not apply a layer of M.D. Forte Hand & Body Cream directly on top of Carmol 20, you may certainly apply them at different times of the day. Remember that using different active agents for skin care goes a long way to help expedite results, regardless of the skin condition you are treating.
For those with known eczema or psoriasis, you will likely need to have on hand some of your prescription therapy as well to combat the condition. Check with your dermatologist as to which moisturizers they would like you to combine with the Rx therapy. Most will be appropriate options.

Fingernails
Keep your nails moist to help prevent brittle, easily broken nails. Minimize water exposure as much as possible. Wear protective gloves when washing dishes. The use of Burt´s Bees Cuticle Cream can be rubbed onto the nail plate as well as the cuticle area whenever you like, preferably at least twice a day during trouble times. Apply a protective nail hardener such as L´Oreal Grow Stronger or O.P.I. to help toughen them up as well. Taking calcium supplements according to package direction will ensure the presence of this important nutrient. If you are prone to kidney stones, check with your doctor before starting them. A cost effective calcium supplement is TUMS.
Scalp and Hair
Winter is the perfect time to have to deal with flares of your seborrhea aka dandruff. Read through my Seborrhea newsletter for a full explanation on this chronic condition. However, you can help keep this condition at bay with great nonprescription shampoos such as DHS with Zinc, AquaGlycolic and Nizoral A-D. Ionil Rinse or Free and Clear Conditioner are good for helping prevent these medicated shampoos from drying out hair and helping make your hair shine.

Skin Rejuvenation

A few simple rules here:

Use the cream base of your skin rejuvenation product if possible. Cream bases rule except for those with oily or acne prone skin. Of course, some creams are non-comedogenic, so read the label. If it has been tested and proven not to flare your acne, then give it a try. There are most definitely those individuals with dry skin who are still acne prone.
Decrease the frequency of use of your topical Vitamin A product. Whether it’s Retin A, Renova, Tazorac, Afirm, etc., make sure you are using it only are often as your skin can tolerate it. Also, make sure you are more diligent about applying it sparingly to very dry skin. This will help prevent irritation during the winter when your skin is already getting dry. Additionally, you may find you need to regress to a weaker strength or switch to a more hydrating/cream based formulation.
You may need to decrease the frequency of use or strength or your AHA. Pay attention to your skin. If it is getting red, rough or irritated, back off on using your M.D. Forte 2 or 3 times a day, use it just once daily. Or, go from level 2 to level 1. There is nothing set in stone, you simply need to use common sense and listen to your body.
Check out options that your rejuvenation line offers. This sounds simplistic, but you may be using Cellex-C and have been avoiding their Cellex-C Hydra 5B Complex due to humid weather, oily summertime skin, etc. Now may be the time to add it into your regimen.
Apply a moisturizer on top of your rejuvenation products to obtain more hydration. The main exception to this is a topical vitamin A product. Applying a moisturizer directly on top of it may increase your potential for irritation. Use the moisturizer at another time of day and apply your vitamin A product solo.
Nothing makes your fine lines look more noticeable than dry skin. The use of moisturizing bases from the active ingredients or adding in a moisturizer help plump up the skin and temporarily smooth out unwanted fine lines while your products are working at dealing with the underlying cause.

GENERAL WINTER ISSUES

How many of you have ever been told that you should only bathe a few times a week during the wintertime in order to reduce skin dryness or eczema flares? That is simply not true. Certainly under normal circumstances, a bath or shower a day should be adequate (no bathing 2 or 3 times a day). However, with the wide variety of mild, nondrying soaps, bath oils and advanced moisturizers on the market, just keep these tips in mind:

Avoid harsh (typically colored, fragrant or antibacterial) soaps and stick with tried and true favorites like Cetaphil Bar Soap, Vanicream Soap or Cetaphil Gentle Skin Cleanser. If you like using an antibacterial soap, try Lever 2000.

Apply your moisturizing cream immediately after bathing and toweling dry. This will seal in the moisture. While there are certain moisturizing creams and ointments that are more appropriate for the body than the face, the truth is that they are all fairly similar. For instance, eczema patients may find themselves using Cetaphil or Vanicream on both face and body. There are moisturizers more appropriate for the body or extremities. These are usually quite occlusive such as heavy in lipid or ointment base. An ideal heavy nonirritating moisturizer for the body is SBR-Lipocream Skin Barrier Repair Cream for those really difficult to treat areas. AHAs have been used on the face for skin rejuvenation, such as prescription LacHydrin, but obviously they may be more irritating for some prone to sensitive skin.

Don’t forget your sun protection! The sun doesn’t go away just because it’s snowing or cloudy! Maintenance use of sunscreen with an SPF of 15 that protects against both UVA and UVB is an important step in your daily skin care. The sun ages your skin...Prevent it! You may find that you prefer a more hydrating base to your sunscreen for wintertime, such as those by Cellex-C, California North or M.D. Forte.

Extra hydration does not mean oily, in fact many of these are still oil-free. Also, wear a sun protective hat such as the California North Sun Protective Hat. It will hide your weekend hair on your way to the gym and protect your skin at the same time.

Season Specific Concerns

Psoriasis, eczema and seborrhea typically flare at this time of year. Look to Exorex, and Balnetar for home psoriasis relief, and agents like Nizoral Shampoo, AquaGlycolic Shampoo and P&S Liquid, among others to help the scalp as well. Keep your prescriptions on hand and start them early. Doing this will cut down on treatment time as well as keep your skin looking and feeling great. Some acne patients swear that their condition flares during the winter. If you are one of them, make sure you book an appointment now with your dermatologist. You don’t want to wait 6 weeks to get your prescriptions filled or changed. Poison ivy is not unheard of during the winter. You’d be amazed at how the plant resin can be carried in on logs for your fireplace. Wear gloves when handling the logs and wash your hands immediately after completing this task.

Protect your skin from frostbite. Frostbite is particularly dangerous at higher elevations, in windy conditions and if your clothing gets wet. Try to avoid dangerous outdoor conditions, change your clothes immediately when coming in from skiing, etc., and carry extra clothing and blankets in your car when traveling.

The seasons will change, and your skin will too. Remember that you can continue looking your very best by following these suggestions for "Winter Skincare".
Thank you for taking your time to read my DERMAdoctor.com newsletter. I hope you have found it informative. For more skincare information and other newsletters, visit DERMAdoctor.com at www.dermadoctor.com.