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Under My Skin 

Ask Dr. Matt

The harsh weather elements we endure this time of year can turn even the supplest, most youthful skin into a lizard-like hide. This is particularly distressing for parents of children sporting cracked, red "winter cheeks" or the painful "mummy hands" that can result from frequent, and appropriate, handwashing.

click to enlarge Matt Thompson, a pediatrician at Spokane's Kids Clinic
  • Matt Thompson, a pediatrician at Spokane's Kids Clinic

Dry skin represents vulnerable skin, so the key is to return the waterproof resilience of intact, healthy skin to the areas at risk. Think if it this way: When you wear your suede house slippers in the rain, they may look fine when they are wet, but once dried inside by the fire, they'll take on a stained, crusty look. (Take it from me; don't ruin your house slippers.) That's unless you remembered to waterproof the suede with a hydrophobic protectant.

Paradoxically, lotions and creams are smooth and creamy because they contain water. Although they initially quickly absorb into the skin, they then dry out instead of forming a protective layer on top of the skin — that's also why they sting when applied. So, as strange as it sounds, choose petroleum-based or synthetic emollients such as Aquaphor, CeraVe or good old Vaseline. For those who prefer a more "natural" approach, shea butter or vegetable shortening (non-butter flavored) work well. It is particularly best to use these topicals right after exposure to water, to help trap what moisture has been absorbed and slow its drying. This prevents the damaging moist-to-dry, moist-to-dry cycle that causes skin cells to swell then crack, swell then crack.

Most of the differences between these hydrophobic options come down to how expensive or messy they may be. Avoid fragrance and scents as much as possible, as they are more likely to be irritants. Sometimes, when skin is beyond dry and is irritated, it helps to simmer down the flare with a topical anti-inflammatory, then top with copious emollient. One percent hydrocortisone, a mild anti-inflammatory, can be purchased over the counter, or a more robust prescription version may be indicated, so confer with your doctor. Be well and stay supple.

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