Pharmacists are well placed to engage with patients on how to effectively treat winter skin conditions but to do so, knowledge and confidence is key. In the following blog, Pharmacist Consultant Deborah Evans shares the advice she gives to customers on how to tackle five different winter skin issues.
A customer with a dry and flaky scalp
A dry and flaky scalp can have a number of causes including seborrheic dermatitis, psoriasis, eczema, and using too much shampoo.1 We can make simple changes to help, such as, washing our hair more frequently, rinsing shampoo fully from the scalp and using a conditioner after shampooing.2 Stimulating the scalp by treating ourselves to a massage, particularly with an oil such as peppermint or coconut can help.3
If the dry, irritated scalp is caused by an overgrowth of yeast on the skin, then a medicated shampoo can help.4 The rash can be red and with greasy looking skin flakes. Anti-dandruff shampoos, anti-yeast creams or ointments containing agents such as clotrimazole, econzaole or ketoconazole can be used regularly.4 For best results, wash into the scalp, then wait at least 5 minutes before rinsing.5 By applying a descaling preparation (containing coconut oil and salicylic acid) before shampooing, thick scales can be removed. This should be applied for a few hours, or if possible, overnight. Be prepared for it to be messy!6
A customer with tight, dry and itchy skin during the winter months
Many of us get dry and itchy skin, particularly in the winter when we wear more clothes and our skin is challenged by both cold weather and central heating. When we scratch our skin to relieve an itch, we stimulate the release of chemicals called histamines and these further cause itching. We end up in a cycle which can leave our skin cracked.7 Preventing the skin from getting to this sore, itchy and broken state is far better than cure.8 Moisturise the skin frequently throughout the day and especially after a shower or bath when the skin is still moist with a product such as Bio-Oil Dry Skin Gel. Use mild soaps or bath oils and avoid any alcohol based products which can dry it out further. In severe cases, an anti-histamine tablet can help break the itch-scratch-itch cycle.9
A customer with chapped skin, particularly on their lips
Cold weather can cause our skin to get chapped especially on areas that are exposed to extreme weather. The skin can become cracked, sore and even bleed. When it is cold, avoid licking your lips as it can make them feel sore.11 If they are hot, painful, sore or swollen, it could be a sign of infection.11 If you are concerned about this, it’s recommended to have a conversation with your doctor who may prescribe an antibiotic or antifungal cream to treat the problem.11 Last but not least, cover up as much as possible when the weather is really cold.
A customer with dry and cracked hands and feet during the winter months
Dry, cracked hands and feet can be very painful and can get worse during the winter months when extreme weather conditions and central heating dry out the skin further. Keeping our skin moisturised with regular applications of an emollient or product can help to prevent the skin cracking. Avoid harsh soaps and especially those containing fragrances or alcohol as these can further irritate the skin.7 Products containing a minimum of 10% urea can be very helpful for cracked feet.12 The key to healthy skin on the hands and feet is to use products regularly and consistently. Sleeping in cotton gloves and socks can also help after applying the oil or moisturiser and avoid walking with slippery feet!13
A customer who suffers from an itchy winter skin rash after being out in the cold for too long
The extremes in temperature from freezing cold to heated homes and offices in winter can bring with it an itchy rash for some people during the winter months. The lower humidity in the air and cold temperatures contribute to the dryness, but we don’t help ourselves with long hot showers and baths.7 Hot water strips our skin of its protective oils in the outer layer, which prevents the cells from locking in the moisture.14 Using strong fragranced soaps, bubble baths and other chemicals can further add to the problem. Check also washing detergents; those with fragrances, dyes and specific chemicals can cause rashes and can make itchiness worse as we layer on the clothing.15
The rash with small bumps and itchiness is often caused by having dry skin and so avoiding the skin getting dry in the first place is the best treatment.8 Cut showers down to a maximum of 10 minutes, only have one per day and lower the temperature and time spent in the bath. Use a moisturising oil, cream or lotion liberally after patting yourself dry from the shower or bath. If the rash is particularly bad in some patches then apply a hydrocortisone cream, available from the pharmacist, sparingly once or twice daily.16 Avoid scratching the area and if the rash doesn’t go away or worsens, you have joint pain or fever with a sore throat or the rash develops after a new medication, then seek additional help again from your pharmacist or doctor.
Final thoughts on empowering your team to give advice on winter skin issues
Pharmacies should and do consider seasonality in the range of products that they stock and this is true for winter skincare. The local market should be evaluated for opportunities including looking at the local populations needs, whether their needs change during the winter if they travel abroad for example and local demographics such as age and income. Some conditions worsen in winter, such as prevalence of cold sores, chapped lips, dandruff and dry irritated skin. Consideration should be given to stocking both effective and market leading brands. Protection from colds and flu means that more people will consider a hand rub, but should also be advised to moisturise as the alcohol can further dry the skin.
It can be helpful to have someone take the role in leading a winter skin campaign and to involve their colleagues in finding innovative ways of raising awareness in the pharmacy. They can combine this campaign with good health promotion messages around eating plenty of fruit and vegetables, increasing oily fish and foods rich in omega oils, keeping hydrated, reducing alcohol intake 17 as well as keeping active. All of which, support healthy skin.
Letting the team sample products can also be very effective in getting their support to promote specific brands; if they can become advocates for products then customers are more likely to take their advice and make the purchase.
Resources to support healthcare professionals:
Like any topic, there is always something new to learn and having seen the Bio-Oil professional series, I would recommend the resources as being very relevant for supporting healthcare professionals in their conversations with patients.
For healthcare professionals:
Download “Dry Skin. Support and advice”
Download “Supporting You: To Understand and Care for Dry Skin”
1 American Academy of Dermatology Association (2017), “10 reasons your scalp itches and how to get relief” https://www.aad.org/itchy-skin/relieve-scalp-itch, Accessed 8.11.19
2 WebMD (2019) “Fight Flaky Scalp”, https://www.webmd.com/beauty/fight-flakes, Accessed 8.11.19
3 Healthline, “Home remedies for itchy scalp”, https://www.healthline.com/health/home-remedies-for-itchy-scalp#organic-coconut-oil, Accessed 8.11.19
4 Healthline, “Can I get a yeast infection my head?” https://www.healthline.com/health/scalp-yeast-infection, Accessed 8.11.19
5 NHS Direct Wales (2019), “Dandruff, adults” https://www.nhsdirect.wales.nhs.uk/encyclopaedia/d/article/dandruff,adults Accessed 8.11.19
6 British Association of Dermatology (2018), “Seborrhoeic dermatitis” http://skinsupport.org.uk/conditions-details/seborrhoeic, Accessed 8.11.19
7 Bio-Oil (2018), “Dry Skin: Support and Advice for Patients”, p4, 11, https://bio-oilprofessional.co.uk/content/uploads/2018/09/Dry-Skin-Leaflet.pdf, Accessed 8.11.19
8 Atopic skin disease, “Topical Tip #12 Dry skin: prevention is better than cure” https://www.atopicskindisease.com/articles/TT12, Accessed 8.11.19
9 Netdoctor (2014), “Antihistamines” https://www.netdoctor.co.uk/medicines/skin-hair/a3664/antihistamines/, Accessed 8.11.19
10 WebMD, “Prevent and Soothe Chapped Winter Hands” https://www.webmd.com/beauty/features/prevent-soothe-chapped-winter-hands#1, Accessed 8.11.19
11 NHS, “Sore or Dry Lips” https://www.nhs.uk/conditions/sore-or-dry-lips/, Accessed 8.11.19
12 Bpac nz better medicine, (2014) “Cracked heels: stop them in their tracks” https://bpac.org.nz/BPJ/2014/December/cracked-heels.aspx, Accessed 8.11.19
13 National Eczema Association (2019), “Managing Ezcema on your hands and feet” https://nationaleczema.org/hand-and-foot-eczema/, Accessed 8.11.19
14 Healthline, “Cold Showers Vs Hot Showers: Which One is Better” (2018) https://www.healthline.com/health/cold-shower-vs-hot-shower, Accessed 06.12.19
15 Healthline, “How to Identify and Treat a Laundry Detergent Rash” (2018) https://www.healthline.com/health/rashes-from-detergent , Accessed 06.12.19
16 NHS (2017),“Hydrocortisone skin creams” https://www.nhs.uk/medicines/hydrocortisone-skin-cream/, Accessed 8.11.19
17 Drinkaware, “How alcohol affects your appearance” https://www.drinkaware.co.uk/alcohol-facts/health-effects-of-alcohol/appearance/how-alcohol-affects-your-appearance/ Accessed 8.11.19
Deborah Evans is employed by Perrigo, the distributors of Bio-Oil.