How to Protect Your Skin During the Cold Months
When the temperature plunges, your body’s largest organ—your skin—gets a bit of a shock as winter weather sets in. Exposure to biting, chilly air and blustery winds can punish skin, leaving it dry, cracked, and even painful. And without proper care, common winter skin issues can put people with diabetes at an increased risk for annoying irritations and, even worse, dangerous infections.
But understanding the cause of and treatments for the top skin problems thatpeople with diabetes face can help you protect yourself and your skin.
Problem: White flakes are falling from my scalp.
The frigid air that sets the stage for snowstorms can make your scalp drier and lead to seborrheic dermatitis, a condition that causes scalp itchiness, dryness, and flakes commonly called dandruff. The lack of humidity (both indoors and out) fuels scalp flaking and amps up the itching, says Robin Evans, MD, a Connecticut dermatologist and professor at Albert Einstein College of Medicine in New York City.
That’s not the only reason you may be spending the season scratching your head. Yeast feeds on sugars, Evans says, and elevated blood glucose can lead to yeast overgrowth on the scalp. When paired with seborrheic dermatitis, your head will feel extra itchy. If you scratch, you’ll dislodge those scaly flakes on your head—hence the flurry of white you might spot on dark clothing.
Besides cosmetic concerns, seborrheic dermatitis can find you scratching an itch to the point of breaking the skin and causing scabs to form on your scalp. “This can lead to an infection that could be difficult to treat, depending on a person’s health,” says Evans.
Solution: Use salicylic acid–based shampoo every other day (without shampooing in between). “Salicylic acid– or urea-based topical products can be purchased over the counter or in prescription strength,” says Evans. “Your doctor can advise the best product for you based on scale thickness and size.”
For best results, apply the shampoo to a soaked scalp, and leave the suds on for an hour or overnight, depending on the degree of the scale. As you wash—and rinse—never rub aggressively or scratch your scalp with your nails.
You can also use shampoos with ketoconazole, zinc pyrithione, or selenium. “Tar-based shampoos can also be used,” Evans says. “But these products may discolor your hair.”
Problem: My nose is as red as a ruby.
Chronic exposure to whipping winds, coupled with a lack of moisture in the air, can leave you with stinging, raw skin, says Daniel Walker, MD, a dermatologist at U.S. Dermatology Partners in Grapevine, Texas. “Wind depletes the skin of natural moisturizing oils and also increases the evaporation rate of water on the skin’s surface.” As a result, your face can become red, itchy, cracked, swollen, and painful.
Chronically high blood glucose also triggers a chain reaction that increases the dryness of your skin and, ultimately, your sensitivity to harsh elements. “Diabetes can cause poor circulation, which leaves skin drier than normal,” says Walker. “That dryness contributes to redness and irritation.”
Solution: Tone down the redness and other symptoms by applying an unscented moisturizer daily, including after washing your face. “Avoid using harsh, abrasive soaps or other facial products when you know you’ll be exposed to wind,” Walker says. “And use a scarf, turtleneck, or even your gloved hand to cover as much of your neck and face as possible when outside.”
Problem: I itch all over.
While many people with diabetes struggle with this year round, the problem is often worse during the winter. “The colder temperatures, lower humidity, and increased use of central heating at home, in the car, and at the office all increase dryness of the skin,” says Walker.
Another potential reason for your winter dehydration? Excessive dry, itchy skin is the result of poor overall hydration, which often occurs when blood glucose levels are higher than normal.
“We also often look to tea and coffee to stay warm, but these are both natural diuretics, which increase urination,” says Saima Farghani, MD, FACE, an endocrinologist in Freehold, New Jersey. If your body loses fluid through urination and you don’t replenish it, you can end up dehydrated, which can open the door to dry skin and, ultimately, an increased risk of infections.
Solution: “Drinking your recommended daily amount of water is one terrific way to prevent dry skin that causes itching,” Farghani says. The National Academies of Sciences, Engineering, and Medicine recommends women get about 91 ounces of water (from food and drink) per day, while men get about 125 ounces daily.
Another way: Limit time soaking to no more than 10 minutes. When you do wash, use mild soaps formulated for sensitive skin. Pat yourself dry, making sure to get areas in between fingers and toes, under breasts, in the groin, and in any skin folds to prevent water from collecting and breeding a fungal infection. “Follow up with a fragrance-free moisturizer that contains ceramide, a naturally occurring substance that is often depleted in dry skin,” says Walker.
Use of indoor humidifiers (whole house or room versions) in the winter may also be effective. “However, if the dryness becomes severe or [skin] becomes red and sensitive, discuss prescription options, like a topical steroid, with your physician,” says Walker.
Problem: My feet are dry and cracking.
Reduced circulation in the legs and feet, coupled with seasonally dry air, can leave the skin on your feet looking—and feeling—rough, dry, and cracked. “Any open wound on the foot—even a seemingly minor crack—can allow bacteria to enter the body and cause a serious infection,” Farghani says. That’s a problem for people with diabetes, who have slower wound healing, and for people with numbness caused by nerve damage, which may make them unable to sense cracks or other wounds.
Because your tootsies spend much of the winter cloaked in socks, slippers, and shoes, you might not notice changes in their appearance until skin is very thick and dry, or an open wound has become infected.
Solution: Look down! “Inspect your feet every day as you’re putting on your socks,” says endocrinologist Maria Peña, MD, a professor at Hofstra Northwell Health School of Medicine. Don’t forget to check the bottoms of your feet, too. You can do this by using a mirror placed on the floor, or ask a family member for help.
If you notice dry skin, use a nongreasy cream or lotion. Just take caution to avoid putting lotion in between your toes.The lack of air circulation there can up the risk of a fungal infection. “Moisturizer is best absorbed right out of the shower on feet that have been gently patted dry,” says Farghani. If your skin’s appearance hasn’t improved after a week of regular moisturizing, Peña recommends seeing your podiatrist for additional treatments.
Another way to do your feet a favor: Wear properly fitting boots and shoes with good support and a soft sole to further decrease the likelihood that the skin on the soles of your feet or heels will become thick and cracked. If you do notice a buildup of skin, think twice before heading to the salon for a pedicure. Peña says anyone with nerve damage in the feet or lower legs, poor circulation, ulcers, or other issues specified by their doctor should stick to a podiatrist performing necessary foot care they can’t administer at home. Nail technicians might not have adequately sterilized tools. “And should they accidently cut your skin, even slightly, that nick could lead to an infection,” she explains. For people with diabetes who don’t have any of the above conditions, pedicures should be safe, but talk to your health care provider if you’re concerned.
Problem: My fingers feel like sandpaper.
Handwashing can help you avoid cold and flu viruses, but it can also lead to overdrying that, if severe, can make fingers feel painful or stiff. “Constant use of soap and warm or hot water to wash hands strips away oils that prevent dryness,” Walker says. “That can lead to cracked and/or irritated skin that may become a portal for an infection.”
Alcohol wipes used before finger-stick blood glucose checks can also dry the skin out. And that may lead to rough, cracked skin.
Solution: Combat dryness by washing your hands in warm—not hot—water and thoroughly rinsing off all soapy residue. “Leaving behind traces of soap prolongs exposure to those harsh, drying chemicals,” says Walker. Pat your hands dry, rather than using hot air blowers.
Immediately after washing, and any other time your hands feel dry, rub a dab or two of a ceramide-based lotion into your hands to make up for the moisture loss. (Use a fragrance-free lotion—anything scented may affect your blood glucose reading if you check your levels soon after lotioning up.) While the pads of your fingers probably won’t get dry enough to affect finger-prick glucose checks, the sides of your fingers might. If you prick there, be sure the skin stays soft and supple.
And remember: There’s no need to use an alcohol wipe before checking your blood glucose. Handwashing with soap underwarm water will do.