Winter Skin Conditions

Our Chicago winter weather brings a substantial decrease in both temperature and humidity compared to what our skin is accustomed to during the warmer seasons. Unfortunately, for many of us, this means the onset of cooler weather can also worsen more challenging and chronic genetic skin conditions such as psoriasis and eczema and dry skin. In affected individuals, the skin can become very inflamed, itchy and irritated.

Although eczema and psoriasis may look very similar to the casual observer on the surface of the skin, there are very substantial differences in terms of what is happening within the skin when comparing these two conditions. Individuals with eczema suffer from decreased effectiveness in the skin’s ability to provide protection from irritating external elements. In addition, eczematous skin has an increased tendency to lose water and become overly dry and inflamed. In comparison, psoriatic skin cells are reproduced much too rapidly and fail to mature properly. In addition, psoriasis involves severe inflammation of the skin due to overly active inflammatory pathways.

Both eczema and psoriasis can affect the skin anywhere on the body, but they do have classic patterns of involvement. Eczema often involves flexural areas like the front of the elbows or behind the knees. Psoriasis classically presents on the posterior hairline, the elbow tips, and the kneecaps. Both frequently appear on the hands and feet. Hand and foot involvement presents an extra difficult challenge for patients and medical providers alike. Similarly, scalp involvement can be more challenging to manage due to the presence of our hair interfering with the delivery of treatment.

Fortunately, over the past two decades, treatment options for both eczema and psoriasis have made substantial advances. In fact, even the most difficult cases can generally be treated very successfully. In the treatment of psoriasis, newer biologic agents have improved many people’s lives dramatically. These drugs are injected by the patient or health care provider, and they offer long-term improvement or even clearance of psoriasis. Similarly, in the near future, those who suffer from severe eczema may witness a similar transformation in their care due to recent advances in systemic treatment.
More mild cases of eczema or psoriasis can often be managed by choosing from multiple classes of topical medications. These are applied once or twice daily to affected areas and are generally effective in clearing up minor or limited rashing. Patients with psoriasis may also benefit from treatment with the Xtrac laser. This is a narrowband ultraviolet laser that can treat involved areas of skin without affecting the adjacent normal skin. Xtrac treatment usually takes ten to fifteen minutes per session, and is typically administered twice weekly until clearance is achieved. Private insurance and Medicare generally cover the cost of Xtrac laser treatment. Advanced Dermatology has Xtrac laser treatment available to patients with psoriasis (as well as vitiligo) in both our Lincolnshire and Glencoe locations.

The treatment of eczema differs from psoriasis treatment in a few important ways. It is often said that there is a fine line between dry skin and eczema. Essentially, this means that keeping the skin hydrated and protected is critical to the prevention and treatment of eczema. Epionce Medical Barrier Cream ($24, 2.5oz) and skinfo® Intensive Hand Cream ($17, 3oz) are two excellent options available at skinfo® to repair and protect dry or eczema-prone skin. In addition, our providers at Advanced Dermatology can prescribe topical anti-inflammatory eczema treatment available through ADVRX or your preferred pharmacy.

If you feel that you may be dealing with eczema, psoriasis, or excessively dry skin, please feel free to schedule with one of our dermatologic providers at Advanced Dermatology for a medical appointment. We would be very happy to assist you and your skin survive the tough winter conditions.