Winter Rash and Dry Skin: Tips to Stay Comfortable This Winter

Winter weather can wreak havoc on your skin, leading to dryness, irritation, and even rashes. Studies have shown a strong link between seasonal changes and skin conditions, with over half of the US and UK population experiencing skin concerns during winter months.^[1] This is because seasonal changes in temperature and humidity can trigger flare-ups of existing skin conditions like eczema and psoriasis, or cause new problems like dry, itchy skin.

This guide explores the common types of winter rashes, provides tips for preventing them, and highlights when to seek professional help from a dermatologist.

Causes and Risk Factors

Winter weather can significantly impact skin health, leading to a variety of issues. The major problem, dry skin occurs when the outermost layer of your skin, called the stratum corneum, loses too much moisture. This can be caused by several factors, including,

• Cold, Dry Air: Cold, dry air strips the skin of its natural moisture, leaving it feeling tight, itchy, and prone to cracking.
• Low Humidity: Indoor heating systems can further dehydrate the air, exacerbating dryness.
• Frequent Hot Showers: Hot showers can strip away the skin’s natural oils, further drying it out.

Risk Factors

• Pre-existing Skin Conditions: Individuals with eczema, psoriasis, rosacea, dermatitis, or allergies are more susceptible to winter rashes.
• Sensitive Skin: People with naturally sensitive skin are more prone to dryness and irritation during winter.
• Sun Exposure: Recent sun exposure, particularly sunburn, can disrupt the skin barrier and increase susceptibility to winter dryness. People who are more outgoing during winter season are susceptible to develop winter rash more frequent. Eg: Athletes, Hikers^[2]

Age: Older adults may experience increased dryness due to age-related changes in skin function, such as decreased oil production.^[3]

Symptoms

Winter rashes can manifest in various ways, often leaving your skin feeling uncomfortable. You might notice,

• Your skin becoming red and inflamed
• Intense itching or tingling sensation
• Development of small bumps or blisters
• The skin might feel rough and scaly
• Increased skin sensitivity.

These symptoms can vary in severity and may be more pronounced in areas of the body more exposed to the cold, such as the face, hands, and legs.

Common Skin Conditions Linked to Winter Rash

Eczema/ Atopic dermatitis

Atopic dermatitis behind the knee showing red, dry, and itchy patches, a common symptom of winter rash.

Cold and dry weather increase the overall risk of flares inpatients with AD and further increase its incidence and prevalence.^[2] Winter weather can significantly exacerbate pre-existing skin conditions, particularly atopic dermatitis (eczema). Cold temperatures and low humidity contribute to skin dryness, further disrupting the skin barrier and triggering eczema flares. Studies have shown a correlation between colder seasons and increased incidence and prevalence of atopic dermatitis. Climate change is recognized as a significant environmental factor influencing the development and exacerbation of allergic diseases, including atopic dermatitis. Research has demonstrated that cold temperatures can induce the production of proinflammatory cytokines and lipid mediators in the skin, leading to itch, skin barrier dysfunction, and ultimately, worsening eczema symptoms.^[2]

Atopic dermatitis is one of the main types of eczema. Learn more about eczema subtypes and management in our eczema overview.

Asteatotic eczema

Asteatotic eczema, also known as xerosis eczema, is a common winter skin condition marked by severe dryness, cracking, and scaling of the skin. It occurs when the skin’s natural moisture barrier is compromised, leading to excessive water loss. The cold, dry air and low humidity during winter significantly contribute to its development, making it a frequent concern during this season.

This condition typically presents as red, itchy, and cracked skin, often resembling a “crazy paving” pattern. It most commonly affects areas like the lower legs, arms, and hands. Individuals with a history of eczema or older adults are particularly prone due to naturally drier skin.

The primary goal of treatment is to restore and maintain skin hydration:

• Moisturizing: Regular use of thick, oil-based moisturizers, especially after bathing, helps seal in moisture.
• Gentle Cleansing: Use mild, soap-free cleansers with lukewarm water to avoid further stripping the skin’s oils.
• Topical Medications: In cases of significant inflammation, topical corticosteroids may be prescribed alongside emollients to reduce redness and itching.
• Advanced Treatments: Moisturizers containing alpha-hydroxy acids can help gently exfoliate and hydrate. Emerging treatments, like N-palmitoylethanolamine (PEA), show promise for reducing inflammation and discomfort in severe cases.^[4]

Rosacea

Winter rash showing rosacea-like redness and dryness on the cheek, worsened by cold weather and temperature fluctuations.

Rosacea is a chronic skin condition that primarily affects the face, causing redness, flushing, and often, the appearance of small, red bumps or pimples. While the exact cause is unknown, it’s believed to be triggered by factors like sun exposure, cold weather, stress, hot beverages, alcohol, and certain foods. The severity of rosacea can vary, and it may progress over time. Treatment typically involves avoiding triggers, using topical medications (like antibiotics and retinoids), and in some cases, oral medications or laser therapy.^[5]

Psoriasis

Psoriasis vulgaris on the lower leg, presenting as a persistent winter rash with red, scaly plaques and silvery scales, exacerbated by scratching and warm water.

Psoriasis is a chronic skin condition where the body’s immune system mistakenly attacks healthy skin cells, leading to an overproduction of skin cells. This results in thick, scaly patches on the skin. It’s a complex condition influenced by various factors, including genetics, immune system dysfunction, and environmental triggers  such as smoking, alcohol use, stress, infections, and certain medications. While seasonal influences may play a role, the overall impact of these factors on psoriasis activity is significant.^[6]

Cold Urticaria

Cold urticaria is a rare condition where exposure to cold temperatures triggers the development of itchy hives (urticaria) or swelling (angioedema) on the skin. Symptoms typically appear within minutes of cold exposure and can range from mild discomfort to severe, life-threatening reactions. If you suspect you may have cold urticaria, it’s essential to consult a dermatologist for proper diagnosis and management.^[7]

Diagnosis

Diagnosis of winter rash incudes a board certified doctor taking a history of your rash and examining the rash you developed. When necessary your doctor will request a cold stimulation test, also known as ice cube test particularly to diagnose cold urticaria.

Treatments

Effective treatment for dry skin focuses on restoring and maintaining the skin’s natural moisture barrier.

• Moisturize Regularly: Applying moisturizer immediately after bathing or showering is crucial. This helps trap moisture in the skin and prevents further water loss.
• Choose the Right Moisturizer: Opt for thick, oil-based creams or ointments that provide a more effective barrier than lotions. Look for ingredients like ceramides, hyaluronic acid, and glycerin, which help to hydrate the skin.
• Gentle Cleansing: Use mild, fragrance-free cleansers and avoid harsh soaps that can strip the skin of its natural oils.
• Warm Water Showers: Limit shower time and use lukewarm water instead of hot water to minimize moisture loss.
• Humidify Your Home: Using a humidifier, especially during the winter months, can add moisture to the air and help prevent excessive skin dryness.

By incorporating these strategies into your daily routine, you can effectively combat dry skin and maintain healthy, hydrated skin throughout the year.

Preventing Winter Rash: Key Strategies

Proactive skin care is essential during the winter months to prevent the development of dry, itchy rashes.

• Moisturize Regularly: Applying moisturizer immediately after bathing or showering is crucial. This helps trap moisture in the skin and prevent further water loss. Opt for thick, oil-based creams or ointments containing ingredients like ceramides, hyaluronic acid, or glycerin, which help to replenish and retain skin moisture.
• Adjust Bathing Habits:
  • Limit shower time to 5-10 minutes.
  • Use lukewarm water instead of hot water to minimize moisture loss.
  • Avoid harsh soaps and detergents, which can strip the skin of its natural oils.
• Increase Humidity: Use a humidifier in your home, especially in bedrooms, to add moisture to the air and prevent excessive skin dryness.
• Protect Exposed Skin: Wear gloves and a scarf to protect your hands and face from the cold, dry air when outdoors.

By incorporating these preventive measures into your daily routine, you can effectively protect your skin from the harsh effects of winter weather and minimize the risk of developing dry, itchy rashes.

When to Seek Professional Help

While many winter skin issues can be managed with home care, certain rashes may require the expertise of a dermatologist.

• Persistent Symptoms: If you experience persistent redness, itching, or cracking that doesn’t improve with over-the-counter treatments, it’s essential to consult with a dermatologist.
• Severe Symptoms: Seek professional care immediately if you experience intense itching, bleeding skin, or signs of infection (such as pus or fever).
• Recurring Rashes: If you experience the same winter rash year after year, a dermatologist can develop a personalized treatment plan tailored to your specific skin type and address underlying factors.

Consulting with a dermatologist can help ensure proper diagnosis and treatment, minimizing discomfort and preventing potential complications

Summary

Winter weather can significantly impact skin health, leading to dryness, irritation, and various rashes. Cold temperatures, low humidity, and dry winds strip the skin of its natural moisture, while indoor heating and frequent hot showers further exacerbate dryness. Individuals with pre-existing skin conditions like eczema, psoriasis, and rosacea are particularly susceptible. Common symptoms of winter rash include redness, itching, dryness, and in some cases, the development of small bumps or blisters.

Key preventive measures include regular moisturizing with thick creams, using lukewarm water for showers, limiting shower time, and using a humidifier.

By understanding the causes and taking proactive steps to protect your skin, you can minimize the discomfort and impact of winter rashes and enjoy healthier, more comfortable skin throughout the colder months.