Managing Winter Skin Conditions: Xeroderma, Psoriasis, and Atopic Dermatitis

Winter intensifies skin itchiness. The skin retains moisture through the skin's stratum corenum. However, in dry air and reduced humidity, it leads to flaking of the skin's outer layer. Symptoms vary depending on the skin conditions, but here are three common skin conditions easily confused during winter.

■Dry skin with Itching and White Scales, 'Xeroderma'

Reduced moisture and lipid barriers lead to white scale formation lead to white scale formation. It frequently appears on areas such as the arms, legs, pelvis, waist, sides, back of the hands, and ankles.

Professor Kwon Soon-Hyo from Kangdong Kyung Hee University Hospital's Dermatology department cautioned, "When xeroderma occurs, there's a sensation of tightness and itching. Unintentional scratching can result in skin injuries. In severe cases, it can exacerbate into red patches (eczema) with swelling and oozing."

Treatment depends on inflammation, but hydration is important for treating xeroderma. Professor Kwon Soon-Hyo recommends using bath oils or oatmeal packs immediately after bathing and suggests using antihistamines with local corticosteroids for severe skin cracking and intense itching."

■Thick layers of scales ‘Psoriasis’

Psoriasis involves thick, layered white scales, but unlike xeroderma, the scales are thicker and accumulate in layers that distinctly define boundaries with adjacent skin areas. It accompanies red patches (plaques) in the affected regions and typically occur symmetrically on areas prone to friction, such as the scalp, elbows, and knees. Also, it causes less itching than atopic dermatitis.

Catholic University Incheon St. Mary's Hospital's Professor Woo Yu-Ri from the Dermatology department stated, "While the cause of psoriasis remains unclear, it's presumed that activated T-cells in the immune system release various inflammatory substances, triggering the proliferation of skin cells."

She added, "in severe cases, psoriasis becomes a systemic inflammatory disease, affecting skin, joints, cardiovascular system, and nails. This can cause swollen, painful joints, and accompanying cardiovascular diseases."

Treatment varies depending on the extent of the lesions. Topical ointments are used for small affected areas, while phototherapy or immunomodulators are typically employed. Recently, biological agents have been used to suppress the hypersensitive immune response in psoriasis.

Avoiding factors that exacerbate inflammation is important. Common triggers include alcohol consumption, smoking, dry environments, and stress. In addition, actions that cause skin injuries or irritation, such as getting injections or vigorously rubbing the skin, should also be avoided.

Professor Woo Yu-Ri commented, "While some may adjust their diet to focus on vegetarian options, there is no proven evidence that vegetarianism helps." She added, "Psoriasis patients often have concurrent cardiovascular diseases and obesity, so it's advisable to avoid oily foods and maintaining a balanced diet is recommended."

■Highly Itchy and Skin Wrinkling, ‘Atopic Dermatitis’

Atopic dermatitis shows as severe itching, with thickened skin, rashes, eczema, and wrinkling, often resembling rough or chicken skin. It commonly occurs around the eyes, ears, and in knees and elbow folds.

Professor Lee Soo-Young from Ajou University Hospital's Pediatrics department remarked, "Especially in winter, dry air, temperature fluctuations, heating, and fine dust worsen itching. Scratching exacerbates symptoms and inflammation, potentially leading to secondary skin infections. If acute symptoms such as rash or eczema occur, it's crucial to use topical corticosteroids to soothe inflammation."

Improving bathing habits is essential. Hot temperature of water intensifies skin itching. Bathing in water around 30 degrees Celsius and using mildly acidic or neutral liquid cleansers are recommended. Avoid using irritating towels. Apply a moisturizer evenly within three minutes after bathing.

Professor Lee advised, "The choice and frequency of moisturizers should be discussed with the treating physician based on the severity of skin dryness. Be cautious as oily substances like oil or Vaseline can worsen pore blockages."

Maintain indoor temperatures at 20~22 degrees Celsius and humidity levels around 40~50%. Avoid tight or woolen clothing that irritates the skin.