Now that winter is in full swing, the dermatology clinic has long lines of patients again. What kinds of skin diseases are more likely to occur in winter and what are the causes? What should be done once you are “hit”? Dr. Ren Ying Ying of Guangdong Dermatology Hospital here lists several skin diseases that are more prevalent or easily aggravated in winter, and briefly introduces the knowledge of disease prevention. Ren Ying Ying, Department of Integrated Chinese and Western Medicine Dermatology, Guangdong Provincial Dermatology Hospital
Scene 1: The patient said: “Doctor, since the weather became cold, my skin started to itch, it’s fine during the day but it’s very itchy at night when I get home, and it’s even more itchy when I get warm under the covers. I can’t help but use hot water and soap to wash every day, the more I wash, the more itchy I want to scratch, look at my skin is scratched, scratch to relieve the hate ah!
Based on these few words, the dermatologist was able to guess that this was a patient with pruritus. People may wonder: many skin diseases will itch, so this disease does not cover all pruritic skin diseases? The answer is no. Pruritus in dermatology refers to a clinically abnormal sensory function dermatosis without a primary rash and predominantly pruritic. In layman’s terms, the patient’s skin should look completely normal from the outside and just feel itchy. Pruritus occurs for many reasons, from external factors, cold and heat stimulation, friction of rough clothing, acid and alkali and other chemical stimulation may cause pruritus; from internal factors, diabetes mellitus, hyperthyroidism, liver and kidney disease and psychological factors can also cause this condition. After excluding pruritus caused by internal diseases, dermatology deals with simple pruritus of the skin in general.
Disease points.
1) External factors: the weather becomes cold and the north wind blows hard
2) Onset characteristics: itchy, but no rash
3) aggravating factors: daily bathing with hot water soap
Based on these 3 characteristics above, the dermatologist would consider this patient to have a high probability of pruritus. The advice to these patients is to
1) Keep warm at home and try to wear finer fiber cotton or natural fabric clothes.
2) Do not bathe in water that is too hot and too often, and avoid using washing products with strong detergency such as soaps and body washes to protect the sebum on the skin.
(3) Pay attention to skin moisturizing, it is recommended that after bathing and wiping the body, before the moisture on the body is completely dry, apply moisturizing cream or body lotion all over the body, such as our vitamin E cream, allantoin cream, compounded nicotinamide cream, etc.
If the situation does not improve after a week of self-treatment, or if rashes such as red spots and cracks appear, or if you have other discomfort, please come to the hospital promptly. On the one hand, the doctor will provide better oral anti-itch medication, while on the other hand, he/she will also help you to investigate whether there are other medical causes.
Scenario 2: The patient says: “Doctor, my eczema comes out in winter, I use salt, soak with pepper water, drink herbal tea to remove the dampness is not good, and when it is strong, it even comes out water, and as a result, the hair is all over the body. What should I do?”
Many patients repeatedly for many years, it is clear that they suffer from eczema, in the case of a long time, many patients gradually embarked on the road of “prescription treatment”. Eczema is a recurring inflammatory skin disease that manifests itself in a variety of shapes such as erythema, papules, blisters, vesicles and oozing, usually with poorly defined boundaries on the skin and prone to recurring episodes. The triggers of eczema are related to allergies and disruption of the skin barrier, so all year round may be a good season for eczema. Many people in Guangdong mistakenly believe that “eczema” is a rash that occurs only in “humid” weather and often say that it is caused by “dampness”. In fact, this is not the case at all. The “wet” in eczema refers to the “oozing” look, which simply means that the skin behaves as a small blister or oozing state, not only is it not related to whether the air is moist or not, but dry skin is also one of the reasons why eczema is triggered and aggravated. “Rubbing salt, rubbing wine, vinegar soaking, dipping pepper water, drinking herbal tea to remove moisture”, these seemingly itchy methods, in fact, not only can not improve the symptoms of the skin, but also because of the intense stimulation leads to further damage to the structure and function of the skin, resulting in a vicious circle.
Because eczema is characterized by recurring episodes, it is recommended to.
1) Resolutely avoid scratching, pinching, picking and other physical ways to stop itching, try not to wear coarse fiber clothing, and eliminate chemical stimulation such as pepper water, salt, vinegar and wine.
(2) If the skin itching is obvious, you can choose to take oral anti-itch effect of internal drugs and external drug combination treatment.
3) Like pruritus, avoid using overheated water, soap, body wash and other baths, and dry your body in time after bathing to enhance moisturizing.
4) Light diet, avoid alcohol, spicy and other stimulating food, healthy life, cheerful mood.
5) Do not drink “dampness tea”, “herbal tea” and other Chinese medicine. Cantonese people like to make soup and like to put herbs in the soup to “clear heat and remove dampness” and “strengthen the body” thinking it is safe and convenient. However, patients with eczema are often not all “hot and damp evidence”, the abuse of “herbal tea” but make the cold and damp Qi trapped in the body, or directly weaken the digestive and absorption functions of the spleen and stomach, or make the original Yin deficiency blood deficiency of the physique even worse. The actual fact is that it is best to consult with a Chinese medicine practitioner before using Chinese medicine, so that you can identify the evidence and treat it, and not take the medicine on your own.
Although eczema is common, the causes of eczema are complex and the forms vary. The acute phase can manifest itself as oozing, blistering, and erythema, while the chronic phase has a variety of forms such as thickening of the skin, so it is important to choose different topical medications according to different rashes. Therefore, it is important to choose a regular medical institution and receive a regular treatment plan.
Scene 3: Patient: “My calves were particularly itchy a few days ago, and it has worsened over the past few days, even on my thighs, sides of my waist, back and arms. When the weather is warm, it won’t be like this, but in winter it will come back, why is that?”
Scene 4: New parents: “After winter my baby’s face and hands have always been red, sometimes chapped and cracked, and in severe cases, skin and water, he always likes to scratch and rub. He always likes to scratch and rub. He is still in trouble even after applying moisturizer, and he doesn’t get better even after applying olive oil.”
Scene 5: Female patient: “My fingertips become very hard in winter, skin falls off, and cracks, which is especially painful, so I can’t do housework or make fingerprints.”
In these three scenarios, the age of the patient is different, the location of the lesions is different, and the shape of the lesions is not quite the same, so why are they put together? That is because the causes of all three diseases are related to the dry and cold weather.
The first type of patient is most common in the elderly, the lesions occur on the extensor side of the calf, thighs, arm extensor side, back and waist sides are good sites, the rash is scattered on the dry skin crack-like erythema, like a dry field lack of water. This is because the sebaceous glands do not produce as much as they did when they were younger, and the lack of a protective layer dries out the skin as if the fields were dehydrated.
The second type of patients are mostly young children, with lesions on exposed areas such as the face and the back of the hands. The rash is erythematous, dry, cracked and, in severe cases, oozing and red, with children crying and fussing. This is because young children’s skin stratum corneum is thin and tender, the skin is rich in moisture, the cold wind blows away the moisture, the exposed parts of the skin will bear the brunt of the disaster.
The third type of patient to middle-aged people, especially women, this is because the usual exposure to more detergents such as detergent, laundry detergent, soap, etc., resulting in the lack of oil on the hands to protect the dry and cracked. Some people say, I obviously wore rubber gloves to isolate but did not get better, this is why? It is because rubber gloves can also aggravate the condition, and some people are allergic to rubber contact, so they should use rubber gloves with fleece lining, or wear an extra pair of thin cotton gloves inside the rubber gloves.
These three patients also have one thing in common, that is, the skin does not improve after using lotion, but will be painful, red and swollen. This is because the moisturizer is “oil-in-water” nature, when applied with a fresh texture, but these three diseases often have more serious damage to the stratum corneum chapped, “oil-in-water” matrix but the formation of irritation, so in the choice of skin care products, should be used to moisturize a large, moisturizing effect of “oil”. The “water-in-oil” base ointment with better moisturizing effect, such as our urea ointment, or Vaseline based herbal moisturizing cream.
Scenario 6: “Doctor, when I walk into an air-conditioned room in summer, I get bumps and itchy bumps all over my body when I blow cold air in winter, and my mouth and throat feel a little swollen when I eat cold drinks, what’s wrong?”
This is a relatively common description of cold urticaria. Urticaria, which the people generally call rash or wind bumps, is a common skin condition that manifests as a wind cluster. A wind-bump is is a well-defined edema in the skin, which is located deep in the skin when the surface pores are sunken down much like the appearance of an orange peel. It usually subsides within 24 hours and does not leave a trace after it subsides. In surveys, about one in two people may experience hives one or more times during their lifetime. Usually food and medications trigger urticaria, and in the winter, when cold temperatures trigger it, it is likely to be cold urticaria. Sometimes severe cases can result in shock or even death from jumping into a cold pool or eating cold drinks. This condition may be inherited, with a genetic predisposition, or acquired, accompanied by other diseases.
We advise patients to.
1) If the attack is very mild, we recommend avoiding cold air and cold water, avoiding cold drinks and keeping warm.
2) In winter, when there are more festivals and gatherings tend to be more frequent, pay attention to a light diet, avoid stimulating foods and alcohol consumption.
3) Apply medication to control under the guidance of a doctor. Chinese medicine can improve the physical condition of patients with urticaria and enhance tolerance to allergens through their own regulation, which can achieve the purpose of “treating both the symptoms and the root cause” with the use of western medicine.
If the rash is prolonged or frequent, it is time to come to the hospital. Your doctor will examine you more carefully, asking about the rash, whether it is accompanied by other discomforts, and your family history, and will arrange for appropriate tests, including infectious, rheumatic, and ice tests, to rule out other diseases.
In addition, other skin diseases with high incidence in autumn and winter are: frostbite, which is related to localized cold and damp skin; atopic dermatitis, ichthyosis, and periorbital keratosis, which worsen due to dry and dehydrated skin; chickenpox, rubella, and measles, mainly due to poor ventilation and susceptibility of the respiratory tract to viruses; and psoriasis, which may be related to upper respiratory tract infections, less sun exposure, and dry skin. These kinds of skin diseases are prone to attack or aggravate in winter.
In conclusion, it is very important to avoid these triggers in the fall and winter when it is cold, dry, sunlight is reduced, and bacteria and viruses are easily contracted. If the disease still comes on its own without telling us, we recommend that you must visit a regular medical institution to relieve your discomfort as soon as possible to avoid delays. We wish you all a comfortable winter!
This article was originally published on the WeChat public platform of Guangdong Dermatology Hospital and written by me.