Regina Yavel, MD is a graduate of Brown University and a board certified dermatologist and fellowship trained Mohs skin cancer surgeon. She completed her dermatology traning at SUNY Downstate Medical Center. Dr. Yavel is a Fellow of the American Academy of Dermatology, Dermatology Foundation Leaders Society, American Society of Dermatologic Surgery and American College of Mohs Surgery. In this article, Dr. Yavel reviews dry skin care basics and reveals interesting connections with dry nasal passages.
Dry skin care is a common problem, particularly in the winter when the air is markedly less humid. Also known as “xeroderma” or “xerosis cutis” from the Greek prefix Xero- (for dry), dry skin can itch, flake, crack, and in severe cases bleed or become swollen. Severely dry or swollen hands may lead to discomfort and pain when one performs tasks such as opening mail, typing, or preparing food.
Realize that dry skin is primed to itch and is more vulnerable to injury. When one uses fingernails to scratch dry, itchy arms or legs, tiny cuts, or microscopic tearing of the skin may result and can provide a gateway to infection. Any bacteria on the skin surface or under the nails can be introduced into these micro-tears, putting one at risk for bacterial skin infection. So remember to wash your hands frequently, keep fingernails short or clean under nails with a scrub brush and moisturize often.
Just as dry skin can form a gateway to infection, so can dry nasal passages. We may appreciate our noses for the air intake function or olfactory stimulation they provide – think of the smell of fresh baked goods from your favorite bakery (or home oven) or grandma’s Sunday meatballs and sauce. However, the nose also has a vital function in protecting us from diseases (immune defense). The nasal membrane structures and secretions are fundamental in the nose’s role of filtering out particles and protecting the airways and nasal sinuses. Nasal cilia, which are hair-like projections on cells lining the nasal passage mucosa (epithelial cells), move in a coordinated manner to move mucus containing pathogens (“germs”), allergens and other debris to the gastrointestinal tract for clearance.
Furthermore, nasal secretions contain substances and enzymes, which defend us from invading bacteria. Some of these enzymes may attack pathogens directly. Others may communicate with the network of blood vessels and lymphatics embedded in the nasal membranes to mount a coordinated response. For example, when a virus is detected, certain substances can trigger the dilation of nasal blood vessels. We call this widening of the blood vessels “vasodilation.” Vasodilation allows for the speedy arrival of various immune blood cells and signals which can mount a sophisticated defense from the virus.
Dry conditions can compromise the nose’s defenses. When the nasal passages become dry, due to low humidity, nasal mucus won’t flow properly, and sinuses won’t drain as they should. As a result, pathogens can gain a foothold on the road to infection. Cold exposure can compound the effects of dry conditions even further. For example, if you are standing at a bus stop or on a train platform on a cold day, and your nose becomes cold, blood vessels in the nasal mucosa will narrow (vasoconstriction). This vasoconstriction can impair the ability of immune blood cells and signals to get to where they are needed to fight invading pathogens, especially viruses. For this reason, it’s always a good idea to have a hat or scarf handy in cold weather to protect the skin and nose from exposure.
At home, keep the air adequately humidified, especially in the winter when the air is very dry. Many newer home heating systems incorporate central humidifiers and regulate air humidity, and may provide a digital display of humidity levels as well as temperature. If, however, you live in an older home or apartment, and you do not have humidity readings available, your first step may be to purchase a device called a ‘hygrometer,’ which measures air humidity and temperature. These are battery-operated devices about the size of a deck of cards, which are available for purchase for as little as $10 from your local hardware store or online. Hygrometers display the humidity level and indicate whether it is adequate or too low. You may be surprised to discover that humidity levels in a room can fluctuate throughout the day and vary from one day to the next. A hygrometer used in conjunction with a humidifier can make a real difference in the condition of your skin and nasal passages during the winter.
Here are some additional tips for dry skin care and combatting low humidity conditions: