What Is Winter Itch and How to Manage It

From November to March, one of the most common concerns faced by skin care professionals relates to the management of dry skin during winter. This skin condition affects many people living in northern climates, with virtually no one completely protected from it. According to data from the National Health Interview Survey (USA), 81 million Americans report experiencing discomfort from dry, itchy, or flaky skin during the winter months.

Given the high prevalence of this condition, also known as “winter itch,” it is essential that skin care professionals are prepared to address it. While advising clients on how to improve dry skin is certainly important, providing recommendations that truly work requires a clear understanding of the underlying causes of this condition. Moreover, by explaining to clients why they experience “winter itch,” you increase the likelihood that they will consistently follow your recommendations.

Physiology of the Stratum Corneum (Protective Layer of the Skin)

To understand the process of skin hydration, it is essential to be familiar with the structure of the stratum corneum of the epidermis. This layer protects the skin from the invasion of bacteria and other aggressive environmental factors.

The stratum corneum consists of flattened corneocytes – dead skin cells, desmosomes (proteins that provide strong cell-to-cell adhesion), and intercellular lipids. Under the microscope, these components are arranged in a pattern resembling a brick wall: corneocytes act as the “bricks,” connected by desmosomes, while lipids serve as the “mortar” that surrounds and protects the corneocytes. Together, these components form a wall-like barrier designed to prevent moisture loss. However, the individual roles of corneocytes and lipids are equally important.

Corneocytes are primarily composed of keratin, which retains water and provides the skin with strength, as well as a number of other compounds known as natural moisturizing factors. Acting as humectants, these components not only retain water but also attract it. Unfortunately, they are water-soluble, which is why the skin becomes dry after prolonged contact with water.

Intercellular lipids consist of ceramides, free fatty acids, and cholesterol. Within the stratum corneum, their role is to prevent the loss of natural moisturizing factors from the corneocytes. At the very surface of the skin, they combine with droplets of sweat to form a thin mantle – an acid-chemical barrier that destroys bacteria and regulates moisture loss. In addition, lipids lubricate the skin and are a key factor in maintaining its smooth texture.

Environmental Impact on the Stratum Corneum

For the stratum corneum to effectively protect the body, it must remain elastic and flexible. This is only possible when the skin is adequately hydrated. Healthy skin typically contains 20–35% water. Each day, it loses approximately half a liter of water through the transepidermal route. This is a continuous process in which water leaves the body and enters the atmosphere via evaporation and diffusion. When air humidity drops sharply, as occurs in cold weather, moisture loss increases significantly. Dry air draws moisture out of the skin. When the water content of the skin decreases to around 10%, the skin begins to dry out, causing discomfort accompanied by erythema, itching, and scaling. As water levels decline, the production of natural moisturizing factors decreases and lipid levels fall, initiating a vicious cycle that is difficult to reverse.

When this process is combined with constant or prolonged exposure to irritants such as soap and hard water, the situation worsens considerably. Such exposure leads to the disruption of the skin’s acid mantle, further increasing transepidermal water loss and reducing lipid levels. As a result, the skin may become so dry that cracking occurs, increasing the risk of infection.

The lower the levels of water and lipids in the skin that are needed to lubricate and protect the stratum corneum, the more impaired the exfoliation process becomes. This leads to excessive accumulation of dead cells on the skin’s surface, giving it a dull appearance. As a result, the overall health of the skin deteriorates, and the skin loses its ability to repair itself. To relieve the discomfort caused by these factors, a variety of solutions have been developed that skin care professionals can recommend to help patients alleviate winter itch.

Moisturizing Products

The primary goal in caring for dry skin is to minimize discomfort. Lotions and moisturizing creams can provide temporary relief. However, contrary to popular belief, these cosmetic products do not add moisture to the skin. Instead, they help restore the barrier function of the stratum corneum and soften small cracks in the skin.

Moisturizing products typically contain the following categories of ingredients:

• Occlusives. These help maintain skin hydration by slowing the rate of moisture loss through transepidermal water loss. This category includes: petrolatum, silicones, beeswax, cyclomethicone, mineral oil, lanolin, dimethicone, and vegetable oils (such as avocado oil and olive oil).
• Humectants. These function similarly to the skin’s natural moisturizing factors by attracting water from the dermis and retaining it within the stratum corneum. This category includes: glycerin, urea, propylene glycol, and sorbitol.
• Emollients. These act as lubricants, increasing skin elasticity and smoothness. In addition, they help humectants and other skin care ingredients maintain a silky texture. This category includes: isopropyl palmitate and jojoba oil.

In addition to these components, research has shown that formulations containing ceramides and aloe vera are extremely beneficial for dry skin.

• Ceramides. For most people, ceramides are among the most abundant lipids found in the stratum corneum. Reduced levels of this key lipid type have been identified in the skin of individuals suffering from eczema. This research has demonstrated the essential role of ceramides in preventing skin dryness.
• Aloe vera. One of the few natural ingredients whose benefits for the body are supported by scientific research. Recent studies have confirmed that aloe vera improves skin hydration due to its moisture-retaining properties.

During winter, dry skin is best treated with creams rich in moisturizing components. Products of this type are usually heavier in texture and are often marketed as nighttime moisturizers. Regardless of the label, dry skin benefits from their use throughout the day. Clients should be reminded of the importance of reapplying moisturizer every few hours. An alternative option is the use of a moisturizing spray during the day.

Exfoliation

Exfoliation is an essential part of skin care throughout the year. When a safe exfoliant is used, it can be performed at home. This step is particularly important for individuals with dry skin. It should be remembered that reduced water content and decreased lipid levels associated with dry skin can disrupt the normal shedding of dead epidermal cells. Regular use of an effective exfoliant supports proper skin cell renewal. As a result, the skin appears healthy and well cared for.

Traditional Recommendations

There are a number of time-tested recommendations that, today as many years ago, have proven their effectiveness and should continue to be shared with clients. These include the following:

• Reduce the frequency of bathing and gradually lower the water temperature. This is an important step for individuals with dry skin, but it is also worth considering for those with normal skin. As mentioned earlier, water washes away the skin’s natural moisturizing factors and affects lipid levels.
• Avoid the use of harsh soaps and cleansers, as well as frequent use of hand sanitizers. These products disrupt the skin’s acid mantle, increasing the rate of moisture loss through transepidermal water loss. Alcohol-free sanitizers and glycerin-based soaps are recommended.
• Use a cool mist humidifier at home and in the office to maintain an appropriate level of humidity. This helps the skin retain moisture by slowing the rate of transepidermal water loss.

Treatment Course

Most skin care professionals have a standard set of effective recommendations for managing dry skin during the winter months and dry skin in general. It is beneficial to stay informed about the latest research related to skin hydration and the ingredients that support it. Scientific advances in skin care contribute to the development of increasingly effective formulations. By keeping up to date with current research, you will be better prepared to select the most appropriate skin care regimen for your clients. This, without doubt, leads to professional success.

Author: Ahmed ABDULLAH, MD – board-certified plastic and reconstructive surgeon, aloe researcher, CEO and founder of Lexli International. Expert in the medicinal properties of aloe vera, member of IASC and associate clinical professor at the University of North Dakota

Editor: Nataliya CHAYKA – Editor-in-Chief of ESTportal

Based on materials from Skin.Inc

First published: 2017
Updated in line with current guidelines and relevant research: 2026