Those falling leaves aren't the only things getting dry this fall. Just take a look at your skin. To help prevent that alligator look this winter, take steps this fall to get your skin into shape after the summer sun and water exposure have depleted precious moisture and nutrients. Realtors have a favorite line "location, location, location". Dermatologists have their standard fall and winter mantra "moisturize, moisturize, moisturize". Here are helpful tips to keep in mind to make the most of your moisturizing experience:

• Don't Over Bathe

  Time was when dermatologists used to tell those prone to horribly dry skin to bathe just once a week. Can you imagine? This myth continues to surface periodically. Nothing could be farther from the truth. What you do need to understand is that whenever you take a bath or shower, as the wash water evaporates from the skin, it takes valuable moisture from the epidermis with it leaving skin vulnerable. What you can do is cut down on the frequency of daily bathing (yes, there are people who through either personal hygiene habits or their jobs bathe more than once a day) and make sure you follow some of the other rules below. Towel dry very well, consider a product like Aquis Body Towel so that you get this bath water off your skin before evaporation has the opportunity to leave your skin dehydrated.

• Add Bath Oil

  If you like taking a bath, one way to help hydrate your skin is to add bath oil into your water. It's luxurious, helps leave the skin feeling quite smooth and some contain aromatherapy ingredients to create a relaxing mood, something we just can never get enough of. Robathol Bath Oil and L'Occitane Almond Shower Oil are great options. Bath oils also come in therapeutic formulations. For anyone prone to psoriasis, Balnetar Therapeutic Tar Bath is one of those can't live without items from September through May. The tar helps alleviate much of the itching and flaking while the oil base helps hydrate dry cracking skin. A note of practicality when using any bath oilthey make your tub slippery! For those of you who would rather not bathe than get into the tub, nothing says you cannot apply splash some oil onto your skin while you shower.

• Carry Extra Hand Cream With You

  Have you ever thought about how many times you wash your hands a day? While I've never stopped to count, it has to be at least 10 if not more. Constant contact with the water, not to mention harsh, often antibacterial soaps can cause dry cuticles, fragile nails and painful finger splits. To prevent this, carry some extra hand cream with you and apply after every hand washing. If you have a job that requires lots of hand washing (bartender, hair stylist, health care worker), keep an extra tube nearby.

• Moisturize Immediately After Washing

  Evaporation may sound like something you learned about in high school chemistry, but it happens every day to your skin, particularly during cold, dry winter months. After you towel dry, increase the moisture content in your skin by applying a hydrating body cream like Korres Guava Body Butter or CeraVe Moisturizing Lotion. Particularly dry skin may savor an extra emollient base such as CeraVe Moisturizing Cream or L'Occitane Shea Butter Ultra Rich Body Cream.

• Switch To A Crme Based Skin Care Regimen

  Whether or not your skin is dry year round or you're prone to oily or combination skin, you should be rethinking your product bases during the fall. Switch to a hydrating base if there is an option for your particular skin care product whether it is for skin rejuvenation or dry skin. You will have a better barrier between you and the environment with a cream vs. a lotion or serum based product. I like Murad Soothing Skin and Lip Therapy, which moisturizes and provides a weatherproof barrier for both the face and lips.

• Moisturize More Than Once Daily

  Who says that a moisturizer is only applied in the morning? Multiple applications of moisturizer will help speed up hydration and skin healing for anyone whose dry skin has gotten out of control. It is not uncommon for me to tell patients with parched symptomatic skin that if they apply their moisturizer 4 or 5 times a day for a week that they will see a significant rapid improvement in symptoms.

• Use An Active Ingredient If Necessary

  An active ingredient is one that helps to exfoliate, hydrate or both. Glycolic acid (aka AHA), lactic acid, urea and salicylic acid (aka BHA) are all potential helper ingredients. While you don't want to actively rub one into an open fissure, their use can help promote softer supple skin less likely to crack during the depths of winter. You may find that you want to mix and match these various active agents such as Priori Advanced AHA Hand & Body Revitalizing Lotion, AmLactin Moisturizing Body Cream or Carmol 20 Cream. Another option would be to use DERMAdoctor KP Duty Dermatologist Moisturizing Therapy For Dry Skin with a combination of glycolic acid, urea, algae, green tea and hyaluronic acid. Any of the above mentioned products can be used twice daily or used once daily along with a regular bland based moisturizing cream.

• Cracks & Splits

  Use DERMAdoctor Handy Manum Medicated Skin Repair Serum with 1% Hydrocortisone at least nightly, ideally twice a day. DERMAdoctor Handy Manum Anti-Itch Fissure Relief Serum contains a bevy of AHAs, salicylic acid and propylene glycol to quickly softens the hard, dry skin, allowing the fissures to heal. It also contains 1 percent hydrocortisone, oat beta glucan and green tea extract to help reduce itching and inflammation. The base establishes a protective barrier to prevent further environmental challenges. I think of DERMAdoctor Handy Manum Medicated Skin Repair Serum with 1% Hydrocortisone as a medicated dry oil; a little goes a long way and won't leave skin feeling greasy.

  Apply Polysporin First Aid Antibiotic Ointment into the splits twice a day. Do not use any topical antibiotic ointment that contains neomycin which is a notorious skin sensitizer and cause of contact dermatitis.

• Eczema Concerns

  Eczema is often a hereditary, chronic dry skin condition and winter is no friend of those with atopic dermatitis. While prescription steroid creams and most recently Protopic are used to help heal those itching scaling patches, Triceram or Nouriva can be used help prevent and even heal often without the need for topical steroid products. Dry skin due to eczema, atopic dermatitis or even environmental or occupational reactions loses its ability to repair itself when the natural barriers are lost. Both Triceram & Nouriva work because the formulation is based upon a ceramide dominant ration of naturally occurring lipids. This in turn helps restore the necessary healthy barrier and repair the skin.

• Bubble Bath Mayhem

  Bubble bath is often just detergent added to water. If you are looking for something to create ambience, look to herbal bubble bath that contains hydrating essential oils such as California Baby. This particular brand offers a variety of aromatherapeutic options that will hydrate your skin with less chance of causing dryness or irritation.

• Humidify Your Environment

  Once you turn on the heat, the air becomes very dry in your environment if you don't have a humidifier on the furnace. Or you can have individual room humidifiers. And of course autumn and winter air lacks the humidity that Mother Nature provides the rest of the year. If you can, humidify your environment, your skin will thank you for it.

• Be Wary Of Winter Time Vitamin A Use

  Vitamin A has a variety of molecular cousins used in the treatment of acne, psoriasis and skin rejuvenation. Tretinoin (Retin A, Renova, Avita), Tazarotene (Tazorac), Adapalene (Differin) and Retinols (Afirm or Neova Retinol ME 0.30%) are likely to cause exaggerated dryness, irritation, flaking or redness during cold weather. You may find that using the product less often may help. Or you may want to use a moisturizer aimed at healing skin dry due to the use of these agents like Nouriva Repair Moisturizing Cream. Kinerase has been very popular for skin rejuvenation treatment who cannot tolerate the use of vitamin A based products during this time of year.

• Nip Itching In The Bud

  Dry skin is often itchy skin. There is nothing harder to break than the itch-scratch cycle. Preventing the formation of dry skin is the best option but when this cycle has started, make sure you attack the symptoms of itching along with the dry skin. The more you scratch, the more the inflamed skin will itch and the harder it will be to heal the affected area. Oral antihistamines like Zyrtec and topical anesthetics like PrameGel, L-M-X or Prax Lotion help keep your from scratching your skin raw. Prescription options such as oral hydroxyzine, doxepin or zonolon cream may be helpful as well. I have personally found those non-sedating oral antihistamines often used to control the symptoms associated with hay fever rarely help control itching.

Avoid rough, dry cracked skin this year by planning ahead. Moisturize your skin this fall and winter. Moisturize, moisturize, moisturize.

Thank you for taking the time to read through this important information. I hope you have found this article informative.

Audrey Kunin, M.D.

(Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.)

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