Don’t take itchy skin in winter lightly. Be careful of this kind of problem, especially for middle-aged and elderly people!

The winter solstice is coming soon, and I believe you have already felt the chill. At the same time, some people's skin will be unbearably itchy, especially at night when they sleep in a warm bed, but they can't stop scratching their skin.

Typical seborrheic eczema (from references)

It turns out that in this season, a common skin problem has quietly arrived, and that is - sebaceous eczema.

What is seborrheic eczema? How can we get a good night's sleep? Today we will talk about this "culprit" and find a way to relieve it.

Seborrheic eczema – dry

If I had to sum it up in one word, whether it is the manifestation of sebaceous eczema or its cause, that word would be - dry.

This disease has other names, such as dry eczema, dry dermatitis, fissure eczema, etc.

At first, it manifests as dry skin accompanied by itching. Later, there will be a more typical appearance, that is, redness and cracks, like a dry riverbed or field, which looks like there are many cracks. In fact, the cracks may be deep and occasionally cause pain and bleeding.

This type of eczema is most likely to appear on the front of the lower legs, but it can also appear on other parts of the body, such as the thighs, arms, and body.

Different severity and manifestations of seborrheic eczema (from references)

This is mainly due to the damage to the skin barrier and increased water loss from the skin. Normal human skin has a complete water-retaining barrier in the stratum corneum, which requires a large amount of water, with a water concentration of about 10% to 20%. When the barrier is damaged, the water evaporation rate will increase to about 75 to 100 times the normal rate at the same temperature, which is very exaggerated.

Therefore, when various factors damage the skin barrier, the epidermal hydration weakens and the transepidermal water loss increases, a series of changes will occur, including dry, rough, peeling, cracks, itching and so on.

So, what exactly causes seborrheic eczema? We have summarized 5 major reasons.

The "five sins" that cause seborrheic eczema

1. Seasonal factors

In addition, seborrheic eczema is also called winter pruritus or winter eczema. This emphasizes its seasonality - it is easy to break out in winter. However, some people begin to show symptoms after autumn.

The reason for the seasonality is that the humidity drops faster in this season and the climate is drier, especially in heated rooms. When the humidity in the environment decreases, it can make the skin lose moisture more easily, which has a significant "drying" effect. Some people are even more likely to develop calf seborrheic eczema when they are close to heating equipment (radiators, electric stoves).

2. Age Factor

Although many people can develop xerosis, adults are more likely to be affected, especially the middle-aged and elderly. Data show that 70% of the elderly will have xerosis, which is higher than the general population, and the median age of onset is 69 years old.

Because the sebaceous glands of middle-aged and elderly people have decreased activity and insufficient ability to produce sebum, this will lead to a weakening of the hydration capacity of the stratum corneum and thinning of the stratum corneum. At the same time, the epidermis' ability to remove substances and sweat decreases, ultimately weakening the stratum corneum barrier repair ability of the skin.

If you have sebaceous eczema, especially in the middle-aged and elderly, you should pay attention to it because they have more risk factors, including dry skin, decreased sebaceous gland activity, and some bad habits of using soap and bath towels, which can make the condition more severe.

If it is not treated in time, or even ignored, it is easy to have obvious itching, and the skin may crack, bleed, ooze and ulcerate. Sleep will be significantly affected, and the quality of life will be 100% reduced. More importantly, if the scratching is frequent and the damage is not healed in time, it is easy to have secondary skin infection, and the skin will continue to ooze or fester and become smelly.

3. Bathing habits

If you have bad bathing habits, it may not be a problem for a few times temporarily, but in the long run it will increase the burden on the skin, damage the skin barrier, and cause sebaceous eczema.

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Common bad habits include: taking a bath with water that is too hot, often exceeding 42°C or even 44°C; taking a bath that is too long, more than 15 minutes or even 20 minutes; using alkaline bath products, such as soap. If you can optimize the details of bathing, the probability of developing sebaceous eczema will be significantly reduced.

4. Disease factors

In very rare cases, some physical diseases may be accompanied by seborrheic eczema, such as skin trauma, hypothyroidism, nutritional deficiencies, renal failure, diabetes, myxedema, malignant tumors, etc.

Ordinary people do not need to worry. If sebaceous eczema is caused by a disease, there will often be other more obvious and prominent manifestations at the same time.

5. Drug factors

One of the side effects of diuretics, retinoic acid drugs, HIV protease inhibitors, and anti-folate preparations is the occurrence of seborrheic eczema. The characteristic of these drug-related lesions is that seborrheic eczema will improve after the drug is discontinued.

What should I do if I have seborrheic eczema?

Given the close relationship between sebaceous eczema and dryness, the best and most targeted treatment is moisturizing. The fundamental purpose of moisturizing is to maintain a relatively normal skin barrier function and reduce excessive water loss from the skin.

Therefore, when sebaceous eczema appears, or even before that, when the skin is dry and rough, you need to use moisturizing products in time. It is best to use it twice a day or more, at any time. However, when you take a bath, it is best to reapply moisturizing products after bathing to reduce the loss of moisture in the skin. If some parts dry out quickly, you can reapply moisturizing products in time.

Some cases of seborrheic eczema are more serious. For example, if the effect of simple moisturizing is not good after 5 to 7 days, there will still be cracks, redness, water seepage or itching. In this case, it is necessary to see a doctor in time and give medication on the basis of continuing moisturizing.

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Daily protection should also be in place, which will better control seborrheic eczema and reduce the risk of attacks. Here are some protection suggestions for your reference:

Take a bath with warm water instead of hot water. The appropriate temperature is below 42°C.

· Bathing time should not be too long, usually it is recommended to control the time to less than 15 minutes;

Choose mild bath products, such as weakly acidic shower gel. Alkaline soap is not recommended.

Don’t get too close to heating equipment, keep a distance to avoid excessive dryness of the local skin;

If possible, properly control the temperature and humidity in the room. The temperature should not be too high (e.g. no more than 24-25°C), and the humidity should not be too low (e.g. no less than 40%-50%). If the symptoms are severe or occur frequently, a humidifier can be used;

When going to low-humidity areas (such as deserts, northern areas, and high-altitude areas), moisturize in advance.

I hope these suggestions can help you get rid of sebaceous eczema and let you sleep well~

References

[1] Zhou Lijuan, Lv Zhongfa. Research progress on the etiology and pathogenesis of seborrheic dermatitis. Journal of Zhejiang University (Medical Edition). 2015(4):465-470.

[2]Asteatoticeczema.https://dermnetnz.org/topics/asteatotic-eczema

[3]Asteatotic Eczema (Eczema Craqueléor Xerotic Eczema). https://my.clevelandclinic.org/health/diseases/asteatotic-eczema

[4]SpechtS,PersaudY.AsteatoticEczema.TreasureIsland(FL):StatPearlsPublishing;2024.

Planning and production

Author: Tang Jiaoqing, attending physician of dermatology department

Review | Feng Jun, Deputy Chief Physician, Dermatology Department, General Hospital of Datong Coal Mine Group Co., Ltd.