Dry skin isn't all it's cracked up to be

The cold of winter tends to really bring out dry skin, which can be everything from mildly bothersome to a major issue if it causes cracks in the skin that become infected. This is what our dermatologists typically recommend to help:

- Bathe once a day or less. As you get older, bathing every other day may be more than enough.

- Avoid long or hot showers, even though they may feel great. Hot water and soap dry out the skin.

- Use a mild soap such as Cetaphil liquid cleanser or bar, Aquanil, Dove unscented soap, Olay bar, etc. Do not use Ivory, which dries the skin a lot, or the heavily scented soaps such as Irish Spring, or Zest.

- Use FRAGRANCE FREE mild laundry detergents such as Arm and Hammer, Free and Clear, or Cheer Free liquid.

- Avoid fabric softener sheets in the dryer. Think about it! These are the only chemicals which are put on your clothing during the laundry cycle which stay in the clothing.

- Avoid fragrant products such as detergent, soap, lotion, or perfume.

APPLY MOISTURIZERS TO THE BODY ONCE OR TWICE A DAY.

Thick creams are better than thin lotions, but only if you will use them regularly. Anything you like enough to use regularly will work better than anything you do not use. They should be applied within 3 minutes after every shower. Lotions may be better for the face if acne is a problem.

Try these three categories of moisturizers, by finding the key words on their labels:
Ceramides -- the skin's natural moisturizing layer.
Alpha hydroxy acids (AHA) -- These pull the moisture found deeper in the skin upwards to combat dry skin
Traditional barrier creams – These stop water evaporation from the skin, like pouring oil on water. If neither ceramide nor AHA is mentioned on the product label, it's probably a traditional barrier cream.

See what approach works best for you, then try different brands in that category.

Usually thicker creams or ointments are more effective than lotions. But if you don't like thick creams, try a lotion. Lotions contain more water.

Oatmeal baths for 15 minutes daily may relieve some itching. You may try Aveeno bath packets or one cup dry oatmeal in a knee-high hose dropped into the bath.

Lotions which provide temporary relief from itching include those with menthol added, such as Sarna Original Lotion, or Eucerin Skin Calming Lotion.

If cortisone products are prescribed, use only on the affected skin areas. These are usually applied twice daily.

NSAIDs

Advil and Motrin are ibuprofen, then you have Aleve (naproxen). Those are the over-the-counter ones. Prescriptions are Mobic (meloxicam), nabumetone, indomethacin, Toradol (ketorolac), diclofenac, Lodine, and the list goes on. All of these medications are in a class called non-steroidal anti-inflammatory drugs (NSAIDs). I'm giving you this list because there is mounting evidence that these medications a) don't work as well as we'd thought and b) have some very serious long term side effects we're finding out more about. NSAID's act by reducing the amount of prostaglandins you make in order to reduce inflammation. However, prostaglandins have a ton of other effects and are involved in the maintenance of just about AIDs and also stronger if they are taken every day and/or around-the-clock. every other organ system that you have. The effect is stronger with higher doses of NS NSAID's work best and are best indicated for times when something is r...

Kidney Stones

I've written about this previously , but it's often hard to explain to people what a 10 is on the "1-10" pain scale if they haven't been in that spot before. For women who have had children, they generally know what a 10 is, but for men it's a little harder. When I was a medical student on my psychiatry rotation, we had a patient calmly sitting there saying his pain level was at a 10 and our resident, who was an ex-military sniper with a large skull tattoo on his forearm and a crosshair through the eye, calmly leaned forward and asked, "so if I lit you on fire and ran you over with my truck, you could not be in more pain than you are now, correct?" The patient changed his answer. Getting to the point, a kidney stone is about the close I can come to describing a 10/10 pain to people who haven't gone through childbirth. The fundamental issue is similar - your body is trying to move a big solid thing through an opening that was not really desig...

Pain

Sorry to be a pain I would say about 90% of the comments I hear from people about their pain threshold is that they think they have a high pain tolerance. Which is statistically impossible unless I just attract people who have a high pain tolerance. We traditionally ask people to rate their pain on a 1-10/10 scale and while we hear a lot of 9's and 10's, I would say that, having been present for a number of them, a 10/10 would be giving birth to a first child. For those who haven't experienced that, my old psychiatry resident described it as "so if I lit you on fire and ran you over with my truck, you would not be in any more pain than you are now" (he was also a former Marine sniper which might explain that). But this is pretty pervasive throughout the medical system and got me wondering as to how people's understanding of what their pain threshold was matched up to what it really was. Fortunately, there were researchers who had a yen to poke peopl...

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