Winter Survival Essentials: What You Need Before You Leave the House

Does your psoriasis get worse when the colder months draw in?

There are lots of things that lead to the worsening of our skin in the winter. These can range from mold sensitivity reactions to a reduction in our ability to detect thirst in cold weather.¹ To offset some of these challenges, these are the things I will not leave my house without in winter:

1. Lip balm for chapped skin

Now you may be thinking "ah yes, very sensible, chapped lips" and you would be right. Lip balm also has many other uses:

• It can soothe the skin behind your ears if you feel it starting to crack when you are out and about (you know the ear-scalp fold I am talking about).
• It can tackle dry patches as soon as you notice them, softening dry skin through the day. Scales are less noticeable when they are moist.
• It is an excellent tool for eyebrow psoriasis. I apply lip balm to my brow, rub it in, gently peel off any easy to remove scales, then wipe excess lip balm off with a tissue.

You want to avoid ingredients such as perfume (often listed as parfum) because if you're applying this to damaged skin, you do not want to increase irritation; and to include highly moisturizing ingredients like beeswax, cocoa butter, and shea butter as long as you tolerate them well.

2. Headwear and scarves to hide flaking or flares

In the winter I often leave the house thinking my scaling is absolutely fine, only to realize after a short session in a heated building that as my skin is dried out and the scaling is much worse than expected. Lip balm can only do minimal editing- if my entire hairline is flaking visibly, then a headscarf can be an absolute star. A swift wrap around my head and I can hide away unsightly areas until I get home and deal with them appropriately. This is also great if I realize my jumper or coat is rubbing on my neck, because for me this creates ideal conditions for culturing neck psoriasis- I can use the scarf to reduce friction from collars and zips. A beanie hat will work just as well, only they can be less acceptable indoors.

3. Water (or a flask of decaf) to stay hydrated

It is inescapable (and annoying) but our skin hydration is critical, and in the winter all elements are against us. Central heating dries us out externally and the lower humidity of the air around us even when outside can dry out the skin. Add to this the fact that we don't notice that we sweat as much in the colder months (cold, dry air evaporates sweat from our bodies much more effectively than it does in the summer) and that our bodies work harder than we realize carting around all of that bulky winter clothing we have draped over ourselves.

That's not touching on another factor: the "smoking." When you breathe out, you can see the water in your outwards breath condense in front of your eyes. Its magical *and dehydrating*. Some of that water was put into that air by your lungs. So the more you breathe, the more you lose water (are you feeling thirstier yet?). I feel I would be amiss if I did not remind you that you must breathe, therefore use your smokey looking condensate as a good excuse to go for a decaf coffee instead.

Speaking of thirst, did you know we are up to 40% less aware of thirst when we are cold? This is because our bodies move blood away from the skin when we are cold to maintain the body temperature at our core, so our brains do not notice a reduction in blood volume even though there is less volume in the whole body. Therefore the body loses more water before the feelings of thirst kicks in.¹

So now you need to know how to stay hydrated. Try sipping drinks even when you're not feeling thirsty. It is nice to keep them hot and relaxing, but avoid caffeine which can dehydrate you.

Another tip is to monitor your urine if your urine is dark or smells strong, you need more fluids.

4. A book (or headphones)

So this one is a touch anti-social, but everyone's skin dries out in winter. I find that people feel like talking to me about dry skin more during the winter months because I am in jumpers and leggings people only see my flaky hairline and maybe a few "dry patches" on my face and think we are the same. I find that if I am not in the mood to talk to people (as an introvert this is most of the time) then having a book at hand when I sit down to relax help keep me free of well-intentioned interlopers.

The side effect of this is that instead of checking Facebook in a queue I can actually invest in my personal development. I can't read fiction is queues because I tend to find myself standing in the same place 15 minutes later, but if you can refrain from total absorption (or have better peripheral vision than me), then you go for it.

5. Hydrocortisone for psoriasis flares

Now if I were a more organized person this wouldn't be on my list. I have this everywhere in the winter as during these months my psoriasis always comes up in my eyebrows and starts to flake much more around my ears. During my morning routine, I leave my moisturizer to settle in and therefore often forget to go back and add this mild steroid cream.

It is in my bag and in the ashtray of my car (isn't that what they were designed for?) so when I realize I have not applied it, I can whip it out and get it on there. It is most effective when used consistently for a couple of days, and this regular application is also necessary to enable a complete break from treatment. This is critical when using topical steroids to reduce the impact of skin thinning. Applying a topical steroid haphazardly week in and week out is terrible news for your skin, and if you do this, you need to speak to your doctor for a more effective protocol.

What do you pack to survive the winter months?