Itchy skin in winter is frustrating and painful.
Topical treatments for dry itchy skin include emollients, cannabis, glycerol, urea, zinc oxide, colloidal oatmeal, and peppermint.
Treatment of itchy skin should include prevention by emollients and aim for a quick disruption of the itch-scratch cycle.
This article will discuss 10 treatments for dry itchy skin in winter:
- Emollients for itch relief
- Omega 3 fatty acids for itch relief
- Cannabis for itch relief
- Glycerol for itch relief
- Urea for itch relief
- Zinc oxide for itch relief
- Colloidal oatmeal for itch relief
- Cold exposure for itch relief
- Peppermint and menthol for itch relief
- Vinegar for itch relief
What is winter dry skin?
'Winter dry skin' is dry skin that develops during the cold winter season.
Winter dry skin can have a wide spectrum of symptoms - from mild dryness and flaking to severe itching, redness and pain.
Winter dry skin symptoms are painful and frustrating, and often associated with skin conditions such as eczema or atopic dermatitis.
Learn more: Winter Dry Skin - What is it?
10 treatments for dry itchy skin in winter
There are several treatment options for dry itchy skin in winter:
- Emollients for itch relief
- Omega 3 fatty acids for itch relief
- Cannabis for itch relief
- Glycerol for itch relief
- Urea for itch relief
- Colloidal oatmeal for itch relief
- Zinc oxide for itch relief
- Cold exposure for itch relief
- Peppermint and menthol for itch relief
- Vinegar for itch relief
Talk to your doctor about treatments for dry itchy skin in winter.
1. Emollients for itch relief
Emollients and barrier-improving creams are the first-line therapy for the treatment of all skin barrier related itch (Pavlis et al, 2018; Moncrieff et al, 2013).
Emollients are a broad category of skincare ingredients and products.
Skincare ingredients that function as emollients include plant butters, vegetable and fruit oils, animal fats, petrolatum, mineral oil, and esters.
Products that function as emollients include moisturizers, creams, oils, serums, and balms.
An emollient is an ingredient in a moisturizer. The job of the emollient is to soften skin.
Learn more: What Are Emollients? Best Emollients for Dry Skin
Moisturizers and oils rich such as mineral oil and sweet almond oil can relieve itching. Furthermore, individual fatty acids such a gamma-linolenic acid can also relieve itching.
What are the benefits of emollients?
The function of emollients in skincare is to soften the skin, help the skin retain its moisture and to support the skin’s barrier function.
Skin that does not have sufficient lipid content on its surface can appear dull, dry and rough. Emollients "fill in the gaps" in the skin barrier and soften it along with giving it a healthier look
The role of emollients in the treatment of dry skin conditions is often underestimated. Emollients promote optimal skin health and prevent skin breakdown, and their use can improve quality of life (Moncrieff et al, 2013; Newton et al, 2021).
Emollients are skin conditioning – the give skin a soft and smooth appearance, restoring suppleness and improving elasticity (Brown et al, 2005).
- Make your skin feel soft and smooth.
- Help reduce flaking and roughness from dry skin.
- Help assist the skin barrier by filling in gaps between cells.
Moisturizers for itch relief
A moisturizer is a skincare product, such as a cream or a lotion, that is used to prevent dryness in the skin.
Moisturizers contain water and add moisture to the skin.
Moisturizers also contain emollients, humectants and occlusives.
- Emollients soften, smooth, and condition the skin.
- Humectants attract and hold moisture to the skin.
- Occlusives form a protective film that prevents moisture loss from the skin.
The balance of these ingredients determines whether a moisturizer is better for dry skin or oily skin. For instance, a moisturizer for dry skin would contain a high percentage of emollients and occlusives.
Moisturizers have been shown to improve skin barrier function, by preventing excess transepidermal water loss (TEWL) and the entry of external pruritogens, which may help alleviate itching (Kamo et al, 2016).
As the composition of moisturizers varies, the effectiveness of moisturizers can differ depending on the base ingredients and actives.
For instance, using emollients with anti-itch ingredients, e.g., urea (5–10%), glycerol (20%), menthol (1%), zinc oxide (10%) has shown to be effective against pruritus (Weisshaar et al, 2019).
Mineral oil for itch relief
Mineral oil (baby oil) has been shown to relieve itching in patients with uremic pruritus (Lin et l, 2012; Karadag et al, 2014; Singh et al, 2021).
For instance, topically applied mineral oil soothed itching briefly and improved sleep quality and quality of life in a randomized clinical trial of 70 hemodialysis patients with pruritus (Karadag et al, 2014).
Applying baby oil is a simple, safe, inexpensive and easily administered treatment for itchy skin in haemodialysis patients (Lin et al, 2012).
Sweet almond oil for itch relief
Sweet almond oil is an excellent emollient and is known for its ability to soften the skin. Topical sweet almond oil has been shown to reduce itch, and significantly improved the itch-related quality of life of patients with uremic pruritis (Afrasiabifar et al, 2017; Mehri et al, 2018).
Sweet almond oil contains approximately 60 - 75% oleic acid, 15 - 30% linoleic acid, 3 - 9% palmitic acid. Interestingly, oleic acid and linoleic acid have both been shown to inhibit TRPV1, a receptor that plays a role in itch and pain responses (Morales-Lázaro et al, 2016).
Gamma-linolenic acid for itch relief
In a study in which topical 2.2% gamma-linolenic acid cream was applied to patients with refractory uremic pruritis, the treatment alleviated itch more than a placebo-based cream did (Chen et al, 2006).
2. Omega 3 fatty acids for itch relief
Omega 3 fatty acids consist of alpha-linolenic acid (ALA), and its two active metabolites, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).
- alpha-linolenic acid (ALA)
- docosahexaenoic acid (DHA)
- eicosapentaenoic acid (EPA)
Alpha-linolenic acid (ALA) is found in green leafy vegetables, flaxseed, walnuts, soybean, and canola oils.
The body has a minimal ability to convert ALA into DHA and EPA.
Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are found in fish oils, marine algae and phytoplankton that naturally produce them.
Fish oil supplements and omega-3 fatty acid supplements contain oil derived from the tissues of oily fish rich in omega-3 fatty acids, such as salmon, mackerel, sardine, and anchovy.
Fish oil supplements contain a combination of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)—the two main types of omega-3 fatty acids that provide health benefits.
Can omega 3 fatty acids help with itching?
Supplemental omega 3 fatty acids have been shown to help with itching in patients with atopic dermatitis (eczema), hemodialysis and end-stage renal disease.
In 3 clinical trials, patients with atopic dermatitis took daily omega 3 fatty acid doses ranging from 5000 to 8200 mg and found improvement in disease symptoms including itching (Søyland et al, 1994; Koch et al, 2008; Mayser et al, 2002).
In a clinical trial of 47 hemodialysis patients who had chronic itching, there was a significant improvement in pruritus and xerosis at 8 weeks of treatment with 6000 mg/d omega 3 fatty acid (Peck et al, 1996).
Dry skin is an extremely common symptom found in end-stage renal disease patients and has been suggested to be a contributor to pruritis (Shirazian et al, 2017).
Patients with chronic kidney disease consumed 1000 mg fish oil once daily for 3 months found significantly improved skin hydration on both the face and arms, as well as disease-related symptoms of pruritus (Lin et al, 2022).
These results suggest a potential promising therapeutic of omega-3 supplementation for improving skin conditions and consequent pruritus symptoms.
Currently, no study exists recommending the optimal therapeutic dosing of omega 3 fatty acid supplementation for improved skin health. However, significant outcomes were reported with doses ranging from 1200 mg/d EPA + DHA to 18 000 mg/d EPA + DHA (Thomsen et al, 2020).
Given its high safety profile, low cost, and ease of supplementation, omega 3 fatty acids and fish oils are a reasonable supplement that may benefit patients wishing to improve inflammatory skin conditions through diet (Thomsen et al, 2020).
3. Cannabis for itch relief
Topical cannabinoids show great promise for the treatment of itch, including difficult to treat itch.
Topical cannabinoids are of interest in skin disease because of the high safety profile and direct, local application to involved areas, and recent years have brought an assortment of cannabinoid-containing topicals specifically advertised for use on the skin, such as oils, lotions, emollients, creams, and patches (Avila et al, 2020).
- Phytocannabinoids derived from the Cannabis sativa plant (e.g., D(9)- tetrahydrocannabinol [THC], cannabidiol [CBD])
- Endocannabinoids (e.g., anandamide and 2-arachidonoylglycerol [2-AG])
- Synthetic cannabinoids
(Gaoni et al, 1971; Merchoulam et al, 2014).
Human studies, although limited, have consistently shown significant reductions in both scratching and symptoms in chronic pruritus (reviewed by Avila et al, 2020).
Clinical studies have shown a reduction in pruritus (itching) in several skin diseases, including atopic dermatitis, psoriasis, asteatotic eczema, prurigo nodularis, and allergic contact dermatitis, as well as systemic diseases, including uremic pruritus and cholestatic pruritus (Avila et al, 2020; Szepietowski et al, 2005; Yuan et al, 2014; Visse et al, 2017; Dvorak et al, 2003).
Dietary hemp seed oil for itch relief
Dietary supplementation with hemp seed oil has been shown to improve the skin barrier and significantly alleviate symptoms of eczema, including dry skin and
itchiness (Callaway et al, 2005).
Hemp seed oil is obtained by pressing hemp seeds from the hemp plant and extracting the oil.
Cold-pressed, unrefined hemp seed oil is a vibrant green color, with a nutty flavor.
Hemp seed oil should not be confused with hash oil or cannabis oil, which also comes from the cannabis plant, and contain psychoactive cannabinoids THC and/or CBD.
Because hemp seed oil is derived from the seeds of hemp plants, rather than the stalks and leaves, it contains only trace amounts of cannabinoids.
Hemp seed oil has a long history of safe and effective use.
Learn more: 5 Benefits of Hemp Oil for Skin - Soften and Strengthen Your Skin Barrier
More research is required to develop treatment regimens and indications for treating itchy skin with cannabinoids.
4. Glycerol for itch relief
Glycerol is also known as glycerin.
The beneficial effects of glycerol on the skin have been recognized for over 75 years, and glycerol has been widely used as an ingredient of skincare formulations for its moisturizing and smoothing effects (Fluhr et al, 2008).
Glycerol is made by your skin, and endogenous glycerol plays a role in skin hydration, cutaneous elasticity and epidermal barrier repair (Fluhr et al, 2008).
Interestingly, glycerol is decreased in the stratum corneum of patients with uremic xerosis, and a decrease in glycerol is correlated to an increase in severity of itching and skin barrier alteration (Yosipovitch et al, 2007).
Topically applied glycerol is known to increase stratum corneum hydration, improve epidermal barrier function and decrease clinical signs of inflammation (Breternitz et al, 2008).
Topically applied glycerol has a rapid hydrating and smoothing effect that can be achieved at concentrations ranging from 10 to 15% (Loden et al, 2000).
In patients with uremic xerosis, treatment with a skin protective product combining 15% glycerol and 10% paraffin was associated with a substantial improvement of the uremic pruritus and quality of life (Balaskas et al, 2011).
5. Urea for dry itchy skin
Urea is a hygroscopic molecule, meaning it can attract and hold onto moisture.
Urea is naturally present on the skin as a component of the complex mixture of natural moisturizing factors (NMFs) that contributes to skin hydration (Verzi et al, 2020; Lacarrubba et al, 2020).
In particular, at low concentrations (2–12%), urea acts as an emollient (filling the gaps between desquamating corneocytes thus contrasting dehydration) and a humectant (attracting water from dermis into epidermis and also from the external environment in humid conditions) (Micali et al, 2020; Friedman et al, 2016).
Moreover, some studies suggest that urea may regulate filaggrin gene expression necessary for proper barrier function maintenance (Friedman et al, 2016; Benintende et al, 2017; Danby et al, 2016).
Based on these properties, urea has been topically used for the treatment and prevention of senile xerosis or xerosis associated with skin diseases such as ichthyosis, atopic dermatitis and psoriasis, at concentrations ranging from 2 to 12% in different formulations (Lacarrubba et al, 2020; Pan et al, 2013; Micali et al, 2018).
Clinical studies have demonstrated that urea‐based topical formulations restore the stratum corneum ability to attract and maintain hydration (Benintende et al, 2017).
6. Zinc oxide for itch relief
Zinc has been used as a skin treatment for centuries.
Topical preparations like zinc oxide, calamine lotion, or zinc pyrithione have been used as soothing agents and anti-itch relief (Gupta et al, 2014).
Calamine lotion contains zinc oxide or zinc carbonate and is used frequently for symptomatic relief of itch because of its soothing properties (Gupta et al, 2014).
Zinc oxide paste and zinc sulphate are effective in diaper dermatitis and hand eczemas (Baldwin et al, 2001; Faghihi et al, 2008).
Although zinc is less effective as compared to other treatment modalities like topical corticosteroids, it is a useful soothing and anti-itch agent (Landsdown et al, 1996; Baldwin et al, 2001).
Topical zinc oxide has strong antioxidant and antibacterial action and is used to treat atopic dermatitis or eczema (Gupta et al, 2014).
Zinc inhibits mast cell degranulation and reduces the secretion of histamine, an important mediator of inflammatory response and an inducer of itch, thereby making it a useful treatment option for itch relief (Marone et al, 1986).
Interestingly, zinc oxide infused textiles have been tried for the management of atopic dermatitis in a study and a significant improvement was observed in the disease severity, pruritus, and subjective sleep, in patients who wore zinc oxide infused textiles (Wiegand et al, 2013).
Topical zinc oxide is available in various concentrations - from 10% to 40%, and in a variety of forms including creams, ointments, pastes, powders and sprays.
Zinc oxide creams are generally safe for long term use.
7. Colloidal oatmeal for itch relief
Oatmeal (Avena sativa) has been used for centuries as a soothing agent to relieve itch and irritation associated with various skin diseases.
Colloidal oatmeal is a natural product that is derived from the whole dehulled grain. Colloidal oatmeal is made by grinding oat grain into a very fine powder.
Colloidal oatmeal is so finely ground, that you don't feel any grittiness when it is added to skincare products. It feels smooth and comforting on your skin.
Colloidal oatmeal has an excellent safety record and is approved by FDA (US Food and Drug Administration) as an over-the-counter skin protectant (Kurtz et al, 2007).
Creams containing 1% colloidal oatmeal have been shown to be effective for the management of mild to moderate atopic dermatitis in children (Lisante et al, 2017A; Lisante et al, 2017B) and hand dermatitis in adults (Sobhan et al, 2020).
An over the counter 1% oatmeal cream was found to be equally effective and safe as the prescription barrier cream for the symptomatic treatment of mild-to-moderate atopic dermatitis in children (Lisante et al, 2017A).
Symptoms including itch were improved after applying the 1% colloidal oatmeal cream, and improvements were maintained over the course of treatment. In some children, itch was immediately relieved after applying 1% colloidal oatmeal. Transepidermal water loss values were significantly reduced, and skin hydration was significantly increased throughout the study (Lisante et al, 2017A).
A study on acute burn patients showed that the patients experienced less itching and requested significantly less antihistamine when using liquid paraffin with 5% colloidal oatmeal compared to liquid paraffin only (Matheson et al, 2001).
Colloidal oatmeal contains various active compounds that have moisturizing, protective, soothing, antioxidant and anti-inflammatory activity, including avenanthramides and beta-glucans (Fowler et al, 2012; Pazyar et al, 2012).
The active ingredients in oatmeal consist of polysaccharides, beta-glucans, proteins, lipids, saponins, enzymes, flavonoids, vitamins, and avenanthramides.
Avenanthramides from oats can reduce histamine release from mast cells (Cerio et al, 2010; Pazyar et al, 2012) and their topical application decreases inflammation and scratching in pruritus-induced models (Fowler et al, 2012). Oatmeal produces a protective moisturizing barrier on the skin which helps to soften and moisten the skin and heal tissue, and reducing pruritus (Fowler et al, 2012).
Colloidal oatmeal is well tolerated in children and adults for short-term and long-term use for itch relief (Cerio et al, 2010; Fowler et al, 2012).
Colloidal oatmeal suspensions are available in many different products, including bath soaps, shampoos, shaving gels, and moisturizing creams.
Colloidal oatmeal can also be mixed into bathwater.
8. Cold exposure for itch relief
Topical cooling is a frequently used remedy for itch. Cooling the skin by application of ice, gel packs, cool compresses, or cold water can temporarily reduce itch in patients affected by atopic dermatitis, contact urticarial, or psoriasis (Fruhstorfer et al, 1986).
Cooling is an effective temporary remedy for itch, and can bring welcome relief to itchy insect bites, nettle stings, poison ivy, atopic dermatitis, and psoriasis (Liu et al, 2018).
In a nursing home, elderly people with senile pruritus reported that that a cold compress and/or cold showers could relieve the itch (Dyhre-Petersen et al, 2019).
Senile pruritus is defined as chronic itch of unknown origin in individuals of old age. In this context, the word ‘senile’ refers to ‘one of old age’. No international agreement exists regarding an age limit for being categorized as one of old age, though commonly the limit is set to ≥60 years or ≥65 years (Clerc et al, 2017).
Although many patients report that cold showers reduce itch, no scientific studies have been performed to confirm this observation (Weisshaar et al, 2019).
9. Peppermint and menthol for itch relief
Peppermint essential oil (Mentha arvensis) and menthol can be used topically to relieve itchy skin.
Peppermint essential oil naturally contains high amounts of l-menthol, an organic compound with local anesthetic properties that provides a cooling sensation, while it naturally alleviates skin irritation, itch and pain (Zhao et al, 2022; Li et al, 2022).
Menthol triggers a cooling sensation through receptor TRPM8 (transient receptor potential cation channel subfamily M member 8), which is found throughout the skin.
Low to moderate concentrations of menthol activate TRPM8 in the primary nociceptors, generating a cooling sensation, whereas menthol at higher concentration could induce pain - cold allodynia, and cold hyperalgesia mediated by TRPM8 sensitization (Li et al, 2022).
Patients with pruritus of hepatic, renal, and diabetic origin were treated with 5% peppermint oil in petrolatum for 2 weeks and had significant improvement of itching. The topical treatment of chronic pruritus with peppermint oil was found to be effective, easy to use, safe, cheap, and had a favorable odor (Elsaie et al, 2016).
Pregnant women with pruritus gravidarum were treated with 0.5% peppermint oil in sesame seed oil twice a day for 2 weeks and had a significant improvement in severity of itching (Akhavan et al, 2012).
Application of a 3% menthol-containing moisturizing cream was safe in healthy individuals and participants with dermatitis. In the latter, itch scores were significantly reduced during follow-up (Tey et al, 2017).
Peppermint oil is generally recognized as safe (Food and Drug Administration, 2014).
Always dilute peppermint oil before use and start with low doses - such as 0.5% peppermint oil in a carrier oil.
High doses of peppermint oil can be irritating and cause pain.
12. Vinegar for itch relief
Vinegar can be used topically to treat itchy skin.
The use of vinegar in the treatment of skin disease and wound management dates back to Hippocrates (Elhage et al, 2021).
In preliminary studies, vinegar has been reported to be useful for the treatment of itch or pruritus (Long et al, 1985; Oh et al, 1998; Delavar et al, 1996; Lee et al, 2011; Nakhaee et al, 2015).
Vinegar has been shown to be safe and effective in treating uremic pruritus. A 5% white vinegar solution applied to itchy areas two times a day for two weeks significantly decreased all dimensions of pruritus (Nakhaee et al, 2015).
It is thought that by maintaining the acidic pH of the skin surface, vinegar helps to preserve skin barrier function and reduces skin irritation (Yosipovitch et al, 2008).
However, use vinegar with caution if you have eczema.
The application of 0.5% apple cider vinegar soak increased transepidermal water loss in patients with eczema, although it decreased skin pH.
Unfortunately, the beneficial acidification of the skin did not last more than 60 minutes, and the majority of eczema patients suffered skin irritation after the vinegar application (Luu et al, 2019).
While generally safe, inappropriate use of vinegar can result in damage to the skin. Avoid using vinegar full strength - only use diluted vinegar.
Dry itchy skin is common during the cold winter months.
Dry itchy skin can be complex, and difficult to treat.
How to treat dry itchy skin in winter?
- Protect your moisture barrier:
- Drink water
- Use a humidifier
- Use a moisturizer with humectants
- Try 10 - 15% glycerol for itch relief
- Try 5 - 10% urea for itch relief
- Protect your lipid barrier:
- Emollients for barrier repair and itch relief
- Supplement with omega 3 fatty acids
- 1200 mg/d EPA + DHA to 18 000 mg/d EPA + DHA
- Try topical cannabis for itch relief
- Protect your acid mantle:
- Avoid high pH soaps
- Choose a gentle cleanser
- Try 0.5 - 5% vinegar for itch relief
Certain treatments for itch are soothing and can be used as often as desired.
For instance, emollients, moisturizers, topical fatty acids, such as linoleic acid, zinc oxide creams, colloidal oatmeal and cannabis can help sooth irritation and itch.
Things to try for soothing itch relief:
- Carrier oils and fatty acids
- Try 1 - 5% colloidal oatmeal
- Try 10% zinc oxide or calamine lotion
- Try topical cannabis
Other treatments for itch should be used sparingly or as spot treatments.
Cold exposure, peppermint, menthol, and vinegar can be irritating and damage your skin barrier if overused, or in the wrong dose.
Be careful, and always dilute menthol and peppermint essential oil. Do not use full strength essential oils on your skin.
Things to try for quick itch relief:
- Cold exposure - cold water, cold compress, ice cube on itchy area
- 0.5 - 5% peppermint oil in a carrier oil or moisturizer
- 0.5 - 5% vinegar
No treatment can claim consistent or complete efficacy, and often a combination of treatments is required to control itch.
Some people with itchy skin may require medications to control symptoms, including antimicrobial agents, antihistamines, anti-inflammatory agents, immunotherapy, biologicals, phototherapy and others.
If you have dry itchy skin, you may require a dermatologist’s help, and they can prescribe medications to help with itching, redness and pain.
Learn more: Itchy Skin in Winter - How to Treat?
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