Winter Skincare Mistakes Interview

Interview with Dr Antoinette Ciconte, MBBS, BSc, FACD Fellow of the Australasian College of Dermatologists, Melbourne

Dr Antoinette Ciconte is a specialist dermatologist and a Fellow of the Australasian College of Dermatologists. Dr Ciconte completed her medical degree with Honours at Monash University and has since worked in numerous teaching hospitals in Melbourne. Dr Ciconte has also undertaken further training in cosmetic dermatology in New York, USA.

Dr Ciconte has over 10 years of experience in cosmetic and laser dermatology and has practised extensively in this field, specialising in the use of laser treatments for sun damage, freckles, ageing, rosacea and vascular skin conditions.

Dr Ciconte has had considerable experience in the use of dermal fillers, anti-wrinkle injections, sclerotherapy, and in the treatment of axillary hyperhidrosis and hyperhidrosis of other body regions.

Dr Ciconte has worked as a consultant dermatologist at Royal Melbourne Hospital and the prestigious St George's Hospital in London. She is currently a consultant dermatologist at Box Hill Hospital, Melbourne.

Dr Ciconte has a special interest in Rosacea, acne and acne scarring.

Question: How does the winter weather affect our skin?

Dr Antoinette Ciconte: Cold temperatures often mean low humidity so skin becomes dry and dehydrated. Many people find their skin is more prone to peeling and feeling rough, dry and cracked during the winter months.


Question: What are the most common skin problems we face in winter?

Dr Antoinette Ciconte:
• Common skin conditions such as atopic dermatitis and psoriasis commonly flare up in the cooler months.
• Rosacea, another chronic skin condition, is often exacerbated by cold winds and excessive exposure to indoor heating and heaters. In winter we are far more likely to reach for a hot beverage or have a hot meal, which often flares up rosacea.
• Cold urticaria – causes swelling and hives that develop on the skin as a reaction to the cold.
• Asteatotic dermatitis - a common skin disease characterised by dry skin, itching, redness and skin peeling. This is common in elderly people, people on certain medication and patients that are malnourished, have thyroid disease and cancer.
• Winter itch – is a dermatitis that affects individuals during the colder months, often much worse in dehydrated skin.

• Raynaud phenomenon – characterised by an exaggerated narrowing of the blood vessels in the fingers and toes brought on by the cold, causes the fingers to look white and blue and can often cause pain and numbness in the extremities.
• Chilblains – results in itchy, red, swollen and often tender areas of exposed skin (e.g. fingers, toes, ears) in response to exposure to cold temperatures. This occurs because the small blood vessels under the skin expand quicker on rewarming than the larger vessels, causing leakage of blood into the tissues and resulting in swelling and pain.

Lower moisture and air humidity, cold winds and skin dehydration play a role in all of these conditions.


Question: How can we avoid these problems?

Dr Antoinette Ciconte:
Wear the right clothing
• If you are prone to skin conditions such as Raynaud phenomenon or chilblains, get into the habit of wearing gloves and thick socks that don't sweat.
• For people who have rosacea, a handy tip is to wear a scarf to protect your face from cold wind or rapid changes in temperature to prevent a flare up.

Moisturisers
• Keep your skin hydrated using a richer moisturiser on a regular basis. Moisturisers with oils may help very dry skin restore natural fat (lipids) loss in the skin that helps to keep your skin looking fresh.
• A good trick is to apply moisturiser when the skin is still damp after a shower or bath to seal in moisture.
• Use a night cream richer in consistency to give your skin an extra moisture boost at night to help the skin rest and regenerate.
• Add a serum or face oil to your routine if your skin is very dry and flaky.
• Body oils or even coconut oil can be used to add extra moisture to very dry skin particularly on the hands, arms, legs and feet.

Cleansing
• Use a gentle cleanser to wash your face and body.
• Don't over exfoliate - use a product which is gentle and does not contain harsh grains or beads which can damage the skin barrier.
• Swap a shower for a bath - long hot showers can dry out your skin by removing natural oils from the skin. Using bath oils can help to boost skin hydration.
• Avoid soap, use a gentle body wash instead. • Hands can dry out and crack and develop dermatitis if over washed.

Other useful tips
• Use a humidifier if you are prone to eczema or dermatitis or even if you just have very dry skin.
• Get into the habit of using lip balm regularly instead of licking your lips.
• Just because its winter, doesn't mean you should forget wearing sunscreen. Most sunscreens have a moisturiser in them too.
• Keep your water levels up and avoid too much caffeine. Try a herbal tea or green tea instead. These can help to keep you better hydrated and are a rich source of antioxidants.


Question: What mistakes do most of us making during the winter, in regards to skincare?

Dr Antoinette Ciconte: As a dermatologist I often see and treat photo-aged skin, so honestly, I would consider not using a sunscreen (particularly in winter) the biggest avoidable mistake. The UV index on a cloudy overcast day can be as high as on a sunny day with a clear sky. Other simple things that people often forget or overlook include hydration levels both internally and externally, taking excessively long hot showers, not moisturising at all or using the wrong products and using toners which contain alcohol.


Question: Why does skin sting when moisturised, during winter? How can we best keep our lips hydrated?

Dr Antoinette Ciconte: If the skin barrier is damaged or the skin is interrupted because of eczema or dermatitis it may sting if moisturiser is applied.

Stinging can also be an indication of severe skin dehydration. Sometimes a certain ingredient in moisturiser can cause a stinging sensation. If this occurs stop using the product and replace with a gentler moisturiser with high oil content to hydrate the skin and replace the lipid barrier. Switch from using lotions to cream in winter. Soap can also have quite a damaging effect on the skin barrier, so best avoided if you have damaged stinging skin.

Our lips need extra TLC in winter. The most common mistake that people make is licking their lips, in an attempt to soften them, but this can lead to a dermatitis or dry, cracked lips.

Use a well formulated lip balm during the day and before going to bed at night and avoid lip balms with menthol, camphor or eucalyptus. Dry lips are often a sign that you are poorly hydrated, so grab a glass of water or two.


The Australasian College of Dermatologists (ACD) is Australia's leading authority for dermatology. For more information or to find a dermatologist who can help you to manage your skin, hair or nail condition visit www.dermcoll.edu.au.
Interview by Brooke Hunter
Photo by Curology on Unsplash