Why Is My Skin So Itchy in Winter? A Dermatologist Explains
Every year, as the heating goes on and the air turns cold, the same complaint arrives: skin that itches for no obvious reason, especially on the shins, the back and the hands, and worst at night. There is nearly always a reason. Cold, dry air pulls water out of the outer layer of the skin, the barrier starts to leak, and itch is the first signal that it has.
Every year, when the heating goes on and the air turns cold, the same question comes in: why does my skin itch so much? It is usually the shins, the back and the hands, and it is worst at night. There is nearly always a reason. Cold, dry air pulls water out of the top layer of your skin, that layer starts to leak, and itching is the first sign.
Winter itch: the essentials
The short version
Xerosis, often called winter itch or, on the shins, asteatotic eczema when it cracks
Xerosis, which just means dry skin. When it cracks on the shins it is called asteatotic eczema.
Low humidity and cold air reduce the water in the outer skin and weaken its barrier
Dry, cold air takes water out of the top layer of skin and weakens it.
Shins, outer arms, back, hands and, in older skin, almost anywhere
The shins, the outer arms, the back and the hands. In older skin, almost anywhere.
Shorter warm showers, a gentle cleanser and a thick fragrance-free moisturiser within minutes of drying
Shorter warm showers, a gentle wash and a thick fragrance free cream put on within a few minutes of drying.
Most simple winter itch eases within one to two weeks of a consistent routine
Most simple winter itch settles within one to two weeks if you keep the routine going.
Itch keeps you awake, a rash spreads, skin cracks or bleeds, or there is no rash at all
The itch keeps you awake, a rash spreads, the skin cracks or bleeds, or you itch with no rash at all.
What winter does to the skin barrier
What winter does to your skin
The outermost layer of the skin, the stratum corneum, is a thin wall of flattened cells held together by fats. It keeps water in and irritants out, and it needs a little water of its own to stay flexible. In winter, cold air outdoors and heated air indoors both carry very little moisture, so the skin loses water faster than it can replace it.
The very top layer of your skin is a thin wall of flat cells held together by natural fats. It keeps water in and irritants out, and it needs a little water of its own to stay soft. In winter, cold air outside and heated air inside both hold very little moisture, so your skin loses water faster than it can replace it.
As that layer dries, it shrinks and develops tiny cracks, and the gaps let irritants in and more water out. A review of the research in 2016 found that low humidity and low temperatures reduce skin barrier function, make the skin more reactive to irritants and allergens, and are linked with more flares of atopic dermatitis. In other words, winter does not only dry the skin; it makes it more sensitive.
As that layer dries, it shrinks and gets tiny cracks. The gaps let irritants in and more water out. A review of the research in 2016 found that dry, cold air weakens the skin’s protective layer, makes skin react more to irritants and allergens, and is linked with more flares of eczema. So winter does not only dry your skin. It makes it more sensitive too.
Nerve endings in the upper skin respond to that change, and the result is itch. It is often worse at night, when the skin is warm under bedding and there is nothing else to distract from it. Scratching then damages the barrier further, which is why winter itch can build into a cycle that is hard to break without changing the routine.
The nerve endings near the surface react to that, and you feel it as itch. It is often worse at night, when your skin is warm under the covers and there is nothing else to take your mind off it. Scratching damages the skin further, which is why winter itch can turn into a cycle that is hard to break without changing your routine.
Why the shins, the back and the hands
Why the shins, the back and the hands
Some areas have fewer oil glands and a thinner supply of natural fats, so they dry first. The shins are the classic example, followed by the outer arms and the flanks.
Some areas have fewer oil glands and less natural fat in the skin, so they dry out first. The shins are the classic example, followed by the outer arms and the sides of the body.
On the shins, very dry skin can crack into a fine pattern that looks like crazy paving or a dried riverbed, sometimes with red, sore edges. Dermatologists call this asteatotic eczema, and it is common after the age of sixty, when the skin makes less of its own oil. Hands suffer for a different reason: frequent washing and sanitiser strip the barrier many times a day.
On the shins, very dry skin can crack into a fine pattern like crazy paving or a dried-up riverbed, sometimes with red, sore edges. Skin doctors call this asteatotic eczema. It is common after sixty, when the skin makes less of its own oil. Hands suffer for a different reason: washing and hand gel strip the skin many times a day.
The back is easy to overlook because it is hard to reach with a moisturiser. People often say the itch is between the shoulder blades and nothing seems to be there. If the skin there looks normal and the itch is in one fixed spot, it is worth mentioning at a visit, because a few nerve-related conditions cause exactly that pattern.
The back is easy to forget because it is hard to reach with a cream. People often say the itch is between the shoulder blades and nothing seems to be there. If the skin looks normal and the itch is always in one spot, mention it at a visit, because a few nerve problems cause exactly that.
The routine that fixes most winter itch
The routine that fixes most winter itch
For most people, winter itch is solved by changing a handful of daily habits rather than by a prescription. The difference between what helps and what quietly makes it worse is often small.
For most people, winter itch is fixed by changing a few daily habits, not by a prescription. The difference between what helps and what makes it worse is often small.
| Helps | Makes it worse | |
|---|---|---|
| Showering | Five to ten minutes, warm water | Long, hot showers or baths |
| Cleanser | Gentle, fragrance-free, only where needed | Foaming soap all over, scrubs, loofahs |
| Drying | Pat dry, leave the skin slightly damp | Rubbing hard with a towel |
| Moisturiser | Thick cream or ointment within three minutes, then again at night | Thin, fragranced lotion once a day |
| Home | A humidifier in the bedroom, cooler room at night | Hot, dry air and heavy bedding |
| Clothing | Soft cotton next to the skin | Wool and rough fabrics against bare skin |
| Helps | Makes it worse | |
|---|---|---|
| Showers | Five to ten minutes, warm water | Long, hot showers or baths |
| Soap | A gentle, unscented wash, only where you need it | Foamy soap everywhere, scrubs, loofahs |
| Drying off | Pat dry and leave skin a little damp | Rubbing hard with a towel |
| Cream | A thick cream or ointment within three minutes, then again at bedtime | A thin, scented lotion once a day |
| At home | A humidifier in the bedroom, a cooler room at night | Hot, dry air and heavy covers |
| Clothes | Soft cotton against the skin | Wool and scratchy fabrics on bare skin |
The single most useful habit is timing. A moisturiser applied within a few minutes of a shower traps the water that is still in the skin; the same cream applied an hour later mostly sits on top. Thicker products work better than thin ones: a cream that comes in a tub or an ointment such as petrolatum will outlast a pump lotion, and fragrance-free versions avoid adding an irritant to skin that is already reactive.
The most useful habit is timing. A cream put on within a few minutes of a shower holds in the water that is still in your skin. The same cream an hour later mostly sits on top. Thicker products work better than thin ones: a cream from a tub, or an ointment like petroleum jelly, lasts longer than a lotion from a pump. Unscented ones avoid adding an irritant to skin that is already touchy.
Products containing ceramides, glycerin or urea can help rebuild the barrier, and a urea or lactic acid cream is particularly useful on rough shins and heels. These ingredients can sting on cracked skin, so start with a plain ointment if the skin is broken. More on the basics is on our Dry Skin page.
Creams with ceramides, glycerin or urea help repair the skin’s protective layer, and a urea or lactic acid cream is especially good on rough shins and heels. These can sting on cracked skin, so start with a plain ointment if the skin is broken. More of the basics are on our Dry Skin page.
When winter itch is really eczema
When winter itch is really eczema
Dry skin and eczema sit on a spectrum. When dryness is left long enough, or in someone prone to eczema, it tips into inflammation: red or darker patches, rough plaques, weeping or thickened skin from scratching.
Dry skin and eczema are two ends of the same line. If dryness goes on long enough, or you are prone to eczema, it turns into inflammation: red or darker patches, rough raised areas, weeping, or skin that has thickened from scratching.
At that point moisturiser alone is usually not enough, and a short course of a prescription anti-inflammatory cream, used correctly, settles the skin far faster than more cream on top. People with a history of eczema often find it flares every winter, and a plan made in autumn, rather than during a flare, works best. Our Eczema page explains the treatments, and Eczema Awareness Month covers the newer options.
At that stage, cream alone is usually not enough. A short course of a prescription cream that calms inflammation, used the right way, settles the skin much faster than piling on more moisturiser. People who have had eczema often find it flares every winter, and a plan made in the autumn, not in the middle of a flare, works best. Our Eczema page explains the treatments, and Eczema Awareness Month covers the newer options.
On darker skin, inflamed eczema may look purple, grey or dark brown rather than red, and it can leave marks that take months to fade. That is one more reason not to wait out a winter flare.
On darker skin, eczema may look purple, grey or dark brown instead of red, and it can leave marks that take months to fade. That is one more reason not to just wait out a winter flare.
When to see a dermatologist
When to see a skin doctor
Most winter itch responds to the routine above within a couple of weeks. Some itch is a sign of something else, and it is worth having it examined rather than adding more creams.
Most winter itch gets better with the routine above within a couple of weeks. Some itch is a sign of something else, and it is better to have it looked at than to keep adding creams.
Book a visit if the itch is keeping you awake, if a rash is spreading or weeping, if the skin cracks and bleeds or looks infected, or if two weeks of good habits have made no difference. Itch with no rash at all, particularly if it is widespread and new, deserves a look too, because thyroid, kidney, liver and iron problems, and some medicines, can all cause it. Itch that wakes several people in the same household at night suggests scabies rather than dry skin.
Book a visit if the itch keeps you awake, if a rash is spreading or weeping, if the skin cracks and bleeds or looks infected, or if two weeks of good habits have made no difference. Itching with no rash at all also needs a look, especially if it is all over and new, because thyroid, kidney, liver and iron problems, and some medicines, can all cause it. If several people at home itch at night, it may be scabies, not dry skin.
At the visit, Dr. Gallacher looks at the pattern, asks about your routine, your medicines and your health, and decides whether this is dry skin, eczema or something that needs tests. Often the answer is a clear plan for the next few weeks and a simpler routine for the rest of the winter.
At the visit, Dr. Gallacher looks at the pattern, asks about your routine, your medicines and your health, and works out whether it is dry skin, eczema or something that needs tests. Often you leave with a clear plan for the next few weeks and a simpler routine for the rest of the winter.
Questions patients ask
Why is my skin so itchy in winter but not in summer?
Why does my skin itch in winter but not in summer?
Winter air, both cold air outside and heated air inside, holds far less moisture. The outer skin loses water, its barrier weakens and nerve endings respond with itch.
Winter air holds much less moisture, both the cold air outside and the heated air inside. Your skin loses water, its protective layer weakens, and the nerves react with itch.
Why are my legs so itchy in winter?
Why do my legs itch so much in winter?
The shins have fewer oil glands than most of the body, so they dry first. Long hot showers and rough fabrics make it worse, and very dry shins can crack into asteatotic eczema.
The shins have fewer oil glands than most of the body, so they dry out first. Long hot showers and scratchy fabrics make it worse, and very dry shins can crack into a type of eczema.
What is the best moisturiser for winter itch?
Which cream is best for winter itch?
A thick, fragrance-free cream or ointment applied within three minutes of bathing. Ceramides, glycerin and urea help, but timing and thickness matter more than the brand.
A thick, unscented cream or ointment put on within three minutes of washing. Ceramides, glycerin and urea help, but when you put it on and how thick it is matter more than the brand.
Does a humidifier help itchy skin?
Does a humidifier help?
It can. Raising the humidity of a bedroom reduces overnight water loss from the skin. Keep it clean, and use it alongside, not instead of, a moisturiser.
It can. Moister air in the bedroom means your skin loses less water overnight. Keep it clean, and use it as well as a cream, not instead of one.
When is itchy skin a sign of something serious?
When is itchy skin a sign of something serious?
When it is widespread with no visible rash, keeps you awake, comes with weight loss, fatigue or night sweats, or does not respond to good skin care. These deserve a medical assessment.
When it is all over with no rash you can see, keeps you awake, comes with weight loss, tiredness or night sweats, or does not get better with good skin care. Get these checked.
- Engebretsen KA, Johansen JD, Kezic S, Linneberg A, Thyssen JP. The effect of environmental humidity and temperature on skin barrier function and dermatitis. J Eur Acad Dermatol Venereol. 2016;30(2):223-249. Source
Talk it through with a physician first.
Every plan starts with an assessment of your skin, your anatomy and what you actually want to change.
This page is general health information, not medical advice. It cannot tell you whether a treatment is right for you. Approved uses, risks and results differ from person to person, and product labelling changes. Ask us at Dermatology and Laser Centre about your own situation, or make an appointment, and seek urgent care for any serious symptom.
