I didn’t grasp the importance of using moisturizers on my dry skin until my mid-thirties. Back then I broke all the rules. I used my lotions and creams intermittently, not routinely. I took two showers a day, which I later learned was stripping my skin of natural oils. At every clinic appointment, my dermatologist noted the parched, dry desert that was my skin. I ignored his pleas for me to moisturize my skin.
Then I endured the worst stretch of skin health in my life. Psoriasis covered more than 95 percent of my body, and I was overwhelmed by feelings of depression. My dermatologist referred me to the Psoriasis Treatment Center at the University of California in San Francisco.
One nurse told me that their patients moisturize every two hours. I just nodded my head in agreement, not mentioning how my lotions and creams sit idle most days. Even though I didn’t end up receiving treatment there, I learned a valuable lesson that stays with me to this day: Moisturize your skin regularly.
Since I have both psoriasis and eczema, I have double the reason to moisturize my skin.
On its website, the National Psoriasis Foundation (NPF) states that “keeping the skin lubricated on a daily basis is an important part of psoriasis care because it reduces redness and itching and helps the skin heal.”
Vivian Shi, MD, assistant professor of dermatology and director of the Eczema and Skin Barrier Clinic at The University of Arizona in Tuscon, has written that moisturizers work by “directly hydrating the skin,” and “bolstering the skin barrier to prevent the skin from losing water.”
I first met Dr. Shi when she was a resident at the University of California in Davis dermatology clinic in Sacramento, and I came to know her work better when I volunteered for an eczema study she conducted. I enjoyed catching up with her over the phone recently about skin moisturizers. On the call, she reinforced the importance of finding an effective moisturizer, as well as adhering to a skin moisturizing plan.
Narrowing Your Search
I asked Shi what was the right moisturizer to use on my skin. “Find the one that you will use," she says. "At the end of the day, you have to pick one that you will use.” She cautioned me to avoid parabens, dyes, fragrances, and other allergens since I have sensitive skin.
Skin-care products dominate entire stores shelves. so how do you narrow your search for a moisturizer? One way is to look for stamps of approval from organizations such as the National Eczema Association (NEA). I also read articles like the NPF’s blog post, 10 Must-Have Lotions for Under $10, to get ideas. Physicians will often provide free samples to try at home, and I also enjoy sharing moisturizer and treatment ideas with friends and acquaintances.
Part of searching for a moisturizer is learning more about them. For example, Shi’s article taught me the difference between “fragrance-free” (no substances are used to impart an odor) and “unscented” (the product may have a fragrance that's masked by another substance). She recommends fragrance-free products.
What about the difference between ointment, cream, and lotion? Ointments are the thickest moisturizers and do a great job of preventing water loss. Creams are less greasy than ointments, as they mix greases with a liquid, such as water. But according to the NEA, creams may “contain stabilizers and preservatives to prevent separation of their main ingredients, and these additives can cause skin irritation or even allergic reactions for some people.” Shi notes that lotions contain more liquid or water than grease. Since this liquid evaporates quickly, lotions generally don't moisturize dry skin as well as ointments and creams.
I’ve used many ointments and creams over the years. Personally, I don’t mind a moisturizer that's greasier, but I don’t like the feel of something like pure petroleum jelly. I tolerate thicker creams best. Cost and availability are also considerations. By weighing my needs and preferences, I've settled on products that I will use routinely.
Developing a Routine
Finding the right moisturizer is only half the battle. As Shi says, “the moisturizer is only good when applied on the skin.” I can certainly relate when she says that about 50 percent of people forget their doctor's moisturizing directions as soon as they leave the office.
Over the last decade, I've refined a routine that works for my skin and lifestyle — a process that begins with a discussion with my doctor about my skin needs. I set aside time to moisturize at least twice a day. After I shower at night, I apply moisturizing cream within minutes of patting my skin dry. Then I apply topical prescription medication on affected skin lesions. When the weather is dry, I apply another layer of moisturizer after the topical medication.
I have the same routine in the morning, but without the shower. And keeping moisturizers in my backpack and at the office gives me the opportunity to moisturize outside of my two regular times if I feel the need.
Your routine will no doubt vary from mine. Some people, for example, set alarms on their phones to remind them to moisturize. Whatever you decide, stick to a routine that works. If you need to, modify your routine so that the moisturizers you’ve carefully chosen and paid for don’t sit idly on the shelf.
If you’d like to read more about my experiences living with psoriasis, check out my other blog posts and my website.