With the worsening of climate change, the weather, as we know it, has undergone sudden changes, as attested by the temperatures that were felt at the beginning of 2021 in Portugal, where the thermometers reached - 4 and - 1 ° C, in inland areas of the country.

At a time when, every day, the newspapers open with terrifying news about the calamitous evolution of the pandemic and when the environmental issue seems to have been relegated, it seems that the cold and the diseases caused by it, or worse, are not on the media agenda.

However, there was something that caught my attention during the period of low temperatures: the lack of heating in our old houses and the stock of akilhiver cream sold out at chemists. It was then that together with the editorial team of News, in a kind of brainstorming session, we tried to identify the diseases associated with the cold. The first shared idea was “The skin”. Functioning as a protective wall for our body, it seemed to us that this was the organ most threatened by the harsh temperatures.

Having worked the idea out, and not forgetting the importance of other clinical specialties that also suffer from Mr. Cold’s effects, we spoke to dermatologist Paulo Manuel Leal Filipe, a FMUL Professor and Director of the Dermatology Service at the CHULN, to obtain information about skin diseases that tend to appear, or have their symptoms worsened during the winter.

What dermatological diseases come up when the temperature drops? What are the main treatments?

Paulo Filipe - The main dermatoses caused by the cold are cold urticaria, Raynaud's phenomenon, cold panniculitis, cryoglobulinemia and, most frequently, perniosis (commonly referred to as chilblains). Some of these conditions are very specific and may even involve other organs and systems, so their treatment is complex and must be guided by specialists in these areas. A fundamental point, common to all, is to avoid exposure to cold weather.

There are many diseases such as chilblains, which manifest themselves at the extremities of the body and become chronic. What are the main prevention/treatment measures to be taken?

Paulo Filipe – The main preventive and general care measures involve avoiding the cold, namely using gloves in colder environments; avoid very noticeable thermal variations, for example, placing cold hands under excessively hot water; have proper hand hygiene, but without incurring in excessive washing or use of irritating products; proper hydration of the skin; and, sources of heat should be avoided when there is active perniosis, since heat can aggravate the inflammatory manifestations of the disease.

Is it possible that the cold does not cause, but worsens some type of pathology?

Paulo Filipe – The cold can aggravate several dermatoses, including eczema, and in particular, atopic eczema, which is the most frequent inflammatory dermatosis in the world. The skin becomes more xerotic in winter, requiring additional hydration.

What care should we take with our skin during the winter?

Paulo Filipe – One should avoid bathing and washing the skin with very hot water (it must be lukewarm) and ensure daily hydration after a shower. In more xerotic and sensitive skins, more frequent hydration may be necessary.

How does our lifestyle (stress, routine, heating habits) affect the health of our skin?

Paulo Filipe – The skin is the interface between the internal environment and the external environment of our body. Consequently, the pathology of the skin reflects the aggressions that we suffer from our environment, but it also reflects changes in the endogenous environment. The health of the skin thus depends on the health of the rest of the body and healthy lifestyle choices. Going to solariums, smoking, obesity and metabolic syndrome, among many other variables, can have an impact on the skin and contribute to the appearance of dermatoses, as a risk factor, or exacerbate existing dermatoses, as aggravating factors.

Can the health of our skin and hair reflect our emotions?

Paulo Filipe – Some dermatoses aggravate during periods of psychological and emotional stress, namely frequent pathologies such as psoriasis, atopic dermatitis or seborrheic dermatitis. Hair loss is also frequent, which worries people. However, the role of emotional stress is less clear as a causal factor for skin pathology, except for some conditions, namely psychodermatoses.

Isabel Varela
Editorial Team