Q. My skin is in terrible shape. Every winter about this time my hands start cracking and peeling and they look terrible. The dryness makes my skin feel like sandpaper and the itching is unbearable. I have been a bloody mess from scratching and suffer greatly.
I have been to more than a dozen doctors, including dermatologists and allergists. They give me greasy ointments that I hate or cortisone creams. I have even taken oral prednisone, which worries me because of possible side effects. Antibiotics are prescribed if I get a skin infection from scratching. Nothing really helps for long.
I am at my wit’s end and am willing to try anything to ease the dryness and the itching. Help!
A. You are not the only person who suffers with horribly dry skin at this time of year. Low humidity dries out skin and lips and can make life miserable.
Another reader shared his own experience in this regard:
“I have spent hundreds of dollars on all types of creams and medicines for dry, itchy skin and eczema. I have more back scratchers than Carter has liver pills. I even have them in the car.
“Last December I read an article in a health magazine suggesting that an individual suffering from osteoporosis, as my sister does, take cod liver oil in order to get the necessary vitamins A and D in order to utilize the calcium she was taking. This was especially true for my sister since she was not getting very much sunshine.
“I decided that I would take some along with her, thinking it couldn’t hurt. Well lo and behold, within two weeks I received the best Christmas present I ever received. The itching and rash have entirely disappeared and I am free of this malady once and for all.
“My skin needed oil from the inside out and no one ever figured this out. I don’t think it really matters whether it is cod liver oil or flaxseed oil. I take 4 tablespoons a day, 2 in the morning and 2 in the evening. I hope you can pass this on to others who might benefit from my experience.”
We are delighted to learn that you got such amazing relief from cod liver oil, but we caution against such a high dose. It may have relieved your skin condition, but too much cod liver oil might actually weaken bones and increase the risk for osteoporosis. The reason is the vitamin A (retinol) content in cod liver oil.
We have known for more than two decades that too much vitamin A is associated with osteoporosis and an increased risk for fractures (Annals of Internal Medicine, Nov. 15, 1998. A study published in JAMA (Jan 2, 2002) found that postmenopausal women with the highest intake of vitamin A were at greatest risk for hip fractures.
Investigators who have tried to explain why women from Scandinavia (especially Sweden and Norway) have weaker bones and a higher incidence of hip fractures compared to other Europeans have hit on their high consumption of cod liver oil. They attribute the problem to the high retinol content of cod liver oil, as well as vitamin A-enriched milk and cereal.
Swedish researchers have also found that men with high vitamin A intake are at greater risk for fractures, including hip fractures. They published their findings in the New England Journal of Medicine (Jan. 23, 2003).
Part of the problem may be attributed to the fact that vitamin D levels have been reduced in many cod liver oil products. This is done in large measure to deodorize cod liver oil and make it more palatable. If the ratio of vitamin A to vitamin D is out of kilter, it can increase the risk for osteoporosis and fractures.
Some cod liver oils contain over 13,000 IU of vitamin A in a tablespoon. The maximum people should take is 10,000 IU per day. If you are swallowing 4 tablespoons every day, that could add up to almost 50,000 IU of vitamin A daily…way too much! We think 2,000 IU of vitamin D3 is essential for bone health and immune function and many cod liver oils do not have that much.
Bottom line, we think that it is essential to get a good balance of both vitamin A and D and we worry that many cod liver oil products do not provide that. A high-quality fish oil that supplies omega-3 fatty acids plus a vitamin D3 supplement might provide a good balance of nutrients and ease dry skin. Flax seed might also be beneficial. Keeping cod liver oil intake to under 1 tablespoon daily might also be safe if the vitamin A content is not excessive.
We humbly offer another solution to the dry skin dilemma. It turns out that urea is an amazing natural moisturizer for really dry skin. A study in the most prestigious dermatology journal (Journal of Investigative Dermatology, June, 2012) suggests that when an adequate amount of urea is applied to the skin in a topical cream it can strengthen the skin’s barrier function and boost its resistance to microbes. That may be why it is so helpful for conditions such as eczema (atopic dermatitis).
It is not always easy to find high-potency urea creams. The sponsor of our radio show, Redex Industries, makes a terrific product Udderly Smooth Extra Care 20 with 20% urea at an affordable price. You can find it at this link.