Humidity in July, furnace air in January, and a sun that never fully clocks out. A Knoxville nurse on the small adjustments that fit each season.

By Sarah Hitchcox, RN

I grew up in Knoxville, and I spent the first part of my nursing career in the emergency department before moving into aesthetics. Now I look at faces up close all year at my Bearden and Farragut offices, and the questions I hear change with the calendar as reliably as the leaves on Kingston Pike.

What follows is the pattern I notice, plus what I actually change in my own routine each season. I have tried to keep those two things separate. What I see in the chair is one thing. Why it happens is usually my best guess, and I will say so when it is.

Spring: the sunscreen that got skipped all winter

The first warm weekend in March or April, everybody goes outside at once. Soccer fields, the greenway, yard work. The following week I hear about pink foreheads and noses, usually from people who stopped wearing sunscreen sometime around Thanksgiving and never restarted.

My change for spring is boring: sunscreen goes back on every morning, before I think I need it, and it stays on through November at least. If you make only one seasonal adjustment all year, make it this one.

Spring is also when I quietly swap the heavier moisturizer I used all winter for something lighter. Nothing is wrong with the heavy one. It just starts to feel like too much once the mornings are no longer cold.

Summer: humidity, sweat, and squinting

Knoxville summers are humid in a way that surprises people who move here. By July the air is thick from breakfast onward, and skin that felt tight in January feels slick by noon. My guess is that sweat and product sitting together on the skin is what people are feeling, but that is an explanation, not something I have measured.

What I change: lighter everything. A gel or lotion moisturizer instead of a cream, and a sunscreen I can stand to reapply, because a sunscreen you hate is a sunscreen you put on once at 8 a.m. and forget. A hat goes in the car and stays there.

Summer is also the season for squinting, at the lake, on the ballfield, in the driver’s seat heading west on I-40 at 6 p.m. Crow’s feet and the “11s” between the brows are among the most commonly treated areas at my practice, Sarah Hitchcox Aesthetics, where Botox relaxes the muscles that make those lines while leaving your normal expressions alone. An appointment takes about ten to fifteen minutes, with no downtime. Whether the squinting causes the lines or just makes people notice them, I honestly cannot say. I only know the questions arrive with the heat.

Fall: the season I book my own appointments

Fall is my favorite time to take care of my own skin, and it is when I encourage patients to look at the things they put off in summer. The lake days are over, and the days begi to shorten.

This is when I talk most about laser services, which at my practice cover hair removal, skin revitalization, lesion reduction, and skin tightening, and about microneedling, which we use for skin rejuvenation. I prefer to do my own resurfacing when I am not about to spend a month at a pool. That is a personal scheduling preference, not a rule, and the right timing for you is something to work out in person.

Fall is also when I restart the routine that slipped in summer: cleanser, moisturizer, sunscreen, every day, in that order. I also like to encourage patients to begin incorporating brightening products or pigment inhibitors that they did not feel like using throughout the summer months.

Winter: furnace air and the tight-skin months

Our winters are short and mostly mild, then a cold snap arrives and every furnace in the county runs for a week straight. That is when I hear the word “tight” more than any other. Hands, cheeks, the skin around the mouth. It seems worse in the mornings and worse in houses with forced-air heat, at least in the pattern I notice, though I have never counted.

What I change in winter:

• Back to the heavier moisturizer, and skincare that actually hydrates my skin.
• Shorter, cooler showers. The long hot one feels wonderful, and I regret it by lunch.
• A humidifier in the bedroom, the same trick parents use in a nursery.
• Sunscreen stays on. It is easier to keep a habit than to restart one in March because UVA/UVB damage still occurs during the winter months.

Winter is also when patients ask about hydration from inside the skin rather than on the surface. SkinVive, which we offer, is a micro-droplet hyaluronic acid injectable for deep hydration. It is not a replacement for moisturizer, and I do not present it as one. It is one more option on the list when the surface routine is not enough, and whether it fits is a conversation, not a given.

The part that does not change

Every season, the same three things: cleanse, moisturize, protect from the sun. The products get lighter or heavier and the timing shifts, but the list stays the same. I believe in preventative care and in working with the features you already have rather than trying to change them, and that starts with the everyday routine long before it involves anything I do in the office.

Whatever the season, the goal is the same: figure out what actually needs changing and leave the rest alone.