Eczema

“Eczema” or atopic dermatitis is an inflammation of the skin that results in itchy, red, swollen and cracked skin. Scratching causes these symptoms to worsen which increases the potential for skin infections. Eczema is not contagious. 

Causes

The exact cause is unknown but eczema is believed to involve genetics, immune system dysfunction, environmental exposures, and difficulties with permeability of the skin. Those who live in cities and dry climates are more commonly affected. While emotional stress may exacerbate symptoms, it is not a cause. Exposure to certain chemicals or frequent hand washing makes symptoms worse. Other offending agents include wool clothing, soaps, perfumes, chlorine, dust and cigarette smoke.

Treatment

Typically involves a multi-faceted approach. The following are necessary for every-day care:

  • Knowing what triggers the eczema and avoiding the things that make the rash worse
  • Daily bathing or showering in warm water. Hot water causes the skin to itch more. Clean the skin with a mild soap such as Cetaphil Skin Cleanser, CeraVe Hydrating Cleanser and Aveeno Eczema Care. Dove Sensitive is a good alternative.
  • Moisturizing multiple times daily with a ceramide and/or hyaluronic acid containing cream
    • It is important to apply moisturizer immediately (recommended up to 3 minutes) after a shower when the skin is still damp so that the cream will seal in the moisture
  • Go fragrance-free with all products you apply to your skin. The washes mentioned above achieve this, but other items to be mindful of are laundry detergent, lotions, deodorant, and makeup. 

Other treatment options that may be necessary but do not require daily application:

  • Topical steroids – should be used only during periods of flare and only on the affected areas. Apply twice daily for 2-4 weeks, then weekends only for 2-4 weeks, then stop. You may repeat this every 6-8 weeks as needed. If you are improved after 1 week of twice daily use, decrease to weekends only for 1-2 weeks then stop. Overuse of this medication will thin the skin and the cream will no longer work. Contact our office if your rash does not improve after weeks of treatment.
  • Bleach baths – decrease the bacteria on the skin and reduce the risk of skin infection. Use ½ cup household bleach for a full bathtub, ¼ cup for a half bath. Soak for about 10 minutes and rinse off. Use 2 – 3 times a week only during periods of flare.