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Eczema 101

Eczema & Dermatitis Education

What Is Eczema?

Eczema is a loose term often used to describe sensitive skin, easily irritated by soaps, wool or environmental factors. A common form of eczema, known as atopic dermatitis, is a chronic, recurring skin condition that is not easy to treat. Skin can become extremely itchy, red, dry, scaly, cracked or inflamed. Depending how old the eczema sufferer is, skin "flare-ups" can appear in many parts of the body including hands, feet, face, elbows, skin folds, etc.

Another form of eczema is contact dermatitis. This condition usually results in a red, itchy reaction where the skin has been in contact with a substance that the immune system reads as foreign, like an allergen.

Approximately 35 million people in the United States are affected by eczema, many of whom are infants and young children. In fact, it is estimated that between 10 to 20 percent of all infants suffer from eczema. It can start as early as 6 weeks of age and often disappears before age 3. However, for some, eczema can be a life long problem. Most people that have eczema have a family history of eczema, hay fever, or asthma. Thus, eczema seems to result from a combination of genetic and environmental factors.

The Cycle Of Eczema

Eczema can be a truly vicious cycle. Irritated skin longs to be scratched, thereby creating more inflammation and harming the outer protective layer of skin. Without this barrier, the skin is prone to more drying and exposure to offending allergens, which trigger more rashes. And the irritating itchy cycle begins again.

When eczema-affected areas become red and inflamed, this is often called a flare-up. There are many things that can cause flare-ups for eczema sufferers. Here is a list of some offenders:
  • Rubbing the skin
  • Excessive heat or dryness
  • Dust mite allergen
  • Pet dander
  • Cigarette smoke
  • Scratchy fabrics like wool or synthetic fibers
  • Irritating chemicals in cleaners and detergents
  • Moisture like saliva or milk
  • Common allergic foods like milk, eggs or wheat
  • Emotional reactions to stress or anxiety

How To Avoid and Treat Eczema Flare-Ups

Any physician will tell you that there is no "magic bullet" for treating eczema. Treatment depends on the patient's condition. The first step for effective treatment is to identify what is causing the flare-up. Many families have discovered that their first defense is to manage their environment. I was amazed to read about the number of physicians and professional organizations that strongly recommend allergen avoidance as a first defense against allergic skin conditions. Dr. Alan Greene, MD is the founder of a popular pediatric health website. Here he explains a recent study demonstrating the eczema-environment connection:
"Until recently most dermatologists have not thought that allergy to the house dust mite played a significant role in eczema. A team of dermatologists decided to see what would happen if the amount of house-dust mite antigen in the homes of people with eczema was reduced. They used several different methods to control the house dust, but the most important was encasing the mattress in a [dust mite proof] coverA├║.The severity of eczema significantly decreased in those using the [dust mite proof] mattress covers. This relatively simple intervention could have a dramatic effect on children and adults with eczema."
Managing environmental factors really can help bring relief for allergic skin conditions. So be sure that even your small children's mattresses and pillows are encased, and that stuffed animals are kept to a minimum and washed frequently. Many doctors also recommend having a HEPA room air cleaner in a child's room.

Some other practical ways to avoid flare-ups include cutting fingernails and wearing cotton gloves at night to avoid scratching. For protecting young children from scratches, some doctors recommend placing knee socks on little arms because they fit more securely. Hydration is also an important factor to prevent flare-ups. Soaking affected areas or bathing can re-hydrate skin, but only if an effective moisturizer like Vanicream or Proteque is applied within about 3 minutes of drying off to seal in the moisture. When drying off, eczema sufferers should not rub the skin, but rather pat dry.

Here is a brief summary of some other therapies used for eczema control. While hydration is the most important treatment, the American Osteopathic College of Dermatology (AOCD) also recommends topical steroids, which can be helpful to treat the inflammation and itching caused by eczema flare-ups. However, topical steroids should not be used more than twice a day. Long-term use can cause thinning of the skin, de-pigmentation and acne-like symptoms. The AOCD cautions that oral steroids should be avoided because they can have severe side effects and result in worse flare-ups once discontinued. Doctors also use portable tanning units in a controlled setting as a treatment for eczema.

In severe eczema cases, characterized by yellow crusts or pus developing in affected areas, staph infection may be present. In such a case, you should see a doctor who will likely treat you with antibiotics for 2-4 weeks in order to reduce the infection. The AOCD recommends that topical antibiotics like Neosporin should not beused as it may worsen the skin's condition.

To read more about caring for Sensitive Skin, read the January 2005 edition of our Educational Newsletter.

This information is for educational purposes only. Always consult with your doctor first about your specific condition, treatment options and other health concerns you may have.

Article Quick Read
  • Eczema is skin irritation that affects 35 million Americans.
  • Eczema also effects young children and can last a lifetime.
  • The eczema cycle of itch, scratch and inflammation is called a flare-up.
  • Flare-ups can be caused by allergens, heat or dryness, stress and other factors.
  • Reduce flare-ups by cleaning up your environment.
  • Get relief with moisturizers applied within 3 minutes of bathing to hold moisture.
  • See a doctor if an area of skin becomes infected or severely inflamed.