Eczema, Dermatitis and Skin Care
Skin - Your Body's Largest Organ
The outer layer of skin, known as the epidermis, is constantly regenerating itself, growing from the bottom upwards. Dead skin cells are shed from the outer layer as this regeneration happens about every 52-75 days. I'm sure that dust mites are pleased with this amazing skin regeneration process since they feed on our shed, dead skin cells! Here are some other interesting skin facts:
- The average adult has 21 square feet of skin, weighing approximately 7 lbs.
- Skin is made up of about 300 million cells.
- Human skin is nearly as thin as a few sheets of paper.
- The thickest skin is found on the palms and soles and the thinnest on the lips and around the eyes.
- Skin serves to waterproof the body and protect it from invaders.
- Touch is one of the first senses to develop - even in the womb, a baby feels its way to bring hand to mouth.
Protect And Hydrate
As you can see, skin is an intricate organ that plays a vital role in our lives. So how can we protect it? Any dermatologist will tell you that limiting sun exposure is a major way to protect your skin's look and function. Even though you may not be frequenting the beach this winter, the sun is still shining (even behind the clouds), so before you reach for hydrating body lotion, protect your lips and skin from damage by applying sunscreen - at least SPF 15. Free from many common irritants, the Vanicream brand has both a Sunscreen and a Lip Protectant, both of which offer lasting protection from the sun's rays.
Doctors also recommend keeping our skin hydrated to prevent cracking and pre-mature aging. Before I began research for this article, I knew there were countless moisturizer choices available, but I never quite knew the difference between them all. Here is a summary of the four basic classes of body moisturizers, in order of effectiveness: ointments, oils, creams and lotions.
Ointment moisturizers do the best job at trapping moisture in the skin. However, they usually have a greasy feel. Common examples of ointment moisturizers include Vaseline Petroleum Jelly or even vegetable shortening. When applying these moisturizers, use only a small amount and rub it in well.
Oil moisturizers have less of a greasy feel. The most common oils applied directly to the skin are baby oil, mineral oil, vegetable oil and bath oil (like Robathol). Pure vitamin E oil is another moisturizing agent that I often use after a shower, especially during the winter. Vitamin E oil, available at many health food stores, is said to promote healing of cuts, burns, eczema, and other skin problems, and I'm hoping it fends off those squint lines I'm developing! Another way to get the benefits of vitamin E is to use a product that includes it as an ingredient like Vitec - a high potency lotion that leaves skin soft and nourished.
Cream Moisturizers are more popular than ointments because they don't leave as much of a greasy residue. Typically white in color and of a rather think consistency, creams are rubbed into the skin. Common examples of cream moisturizers include Vaseline Cream, Eucerin and Neutrogena Hand Cream. Many allergists recommend Vanicream, a non-greasy, non-scented moisturizer formulated especially for eczema and other dry skin conditions.
Lotion moisturizers are suspensions of oily chemicals in alcohol and water. Lotions are the most popular moisturizers, available in an endless variety of scents and colors, and usually not as thick as creams. However, those with skin or chemical sensitivities should be cautious since many lotions contain alcohol, lanolin and fragrances. Also, if a lotion does not feel at least a bit greasy when being applied, it may not be providing the hydrating protection you need. Some doctor-recommended lotions include Vaseline Intensive Care, U-Lactin, Lubriderm, and Nivea. We love the U-Lactin for its super-absorbency and soft, non-greasy feel.
What Causes Dry Skin?
The outer layer of skin is like a piece of plastic wrap you'd put on a cake to keep it moist. This prevents the moisture in the cake from escaping into the outside air. This outer layer of skin, called the stratum corneum, is made up of dead skin cells which are embedded in the natural oils produced by your underlying living skin cells. The natural oils act as a barrier to water escaping from the body and they keep irritating germs from entering your body. The skin cells and oils in the stratum corneum attract a certain amount of water, and this is what keeps our skin smooth and pliable. When our protective oils are lost, the coveted water that our stratum corneum holds can escape more readily, causing dryness and a reduced barrier to irritants.
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.
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.
Atopic dermatitis is not contagious. Nor is contact dermatitis, another form of eczema. Contact dermatitis 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. 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 Treat And Avoid 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] cover..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."
I think people give environmental factors less credit than they deserve when it comes to skin conditions such as eczema. 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 U-Lactin 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 be used as it may worsen the skin's condition.
General Tips For Dry Skin Care
Dry skin doesn't just affect eczema sufferers. Tips from various sources:
- Don't scratch!
- Moisturize at least once daily.
- Wear gloves when hand-washing dishes or using household chemicals.
- Keep baths or showers short.
- Use warm (not hot) water.
- Use as little soap as possible or non-abrasive soap and shampoo like the Vanicream Cleansing Bar or Free & Clear Products.
- Wear cotton and sleep on cotton.
- Find out what triggers your flare-ups.
- Test any new product for your face on your body first.
- Use a germ-free humidifier if the air is dry.
- Drink plenty of water throughout the day.
- Be patient.
- Follow your doctor's treatment advice.