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A key component in controlling eczema is Good skin care. For some people with mild eczema, modifying their skin care regime and making a few lifestyle changes may be all that is needed to treat eczema. Other people with more severe eczema may need to take medications to control their symptoms.
What is Eczema?
Eczema or Atopic Dermatitis is a very common chronic, relapsing skin condition characterized by an itch that eventually develops into a rash due to rubbing and scratching. Chronic rubbing and scratching may also lead to thickening of the skin. It usually starts within the first year of life and some patients do grow out of it eventually. Atopic dermatitis is usually associated with a family history of asthma and rhinitis (runny nose). In fact, 35% of infants with atopic dermatitis will develop asthma later in life. Atopic Dermatitis can affect the face, trunk and extremities. Patients with atopic dermatitis are more prone to skin bacterial and viral infections than others.
Special Treatment of Eczema
Removing triggers will certainly help with atopic dermatitis. Reducing contact with water, like long baths, and avoiding frequent hand washing will help. Avoiding bleaching agents in cloth, fabric softeners and switching to ALL-Free detergent will help.
Moisturizing is one of the most important tasks that one can do. There are many modalities of treating atopic dermatitis, most commonly topical steroids and topical immunomodulators like Protopic or Elidel. Every atopic dermatitis patient is unique, so a customized treatment plan by a dermatologist is necessary to keep it under control.
Is eczema contagious? Can I give eczema to my kids or colleagues?
No. Eczema (Atopic Dermatitis) is a hereditary condition where patients lack ceramides in the outer part of the skin. As a result, eczema patients cannot retain moisture on their skin, resulting in a dry skin. The dryness will causing itching. Scratching will cause more itch, resulting in an itch and scratch cycle. Eczema is a genetic condition and it is not an infectious etiology. Thus, it cannot be spread from one person to another person.
Helping Kids with Severe Eczema
Will a kid with eczema ever outgrow it?
Most patients do outgrow eczema by the age of 10. As patients become older, the eczema becomes less severe in most patients. However, there are some patients that have eczema their entire life and it does not get better. Every person is different.
If I had eczema as a kid and it resolved, can I get eczema later on in life?
As adult, patients with atopic dermatitis could develop eczema on the hands, also known as hand eczema. This is typically characterized by redness, scaling, and fissuring associated with lot of itchiness. Chronic excessive hand washing may lead to exacerbation of hand eczema.
What is the most important recommendation for patients with eczema?
The most important step advice for patients with eczema (atopic dermatitis) is to avoid contact with water. Water will dry out the skin and will make the eczema worse. Dr. Behnam has many patients who work in the kitchen (ie chefs) who present with hand eczema. Unfortunately, for these patients who wash their hands a lot, they are just in a bad situation because the constant contact with water will irritate their skin more and will make the eczema flare up. It is very important for these patients to constantly moisturize their hands. Moisturization and avoiding contact with water are the two most important things that can be done to reduce flares in patients with Atopic Dermatitis. The more you moisturize, the better your eczema is going to be.
Are all moisturizers equal, can I use any moisturizer to moisturize my body?
No. Not all moisturizers are created equal. Lotions are typically the worst form of moisturizers and ointments are typically the best form of moisturizers. The reason is that lotions contain a lot of water in them, about 90% to 95%, so the water will irritate your skin more. Creams have about 50% to 55% water in them and are definitely better than lotions, so Dr. Behnam highly recommends his patients to stop using moisturizing lotions and start using moisturizing creams, typically about three to five times a day. This would relieve and alleviate the itch as well as the eczema symptoms. Vaseline, petroleum jelly, or Aquaphor are the best moisturizers because they have the least amount of water content in them. However, the problem with them is that they could be too greasy so lots of patients do not like using them. The most common brands that Dr. Behnam recommends for moisturization include Aveeno, Cerave and Cetaphil.
Taking hot showers, is that good or bad for eczema?
Taking long hot showers is the worst thing that one could do for eczema. Bathing for 20 minutes or using hot scorching shower will dry out your skin more and flare up eczema. Dr. Behnam highly recommends taking a shower once a day (not twice a day), avoid taking baths, use lukewarm water and be in the shower for less than 5 minutes. Once you come exit the shower, please pad yourself dry and use a moisturizer cream (not a lotion) all over the body. By just following these recommendations, eczema will get better. Remember, water is your enemy. Chronic consequence is that water will dry up the skin more, so it is very crucial to avoid water in the patients with eczema.
Why use a humidifier in the rooms for eczema patients?
As humidity drops, the skin becomes dryer. In some patients, it is helpful to use a humidifier in the room. It might not help all patients but in some patients it does helps.
Do different seasons affect eczema?
Yes. Typically, during the winter months, the humidity drops. When this occurs, the skin becomes dryer and eczema flares. Winter months are the worst months for psoriasis and eczema patients. It is very important for patients with eczema to be more proactive in taking care of their skin during the winter months. This means taking showers once a day or every other day, spending less time in the shower, and not using very hot scotching water. This also means that patients should moisturizing more often.
What are some of the moisturizing creams that you recommend?
Moisturizing creams are significantly better than moisturizing lotions. The brand name moisturizers that Dr. Behnam recommends include CeraVe, which contains a lot of ceramide creams, Cetaphil, Aveeno, and Neutrogena.
My 7-month-old child has started to develop a rash around the mouth, is this eczema?
If there is a rash around the mouth of a 7 month old infant, you should see your dermatologist. However, in most cases, this could be eczema. In order to treat eczema around the mouth, it is very important to understand what the etiology of it is. A lot of kids around this age are drooling, especially when they are sleeping. The drooling will cause irritation on the skin. So, Dr. Behnam typically recommends patients’ parents to use Aquaphor (petroleum jelly) on the face before the putting the infant to bed. This way when they drool, the Aquaphor prevent direct contact with the skin and will prevent the irritation. In addition, sometimes a mild topical steroid might be used as well, such as desonide, Desonate, or Cordran lotion.
Do I need to have any allergy testing for my kid with eczema?
No. The reason is that kids with eczema will typically show positivity to allergy testing, but this does not necessarily mean that they are allergic to it. As long as there is no clear and obvious connection between the food kids eat and eczema flares, Dr. Behnam does not recommend restricting patients from eating chicken, fish, meat etc.
Are all the detergents the same?
No. Dr. Behnam believes that using right detergent is very important in preventing eczema flares. Dr. Behnam recommends ALL free detergents. This will lead to less flare-ups of eczema. Also, please avoid using bleaching agents and fabric softeners as they will also irritate the skin in atopic dermatitis patients.