This is a fairly common skin problem. Any area of the body may be affected. The skin is frequently dry, red, rough or scaly and itchy. Itch can severe, and find yourself scratching or rubbing while awake, or even when sleeping. Affected individuals may also be prone to allergies, runny nose, or asthma. The eruptions typically occur on the elbow bends and backs of the knees, ankles, and wrists, and on the face, neck, and upper chest. The skin is very sensitive. It’s normal protective barrier is disrupted. Consequently, the rash may be easily irritated by everyday substances such as soaps, detergents, fragrances, hot water, and rough fabrics. The condition usually improves with time. However, it can come and go throughout life.
Since this condition is associated with allergies,
can certain foods be the cause?
Yes, but only rarely (perhaps 10 percent). Although some foods may provoke attacks, especially in infants and young children, eliminating them rarely will bring about lasting improvement or a cure. If all else fails, foods such as cow’s milk, soy, eggs, fish, wheat, and peanuts can be avoided for at least one to two weeks on a trial basis.
Are environmental causes important,
and should they be eliminated?
Rarely does elimination of contact or airborne substances bring about lasting relief. Occasionally plant allergens, dust, and dust-catching objects like feather pillows, down comforters, carpeting, drapes, and wool along with other rough fabrics, can cause the condition to worsen. Anxiety and stress are also exacerbating factors of eczema.
What should be done to treat this condition?
Treatment is geared toward avoidance of irritants such as rough, scratchy, or tight clothing and woolens, rapid changes of temperature, and any activity that provokes sweating. Proper skin care can be optimized by use of bland ointments or creams applied directly after bathing while skin is still damp and one other time that day.
Medicated or ointments or creams may be prescribed to control inflamed (red) and itchy skin. It is important to follow your provider’s instructions, as inappropriate use of topical steroids can cause the skin to become fragile and tear easily.
Below is a list of general guidelines.
- Avoid any fragrances or products with a good smell.
- Avoid hot water. Baths should be short (5 minutes or less) and in cool, lukewarm water only.
- Use sudsless liquid soaps.
- Keep the temperature in your home cool. If the air is dry, use a humidifier to increase the moisture in the air.
- Use a bland thick moisturizer immediately after bathing while skin is still damp. Apply more anytime the skin looks dry (3-5 applications each day is reasonable).
- Use medicated creams or ointments as prescribed by your dermatology provider.
- Avoid wool or other fabrics that seem to cause worsening of the rash or scratching.
- Avoid dryer sheets, fabric softeners, and detergents, if possible. Consider double-rinsing clothes if detergents are used.
- When bathing, it may be helpful to add one quarter to one half cup of regular Clorox bleach-the 6% sodium hypochlorite strength in a full tub of water. The exposure time in the bath is 10-15 minutes no more than 2-3 times per week.
- Always watch for things that seem to make the rash worse. Try to avoid exposure to these things.
- Remember that taking care of atopic eczema takes a lot of effort and patience. A slow response to treatment or flare-ups of the rash can be uncomfortable and frustrating. You may be asked to return to the office regularly until the rash is under control.