Eczema is a skin condition characterized by itchy, red, cracked, and inflamed skin. It is also known as atopic dermatitis. Eczema can occur in people of all ages, although it is most common in infants and children.
The most common symptoms of eczema include:
- Dry, itchy skin
- Red, inflamed patches
- Oozing and crusting
- Thickened and cracked skin
- Raw, sensitive skin from scratching
The itchiness associated with eczema can be very severe and lead to infection and additional complications from constant scratching and rubbing of the skin.
There are several types of eczema, including:
- Atopic dermatitis: The most common type of eczema, associated with asthma and hay fever allergies. It usually starts in infancy or childhood.
- Contact dermatitis: Caused by an allergic reaction or irritation from something touching the skin. Common triggers include metals, soaps, fragrances, and plants.
- Dyshidrotic eczema: Characterized by small, itchy blisters on the hands and feet. It may be related to allergies or stress.
- Nummular eczema: Coin-shaped spots that are very itchy and may ooze or crust. It often starts after an injury to the skin.
- Stasis dermatitis: Occurs in older adults due to poor blood flow in the legs. The lower legs become very dry and itchy.
Eczema is often confused with other skin conditions like psoriasis. Diagnosis involves a physical exam and detailed history by a dermatologist. Treatment focuses on managing symptoms and preventing flare-ups.
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Conventional Eczema Treatments
Conventional treatments for eczema focus on reducing inflammation and itchiness associated with eczema flare-ups. Some of the most common conventional treatment options include:
Topical Corticosteroids
Topical corticosteroids are frequently prescribed to treat eczema. These creams and ointments work by reducing inflammation and immune activity in the skin. Low-potency corticosteroids like hydrocortisone are available over-the-counter, while higher potency steroids require a prescription. Using topical steroids sparingly and only on problem areas can help avoid side effects like skin damage.
Antihistamines
Oral antihistamines like diphenhydramine or hydroxyzine can provide relief from eczema itching, especially at night. These medications work by blocking histamines, which are chemicals released by the immune system that trigger itching and inflammation. Drowsiness is a common side effect of antihistamines.
Immunosuppressants
For severe eczema cases, immunosuppressant medications may be prescribed. These work by suppressing the overactive immune response causing eczema flares. Examples include cyclosporine, azathioprine, and methotrexate. Immunosuppressants can have significant side effects with long-term use, so they are usually only used for short periods. Careful monitoring is required.
Overall, while medications can help manage eczema symptoms, they rarely provide a cure. Many patients find the best results combining conventional treatments with lifestyle changes and alternative therapies. Working closely with a dermatologist allows customizing an eczema treatment plan with the right balance of therapies.
Lifestyle Changes
Making specific lifestyle adjustments can significantly help manage eczema symptoms and reduce flare-ups. This involves identifying and avoiding triggers, managing stress levels, and maintaining a healthy diet.
Identifying Triggers
It’s important to identify potential triggers that can aggravate eczema. Common triggers include irritants like certain fabrics, soaps, detergents, and skin care products. Allergens like pollen, dust mites, and pet dander can also trigger flare-ups. Other potential triggers include sweat, temperature changes, and infections. Maintaining a trigger journal can help uncover specific triggers. Once identified, avoiding triggers as much as possible is key.
Managing Stress
Stress has been shown to exacerbate eczema symptoms. Finding healthy ways to manage stress levels is essential. Practicing relaxation techniques like meditation, yoga, deep breathing, and mindfulness can help lower stress. Getting enough sleep and regular exercise also helps manage stress. If needed, speaking to a therapist may be beneficial.
Dietary Changes
Certain foods may trigger eczema flare-ups. Common dietary triggers include eggs, milk, soy, wheat, and nuts. Eliminating potential trigger foods and monitoring symptoms may help identify problem foods. Focusing on an overall balanced diet rich in vegetables, fruits, whole grains, lean protein, probiotics, and omega-3 fatty acids can also benefit eczema management. Staying hydrated by drinking plenty of water is also recommended.
Moisturizing
Keeping the skin moisturized is one of the most important parts of managing eczema. Using an appropriate moisturizer can help restore moisture to the skin and serve as a protective barrier. This is especially crucial because people with eczema have a defect in their skin barrier that makes it easier for moisture to escape and irritants to get in.
When choosing a moisturizer, it’s important to pick one that is fragrance-free and formulated for sensitive skin. Thicker ointments and creams tend to work better than lotions since they contain more oil and help seal in moisture. Ointments like petroleum jelly are ideal for very dry, cracked skin. Creams are also effective for dried-out skin and are less greasy than ointments. Lotions provide milder moisturizing effects.
Some popular moisturizing ingredients to look for include ceramides, which help restore the skin’s protective lipid barrier, hyaluronic acid, which is a powerful humectant that pulls in and binds moisture, colloidal oatmeal, which soothes and moisturizes itchy skin, and glycerin, which is another humectant that draws water to the outer layer of skin.
It’s best to apply moisturizer throughout the day, especially after bathing when skin is still damp. Even when skin is clear, consistent moisturizer use helps prevent flare-ups. For some people, thick ointments at bedtime and lighter creams during the day work well. Finding the right moisturizing regimen makes a big difference in controlling eczema symptoms.
Bathing and Cleansing
Keeping skin clean is an important part of managing eczema, but harsh soaps and hot water can further irritate sensitive skin. Experts recommend bathing in lukewarm water for 5-10 minutes once a day or every other day. Choose gentle, fragrance-free cleansers rather than typical soaps. Look for moisturizing cleansers with ingredients like oats or ceramides that don’t strip the skin. Avoid scrubbing or rubbing the skin forcefully. Pat skin partially dry after bathing and immediately apply moisturizer generously while skin is still damp. This helps trap moisture in the skin. Keeping showers and baths short and lukewarm can help prevent excessive drying of the skin. Using gentle cleansers without fragrances or harsh ingredients is also key. Focus on lightly cleansing without irritation to support healthy skin.
Wet Wrap Therapy
Wet wrap therapy involves applying medications or moisturizers to the skin and then wrapping the area with wet bandages. It works by increasing the absorption of medications into the skin and providing a barrier that prevents scratching.
Some key benefits of wet wrap therapy for eczema include:
- Increased hydration and moisture retention in the skin
- Enhanced absorption of topical medications
- Provides a protective barrier from scratching and further irritation
- Can quickly reduce inflammation and itchiness during flare-ups
There are some precautions to take with wet wrap therapy:
- Only use wet wrap therapy for short periods (usually no more than 5 days at a time) to avoid skin maceration
- Take care to properly cleanse and fully dry the skin before applying wet wraps
- Use appropriate antimicrobial soaps or additives in the water to prevent infections
- Avoid wrapping too tightly or using excessive layers that might restrict circulation
- Monitor for signs of skin infection and contact dermatitis from prolonged moisture exposure
With proper precautions, wet wrap therapy can be an effective option for managing severe or widespread eczema flare-ups when done under medical supervision. It helps enhance treatment absorption while protecting and hydrating the skin.
Phototherapy
Phototherapy, also called light therapy, is a common treatment option for moderate to severe eczema. It uses ultraviolet (UV) light to help relieve itching and inflammation. There are different types of phototherapy used for eczema:
Narrowband UVB uses a specific wavelength of UVB light that targets the immune system. It helps calm inflammation and itching. Treatments typically occur 2-3 times per week in a doctor’s office. After several weeks, frequency of treatments is reduced.
Broadband UVB emits a wider range of UVB wavelengths. It may be just as effective as narrowband UVB for some people.
UVA uses UVA rays along with a medication called psoralen. This is called PUVA. The psoralen makes the skin more sensitive to the UVA light. Treatments start at lower doses and increase over time.
Laser uses targeted beams of UVB light only on affected areas. This avoids exposing unaffected skin to UV rays.
Overall, phototherapy is very effective for many people with eczema. It works by reducing inflammation and immune system activity in the skin. Side effects can include dryness, itching, and increased risk of skin cancer with long-term treatment. Working closely with a dermatologist can help minimize risks. Many people find great relief of eczema symptoms with phototherapy.
Alternative Therapies
Alternative and complementary therapies are sometimes used in conjunction with conventional treatments to help manage eczema symptoms. Some of the most common alternative options include:
Acupuncture
Acupuncture involves inserting very thin needles into specific points on the body. Some limited research has found acupuncture may help reduce inflammation and itching associated with eczema. More studies are still needed, but acupuncture is considered safe when performed by a licensed professional.
Homeopathy
Homeopathy uses highly diluted preparations of substances to try to stimulate the body’s self-healing response. There is limited evidence on the effectiveness of homeopathy for eczema. However, some people report improvements in symptoms when using individualized remedies prescribed by a certified homeopath.
Herbal Remedies
Certain herbal remedies are sometimes used to treat eczema symptoms. For example, chamomile, licorice root, and marigold have natural anti-inflammatory and antimicrobial properties. However, research is still limited on the efficacy of most herbal remedies for eczema. It’s important to consult a knowledgeable practitioner before using herbs, as some may cause side effects or interact with other medications.
Overall, more research is still needed on most alternative eczema treatments. They are generally considered safe when used under the guidance of an experienced practitioner. However, they should not replace conventional medical care for managing eczema. Talk to your dermatologist before trying any alternative therapies.
Eczema in Children
Eczema, also known as atopic dermatitis, is very common in infants and children. About 10 to 20 percent of all infants and children develop the condition. Eczema in children is often triggered by common allergens and irritants. Some common triggers to avoid include:
- Dust mites
- Pollen
- Pet dander
- Soaps and detergents
- Fabrics like wool
- Changes in temperature or humidity
- Food allergies
When treating eczema in children, it’s important to use gentle skincare products made specifically for sensitive skin. Choose fragrance-free moisturizers and cleansers with natural ingredients like ceramides and oatmeal. Avoid products with dyes, parabens, phthalates or formaldehyde.
To relieve itching, an oatmeal bath can help soothe inflamed skin. Keeping fingernails short and having kids wear gloves or socks on their hands at night prevents scratching. Use wet wrap therapy for severe flares.
For severe cases, topical corticosteroid creams and oral medications may be prescribed. But use steroid creams sparingly and closely monitor for side effects like skin damage. Focus on repairing the skin barrier with gentle, daily moisturizing.
Work closely with your pediatrician to find the right treatment plan. Educate children on proper skin care routines. With the right lifestyle adjustments and medical treatment, childhood eczema can be managed effectively.
Living with Eczema
Eczema is a chronic condition that can significantly impact quality of life. While there is no cure, living with eczema can be managed with various coping strategies and support.
Coping Strategies
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Identify and avoid triggers – Common triggers like irritants, allergens, stress, and weather changes can worsen eczema. Avoiding triggers can help prevent flare-ups.
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Manage stress – High stress levels can trigger eczema symptoms. Practicing stress-relieving activities like yoga, meditation, or breathing exercises can help.
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Use moisturizer regularly – Frequent moisturizer use, especially after bathing, can help minimize dry, itchy skin.
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Take shorter showers – Long hot showers can strip away natural oils. Opt for shorter lukewarm showers instead.
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Wear soft, breathable fabrics – Tight or rough clothing can aggravate skin. Choose loose, soft, breathable fabrics like cotton.
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Avoid scratching – While scratching can provide temporary relief, it can worsen rashes. Using cold compresses or distractions can help avoid scratching.
Support Groups
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Online forums – Connecting with others through eczema-specific online communities can provide support.
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In-person support groups – Local eczema support groups allow for sharing experiences and tips for coping.
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Friends and family – Having a strong support system of loved ones provides emotional support during flares.
Outlook
While eczema has no definitive cure, various treatments and lifestyle adjustments can help manage symptoms effectively. Support groups and open communication with doctors allow for an improved quality of life. Over time, many people learn to successfully control their eczema. With proper treatment and coping strategies, living with eczema is very possible.
