What is eczema?
That one little word you may have heard over, and over, and over again. It’s a little word, but it causes you BIG problems. 🙄 Up late itching? Eczema. 🙄 Can’t focus at work? Eczema. 🙄 Covering up embarrassing dry skin? Eczema. 🙄 Let me guess, you must be exhausted by eczema! Let’s start off discussing what the heck eczema even is…
Eczema, or what we in healthcare call “atopic dermatitis” (atopic = allergic, dermatitis = skin inflammation), is a chronic condition characterized by itchy, inflammatory skin. Yes, sadly it is chronic (you have it for life) 😔, but symptoms can be well controlled by taking certain measures. It’s unclear exactly what causes the disease, but most believe it’s some combination of an overactive immune system that is going a little haywire and an abnormal skin barrier. Yes, many people with severe eczema are also sensitive to environmental and/or food allergens. But this is usually not the main cause of eczema, and instead a contributing factor.
With eczema, the skin becomes dry, flaky and very itchy. Once the person starts to itch the skin, the affected area can become thick, open up and start to ooze. Broken skin is at risk of infection with bacteria, viruses, or fungus (yikes! 😳). Itchy skin can be very disruptive and painful. The more you itch, the more your eczema will disrupt your life. Before you get too itchy… read on, as there is lots you can do!
Can stress increase eczema symptoms?
Stress can worsen eczema symptoms. The way that stress increases the response in your skin is poorly understood. What we do know is that stress causes an inflammatory response in the skin. This makes eczema worse which can make sleep worse and stress levels rise even more. Taking care of yourself becomes a priority during times of stress. Try to reduce stress in your life to help reduce triggers for your eczema. When you start to feel stressed, it’s common to start to itch. Some people experience flushing of the skin or a hive-like rash. Getting an itchy rash can make you feel even more stressed, exacerbating the eczema. Make a list of things that work for you to help decrease stress. Try and do something other than itch!
Eczema and allergens
Allergens can definitely worsen eczema symptoms, especially when your skin barrier (the epidermis) is not working as well as it should. Allergies to dust, dander, and certain foods (among others) can trigger symptoms of eczema. Other triggers include bathing too often without moisturizing your skin, living in dry environments, just having chronic dry skin, and overheating the skin. For long-term eczema management, it is helpful to figure out what triggers your eczema to worsen, and then avoid those triggers. . Basically, it’s not rocket science, whatever causes your itch, avoid it! 😜
Dust mites, animal danders, molds, and pollens can make eczema worse. Have you noticed these allergens in your living space? What can you do to minimize your exposure to them? Thorough home cleaning can help. I know, I know, who has time for thorough home cleaning? 🙄 But it’s important! Using hypoallergenic sheets and pillow covers, and removing mold are also good places to start. Got pets? If they worsen your eczema then they better not be sleeping in your room, or even worse, in your bed 😆. Vacuum, a lot! Use hypoallergenic sheets and pillow covers.
Some people have a sensitivity and/or an allergy to different foods that causes an inflammatory response and eczema symptoms as well. Following up with an allergist to determine if you or your child has an allergy will be helpful if you are suffering from eczema. Identifying your triggers, then avoiding or treating them, can help to alleviate your symptoms.
Eczema in children
In children under 5 years of age with eczema, up to 30% also have a food allergy, according to The National Eczema Association. Causes of eczema can be complicated and it can be hard to treat. Eczema can be disruptive to sleep and daily life, and can cause infections and complications. It is important to really pay attention to your child’s skin and make an effort many times a day to help alleviate symptoms. Definitely have your pediatrician evaluate your child’s eczema and discuss a plan of action!
What can I do for my eczema?
First, let’s start with what irritants you can remove before we jump to medication treatments. Eczema is usually worsened by an irritant. You must identify what the irritant is and remove it. Start by removing any fragranced products from your daily routine. Washes, shampoos, lotions, laundry detergents, and fabric softeners are often the culprits in causing irritation to the skin. It’s important to find products that are hypoallergenic and fragrance free. The National Eczema Association lists some of their recommendations to help decrease the irritants in your life. Start looking at labels to see what is in the products you are using. Try switching to hypoallergenic products for your home and skin. Many times, simply switching to a non-fragranced fabric softener will significantly improve eczema symptoms.
Often times your eczema may not flair until the heat is blasting in your home, or you are out in the summer heat sweating. It all depends on how your skin reacts. If it helps, write down what bothers your skin so you can remember next year! For example, it may help to add a reminder to your calendar to start moisturizing in late September before the heat turns on at home.
Treatment for eczema
Treating eczema is hard work and takes dedication and action on multiple fronts. Annoying, I know. But, we promise, it will be worth the work! 😊 The main goals are to (1) remove possible external causes of eczema, and (2) keep the skin as moisturized💧as possible! If you’ve been trying a lot on your own without much improvement, working with a primary care provider or dermatologist can be super helpful! The following eczema treatments are worth trying:
- Eliminate fragranced products from your daily routine, including fragranced detergents, body washes, lotions… anything that touches your body.
- Use a cool mist humidifier in your home and room, especially when the heat is on or if you live in a very dry place.
- Take a warm oatmeal or baking soda bath (sometimes doctors even recommend bleach baths. You can ask your provider if this is right for you– don’t go dumping bleach anywhere without a plan!)
- Use daily emollients (types of creams) such as Aquaphor, hydrolatum or Eucerin cream to keep skin moisture locked in. Use the creams directly out of the bath when the skin is still wet. This will help lock in the moisture. I often recommend applying a moisturizing cream onto damp skin, then covering that with vaseline/hydrolatum to lock in the moisture. Some people even recommend wearing damp clothing on top of that to help keep the skin moisturized for hours.
- Apply an over the counter hydrocortisone cream to reddened, irritated areas, once or twice a day. Limit use to 1 week and avoid the face and genital regions. Overuse of steroid creams can thin the skin and cause wrinkles (and that is no fun). If you use hydrocortisone for a week and the problem still persists, or if you need treatment on the face/genital areas, then please discuss with your primary provider, as they can monitor stronger steroid cream use.
- Moisturize, moisturize, moisturize!
- Don’t scratch! If you are having trouble holding back 😤 then consider trying an over the counter antihistamine cream or antihistamine oral medication such as cetirizine (aka Zyrtec) or diphenhydramine (aka Benadryl). Please use only as directed and discuss with your provider if using long term for severe itching.
- If you have any skin breakdowns, or if the rash is starting to become red, consider speaking with your provider and applying antibiotic ointment such as bacitracin or mupirocin.
When to be seen by a medical professional for eczema symptoms
There are many steps in improving eczema and it can take some effort, so be patient. Get checked out by a medical professional if you or your child has a rash that doesn’t improve or gets worse after a few days of really moisturizing and protecting your skin. It’s important to get checked out if the rash begins to have any oozing, pus, redness, swelling, or warmth at the site, or if develop a fever along with the rash then.
For some, eczema can be severe and requires prescription medication to treat eczema flares. We can chat with you if you aren’t sure about your symptoms or want us to look at a photo of your rash.
– Kim Liner, RN, MSN, CPNP
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