Eczema: What’s the Best Treatment for You?It can be associated with infection bacteria, fungi, yeast and viruses of the skin. Steroid injections for eczema of patients with moderate to severe eczema also suffer from asthma, hay fever allergic rhinitisand food allergies. The main symptom is itchy skin. Skin is also ecema dry. Scratching makes the skin red, chafed and thick.
Eczema (Atopic Dermatitis) | Symptoms, Treatment & Management
It can be associated with infection bacteria, fungi, yeast and viruses of the skin. Half of patients with moderate to severe eczema also suffer from asthma, hay fever allergic rhinitis , and food allergies. The main symptom is itchy skin. Skin is also often dry. Scratching makes the skin red, chafed and thick. This allows water to leak out, making the skin dry.
Leaky skin can be caused by genes inherited from parents or by factors in the environment: Proteases break the links between skin cells and make the skin barrier leaky.
Moisturizers are used to improve the skin barrier. Clothing that covers the arms and legs can also help protect the skin from irritation. When there is a lot of redness, application of creams and ointments that dampen down the inflammation are often prescribed. In adults the rash can occur on the creases of wrists, elbows, knees, ankles, face and neck.
The rash is usually itchy, red and scaly. Scratch marks often occur due to the itchy nature of the rash. If one has this rash for a long period of time the affected skin can become thicker. The dry skin can worsen the itching and rash. The rash can become worse after eating certain foods. In the case of eczema, this is usually a delayed reaction. However, other reactions to foods can occur more immediately, including hives itchy welts and swelling.
Allergy tests are often positive even in patients who tolerate the food in their diet, and thus foods should not be removed from your diet solely based on the results of these tests.
Other types of rashes such as psoriasis and contact dermatitis poison ivy can look like the eczema rash. In addition, people with various other immune problems such as immune deficiencies low immune system and vitamin deficiencies low vitamin levels can have a similar rash.
You should be able to participate in your school, work, social, and family activities. There should be no social stigma attached with the condition. You should have little to no side effects from the treatments for eczema.
In addition, sleep should be restful and undisturbed by the need to scratch the skin. Avoidance of Possible Triggers Irritants: Irritants such as chemicals, soaps, detergents, fragrances, certain fabrics, and smoke can further irritate the skin in patients with eczema. The following are steps to perform to reduce irritant exposures: House dust mites are small, microscopic you cannot see them with the naked eye organisms. They are typically found indoors mattresses, pillows, carpet , typically in areas of high humidity.
These have been associated with eczema. Common allergic foods have been associated with eczema. Basic Definitions Topical Therapies: Topical means applying directly to your skin. There are many topical therapies: Tends to have more oil than water, usually is more thick and greasy. These are the most common types of moisturizers used to treat eczema. A mix of oil and water, it usually looks white and smooth. This is a more liquid form, feels like water. This is thicker than a solution.
Topical Moisturizers Dry skin tends to worsen the itching and rash. Various environmental issues, such as exposure to low humidity and wind can further dry the skin. Therefore, moisturizing hydrating, or adding water your skin is an important component to eczema care. After soaking your skin in a bath or shower, pat dry the skin gently pat the excess droplets of water.
It is important to know that moisturizers are NOT steroids. It is also important to tell the difference between steroids or other anti-inflammatory medications and moisturizers. Topical Steroids Topical steroids are anti-inflammatory medications that are used on the rash areas the red and inflamed areas of the skin, not just dry areas of the skin. The steroids used for eczema are different from other types of steroids, such as testosterone and estrogen.
When used properly as advised by your physician, topical steroids are safe. One topical steroid may be stronger more potent than another, and thus, may improve the rash more effectively than a weaker topical steroid. However, the stronger steroid also has potentially more severe side effects including thinning of the skin, and thus potent steroids should not be used on certain areas, such as the underarms, groin area, and face.
Usually, topical steroids found over-the-counter are less strong than prescription ones. Steroid pills or steroid injections shots are much stronger than topical steroids and can therefore cause more side-effects including weight gain and bone problems. In general, they should be avoided, particularly in children. Other Topical Anti-Inflammatory Medications If topical steroids are not effective, other topical anti-inflammatory medications called topical immunomodulators might be tried.
They are usually second-line agents used if steroids are unsuccessful. As they are not steroids, these medicines can be used on eyelid and other facial areas, as they do not normally thin the skin.
Wet-Wrap Therapy Wet wrap therapy is usually used for people with severe and difficult to manage eczema. In this therapy, the skin is soaked in warm water for about minutes and then, is patted dry. Then, a wet not dripping dressing either gauze or clothing is applied on top of the rash areas. This is followed by a dry wrap material, such as elastic bandage, pajamas, or sock, placed over the wet dressing.
For patient comfort, a warm blanket may also be used. Wraps are used typically for hours. Antihistamines Oral, or pill, antihistamines do not reduce the itch associated with eczema, as it is not triggered by histamine. Sedative antihistamines are sometimes used to help encourage much needed sleep at night. However, there are potential side effects, including increased sleepiness, or sedation during the day, increased dryness, and difficulty urinating.
Topical antihistamines should be avoided, as they may worsen your rash. Your skin may be infected if there is oozing, crusting, your clothes start to stick to your skin, or you have the development of cold sores or fever blisters.
Bathing Strategies Including Dilute Bleach Baths Very dilute bleach baths typically, one quarter to one half cup of bleach mixed with 40 gallons of water bath once to twice weekly may help improve the rash and may decrease the need for antibiotics. Stress-Relieving Therapies Stress reduction techniques, such as biofeedback and other techniques may be used to improve mood and decrease anxiety associated with eczema.
Vitamins There has been a recent increase in studies associating vitamin D deficiency with eczema. If you have been diagnosed with vitamin D deficiency low Vitamin D level by your physician, Vitamin D supplements may be prescribed. Biologic Medicines Biologic medications are newer anti-inflammatory medications that have been approved for other allergic diseases, such as asthma, as well as for other skin conditions, such as psoriasis.
They have been studied in difficult to treat eczema patients, and one biologic agent has recently been approved for the treatment of very severe eczema. Probiotics Despite a lot of media attention on probiotics, at present, there is no conclusive evidence showing that probiotic use improves or prevents eczema, and it is not currently recommended in routine eczema care.
Allergy Shots Allergy Injections Allergy shots giving injections of small doses of what you are allergic to, such as dust mites, under the skin in the arms are currently approved for the treatment of asthma and allergic rhinitis hay fever.
Allergy shots can help some patients with eczema. Allergy shots are not the same as steroid shots, or steroid injections. In summary, eczema is usually manageable, regardless of your age. There are many treatments currently available and future therapies are on the way. Clinical Management of Atopic Dermatitis: J Allergy Clin Immunol Pract. Boguniewicz M and Leung D.
J Allergy Clin Immunol ; Atopic Dermatitis Atopic Eczema: Therapeutic Principles in Dermatology. Find out more about skin allergies.