Eczema is a chronic inflammatory condition of the skin. It can occur at any age. It is associated with itching, redness, and scaliness of the skin. It is sometimes associated with nasal allergies and asthma. All three of these are called atopic conditions and can be hereditary. Allergies may contributes to flares of eczema, but often times stress, extremes of temperature, or other environmental conditions are the culprit. Many people with eczema are allergic to nickel and dust mites. Children usually less than two years of age may be allergic to milk, soy, nuts, or chocolate. Wool, sweat, fragrances, pollen, pet dander and chlorine exposure also frequently trigger flares. There also seems to be a fundamental defect in the skin barrier. Because of this, many individuals with eczema are more susceptible to skin infections. These include warts, molluscum, herpes virus (fever blister causing virus), yeast and fungus, like athlete’s foot.
Treatments for eczema include topical medications such as moisturizing barrier creams, steroid creams to reduce redness and itch, non steroid immunomodulator creams (Elidel and Protopic) which work like a steroid but have fewer side effects. Oral steroids and antihistamines can be helpful for severe eczema. Treating underlying infections with antibiotics, antifungals or antiviral medications can help as well. There are new biologic medications on the horizon that will help to address some of the chemical imbalances that contribute to eczema.
Treatment of the skin barrier to repair it with aggressive use of moisturizers several times daily can be extremely beneficial. Highly recommended moisturizers include Aveeno eczema therapy, Aveeno Skin Relief moisture repair cream, Cetaphil Restoraderm, Vanicream, DML lotion and DML Forte, Aquaphor healing ointment. Less expensive options such as vaseline can be helpful as well.
Bleach baths can help to restore normal balance of skin flora (bacteria and yeast). This is a safe way to try to improve eczema by soaking in a full bathtub of lukewarm water with ¼-½ a cup of bleach for 10 minutes 2-3 times weekly. Another tried and true remedy is to apply a wrap soaked in lukewarm water, then wrung out to a flared area. Alternatively if the entire body is flared, a pair of long johns or pajamas can be wet. Dry pajamas, blankets or towels should be used to keep the person warm while these are on. After 10 -15 minutes this should be removed and moisturizer or steroid should be applied. This may be done as as often as needed to relieve symptoms. Other helpful tips may be found on The National Eczema Association website.