Is your skin dry and rough? Do you have white blotches on your cheeks and arms and or dark circles under your eyes?
You may have eczema.
Let’s be more precise as “eczema” is a broad term and when most people say “eczema” they mean “atopic dermatitis.”
Children under the age of two are more likely to have a food allergy or sensitivity; but searching for this with extensive allergy testing is usually low yield. Having said that, if you notice that a certain food makes your child worse, avoid it.
Atopic dermatitis is part of the “atopic triad”which also includes asthma and allergic rhinitis which are seasonal allergies. Some patients have two or all three of these conditions.
There is a theory that bacteria (usually staph) on the skin plays a role in eczema flare-up. It is called the “super-antigen” theory.
Instead of acting like a normal antigen and activating the part of the immune system designed to fight bacteria, it acts as a “super” antigen in eczema patients and activates “everything” so that your immune system goes haywire and results in itchy eczema.
Atopic Dermatitis is diagnosed clinically based on personal, family history and physical exam. Allergy testing including pinprick test, blood allergen tests and patch testing can be helpful in certain cases but are not routinely done.
Eczema treatment consists of a strict sensitive skin care regimen with the use of the right products, appropriate topical steroids, treatment of bacterial colonization of the skin and avoidance of scratching among others.
Here are our top favorite Eczema treatment tips:
- To avoid a flare up, patients should take one short five to ten minute bath or shower daily in lukewarm water. Avoid scrubbing and unnecessary use of soap. We have found Dove Unscented is the least irritating.
- Keep your skin super-hydrated! We recommend moisturizing several times a day but most importantly after showering, when the skin is damp for maximum absorption. Our staff at Minas Dermatology personally recommendsAquaphor,but CeraVe and Vanicream are also excellent moisturizers.
- Keep nails short to avoid scratching.
- Hypoallergenic detergents like Tide Free or All Free and Clear are best for severe eczema patients. Fabric softeners including dryer sheets should be avoided.Interestingly, dark dye in clothing can exacerbate eczema so avoid wearing dark clothes.
- For flare ups, try a bleach bath. Fill your bathtub and add a 1/4 cup of plain old Clorox bleach. It becomes very diluted and smells like a swimming pool. This does not take the place of topical steroids, but can help quite a bit.
And of course, see your dermatologist.
If one topical steroid does not work, we have others
One of the newest ones on the market is Eucrisathe first and only non-steroidal topical monotherapy that inhibits the PDE-4 enzyme in the skin.
Have you tried it?