What is atopic dermatitis?

Atopic dermatitis, often called eczema, is a very common skin condition. The cause is not known, but eczema tends to run in families, plus a variety of factors can aggravate the condition. Eczema can be treated but not cured. It usually goes away before adolescence, often before Kindergarten. It may, however, last for many years, and the treatment may change from time to time. Therapy is aimed at avoiding flare-ups, relieving itching, and treating skin infection.

What things can cause eczema to flare up?

Trigger factors vary from person the person, but there are a few things that seem to both almost every person with eczema: dry skin and irritants.

Dry Skin
People with eczema have a defect in their skin preventing it from staying moist. It is especially bade in the winter when the heat is on in the house and the humidity drops. Other things that dry the skin are bathing too frequently as well as washing with soap and hot water. They remove the natural moisturizing factors from the skin. To prevent dryness we recommend the following:

• Take a bath or shower in cool-to-warm water for 10-15 minutes every day.
• Never use a wash cloth.
• Do not use any bubble bath.
• Do not use any soap or cleanser except in the armpits, groin, and feet. It is important to rinse these areas thoroughly to remove all traces of soap.
• If you take a bath, do not add anything to the water unless advised by your doctor.
• Immediately after bathing PAT the skin gently (do not rub dry), apply medicine creams to the rash areas only, then – while the skin is still DAMP – apply a moisturizer such as DML lotion, Lubriderm, or Nutraderm over the entire body (even on top of the medicine creams).

Irritants
Irritants are any substance outside the body that can cause redness, dryness or itching of the skin.

• Avoid wool, rough and scratchy clothing (cotton is best).
• Avoid harsh chemicals, soaps, bubble bath and excessive sweating.
• Don’t overheat rooms, especially the bedroom.

Do food allergies cause eczema?

Foods probably do not cause eczema to flare up in the majority of people. If you suspect a particular food (for example, cow’s milk, eggs, or peanuts) is causing flare-ups, eat that food one time (a “challenge”) after avoiding it for 2 weeks. If the food does cause flare-ups, the eczema should become very itchy within 2 hours of eating the food.

What can be done to help relieve the itching?

Preventing dry skin (see above) and treating the rash areas with a cortisone-like cream or ointment AND taking an antihistamine medication are the main treatments for the itch of eczema.

• If cortisone-like medicated creams or ointments have been prescribed, they should be applied only to those areas, which are red or itching. They should be applied immediately after bathing (just before the moisturizer) and one other time each day about 10-12 hours later. Avoid putting cortisone-like creams on normal skin.
• When the rash quiets down, use the cortisone-like cream at least once a day for an additional 2 weeks. After that, use it immediately on any spot that itches. When you travel, always take the cream with you. If your supply starts to run out get the prescription renewed.
• An antihistamine such as Benadryl pills given at bedtime will help reduce itching. It is very important to take just enough to cause some drowsiness.

What can be done to reduce the chances of skin infection?

• Keep the fingernail trimmed short and the hands clean.

CALL YOUR DOCTOR IF:

• The rash becomes raw and bleeding in several places.
• The rash looks infected (red streaks, pus, and yellow scabs).

For more information about eczema and atopic dermatitis go to:

www.skincarephysicians.com/eczemanet/index.html

www.nationaleczema.org