Eczema

Eczema

Eczema is a term doctors use to describe all kinds of red, blistering, oozing, scaly, brownish, thickened, and itchy skin conditions. Outbreaks can occur on the face and neck, in the folds of elbows and knees, on the hands, or, in extreme cases, over the entire body. While no one knows the cause, doctors say that allergies, sensitivity to environmental conditions like dry furnace air and scratchy clothes, and possibly stress can trigger eczema flare-ups.

Although many people outgrow eczema when they reach adulthood, others have outbreaks their whole lives. Eczema can be especially irritating for seniors because their oil-producing glands are not as active as they used to be, says John F. Romano, M.D., clinical assistant professor of dermatology at New York Hospital–Cornell Medical Center in New York City. This can lead to dry skin, and thus, greater irritation. And sometimes older skin heals more slowly, especially in the lower legs, because of reduced circulation, Dr. Romano adds.

There are several types of eczema, and some of them require very different treatments. Since many types appear alike, it might be tricky to get a correct diagnosis. But that’s what you need, says Dr. Romano.

Once you know what you’re dealing with, you can manage eczema a number of ways, all of which begin with an effective skin-care routine.

Try This First

Maintain moisture. To prevent the dry skin that is at the root of eczema, you need to trap some moisture. Apply a soothing skin cream right after you finish bathing, says K. William Kitzmiller, M.D., dermatologist in private practice in Cincinnati. The best of the heavy creams or lotions, called emollients, are oily but unscented. Nivea cream, petroleum jelly, or even solid vegetable shortening are excellent for people with eczema, says Dr. Kitzmiller.

Emollients are safe to use as often as needed. “When you step out of the bath or shower, liberally apply your emollient and then blot your skin dry,” suggests Dr. Kitzmiller. Since water gets into your skin when you bathe, the emollient helps trap the moisture and hold it there, he says.

Other Wise Ways

Have some hydrocortisone cream. Most eczema flare-ups can be relieved by nonprescription 1-percent hydrocortisone cream such as Cortaid, according to Dr. Romano. Don’t apply it every day, however, because it can cause spider veins and stretch marks. Intermittent use, no more than three times a week, should keep irritation in check, he says.

Time your baths. Doctors used to tell people with eczema to take quick baths—no longer than 10 minutes—to avoid having their skin dry out. Ignore that old thinking, says Kristin Leiferman, M.D., professor of dermatology at the Mayo Medical School in Rochester, Minnesota. Instead, take a leisurely bath for 10 to 20 minutes per day. Your skin cells will absorb water through their membranes and become hydrated. “You’ll know that you’ve been in long enough when your skin starts to pucker and crinkle,” notes Dr. Leiferman.

Turn down the temp. When you take that bath, though, use lukewarm water. Hot bath water can dry out the skin. And hot water can also irritate skin that’s already tender, explains Dr. Kitzmiller.

Eliminate scented products. Added fragrances are a chief cause of skin allergies and irritant reactions, according to Dr. Kitzmiller. If you have eczema, try to avoid any skin-care products that have fragrances.

Dr. Leiferman recommends nonirritating soaps and cleansers, like Dove or Aveeno, that don’t have a lot of fragrance, color, or additives.

Milk it for all it’s worth. Whole milk compresses are a low-cost way to soothe eczema flare-ups and reduce itchiness, says Dr. Kitzmiller. Saturate a gauze pad or cotton cloth with equal parts cold milk and ice water and apply it to the skin for about three minutes, he says. Resoak the cloth and reapply it at least two more times for three-minute soaks. You can repeat this treatment several times a day, he suggests, but be sure to rinse your skin with cool water after each application. Otherwise, you’ll start to smell like sour milk.

Ice the itch. Another way to control the itch of eczema is to hold a plastic bag of ice on the affected area, says Dr. Kitzmiller. Wrap the ice pack in a towel and hold it on the inflamed zone as long as necessary.

Choose nonitchy clothing. Anything you can do to reduce itchiness is going to minimize damage to your skin caused by scratching, says Karen K. Deasey, M.D., chief of dermatology at Bryn Mawr Hospital in Pennsylvania. Choose cotton clothing and cotton bedding whenever possible. When your body is in contact with cotton, your skin stays cool and can breathe. Synthetic fabrics can be irritating, and so can wool.

Turn to mild detergents. You can further reduce the itchiness of clothes by using mild laundry detergents such as Tide and Ivory and by rinsing garments twice to clear away all traces of detergent, says Dr. Deasey.

Shun the softeners. Avoid fabric softeners, advises Dr. Deasey, because they contain fragrances that can make your skin itch. She also suggests staying away from the newer blue liquid detergents because they leave residues on clothes, and if your skin reacts to those residues, you’ll itch.

Humidify your surroundings. Anything you do to add moisture to the air is going to help relieve the dry skin and itch of eczema, says Dr. Kitzmiller. Ideal humidification, he says, is about 50 percent, “just short of making the windows sweat.” You can add moisture to the air in your home with a cold-air humidifier or by placing shallow pans of water near radiators, Dr. Kitzmiller says.

Protect your hands. Hand rashes are an extremely common form of eczema. Many household items could be causing these rashes, including soaps and detergents, solvents, cleaning agents, chemicals, and the ingredients in skin and personal care products. And once your hands become dry and chapped, they’re even more vulnerable to household agents that could make them itch. Even innocuous-looking substances like water and baby products can make an outbreak worse when your hands are super-dry.

If you have eczema on your hands, doctors recommend wearing a pair of vinyl gloves with cotton liners to protect you from irritants whenever you do dishes or housework. Have four or five pairs and keep them in the kitchen, bathroom, and laundry areas. Be sure to dry out your gloves between cleaning jobs, he says. And always replace gloves that develop holes.

Relax for your rash. “Stress is a definite contributing factor in eczema as well as in other skin conditions,” notes Dr. Kitzmiller. “Skin disorders have multiple causes and a person’s emotional state can play a large part. If you are feeling stressed out or are particularly worried about something, it will only aggravate your condition.”

Stress causes your body to release histamines, which make you itch, Dr. Kitzmiller explains. When you start to feel stressed, take 10 deep breaths, meditate, or go for a walk, he says. “Do whatever it takes to calm down and relax.”

Reduce dust mites. Many doctors think that people with certain types of eczema may be affected by allergens produced by dust mites in the house. Take measures to ban the mites from contact, and your skin condition might improve, says Dr. Kitzmiller.

Bedding, mattresses, curtains, and carpets are all prime real estate for these mites. Regular vacuuming, damp dusting, and routine washing and airing of bedding are the most effective ways to reduce their population, he says.