ATOPIC DERMATITIS (Eczema) MANAGEMENT GUIDE
This is one of the most common skin diseases. In babies, it is most commonly called infantile Eczema. Although it can occur for the first time at any age, it usually begins in infancy. Many children outgrow the problem by young adulthood.
The tendency to develop atopic dermatitis is inherited. There are three conditions, which are very similar diseases but involve different parts of the body – asthma, hay fever, and atopic dermatitis. Eczema is not contagious. While certain allergies may worsen Eczema, they are not the basic cause of Eczema. There is no cure for Eczema but most patients can be controlled with treatments available today. Control of the disease is essential because the itching and other discomforts associated with this disease can intrude on the quality of life.
- Soap is irritating to the skin of persons with atopic dermatitis, and should be used sparingly, if at all. A “soap substitute” such as CeraVe, Cetaphil, Purpose or Oilatum is recommended.
- Wool acts like sandpaper on atopic skin. Wool blankets, upholstery, rugs, car seats and coats should be avoided. Silk and synthetic clothes may worsen the disease also. Cotton is usually well tolerated.
- Dry skin may cause worsening of atopic dermatitis. Low humidity robs the skin of its moisture. Keep the skin moist with bland emollients such as CeraVe or Cetaphil cream. These are most beneficial when applied over wet skin after bathing. A room humidifier/cool mister is helpful during the winter months.
- Emotions – The tiny skin blood vessels are under control of the sympathetic nervous system. We blush with embarrassment, flush with anger, and pale with fright. When persons with atopic dermatitis get mad, their skin gets red and starts to itch. This is true even of small babies.
- The time of year – Most people with atopic dermatitis are worse in the winter and improve during the summer. However, 25% will be worse during the summer because atopic skin develops prickly heat easily causing the dermatitis to flare.
- Geographical area – The place you live rarely makes any real difference. Atopic dermatitis occurs in all peoples of all nations of the world.
- Scratching – Atopic dermatitis is commonly known as “the itch that rashes”. Persons with atopic dermatitis itch much more easily than those who do not have Eczema. Rubbing and scratching worsen Eczema – it is very important to minimize scratching. Eczema does not cause scars but scratching may.
- Diets – Special elimination diets are seldom of help in Eczema. A normal, well-balanced diet should be followed.
- Avoid things that irritate – Fragrance, woolen products, excess heat or cold, emotional upsets, dust, soaps, animal hair, feathers.
- Control the dry skin – Special soap substitutes should be used. Bathe no more than once daily. After bathing apply the prescribed medications or a lubricating cream to the moist skin to help keep water in the skin.
- Apply a cortisone preparation to the areas of the rash as directed, usually twice daily.
- Control scratching – Stockings over hands may help control scratching in children. Keep fingernails trimmed. Antihistamines (used as anti-itch medications) are helpful, especially at bedtime.
- In severe cases or flare ups, oral medications, light therapy, or injections may be used to control the disease. Flare-ups should be brought under control early – waiting will only make it more difficult to achieve control.
- Avoid contact with persons having Fever blisters. The virus that causes Fever blisters can spread to all areas involved with Eczema and cause serious complications.