Eczema — “The itch that rashes”

eczemaJacob always seemed to have a crusty rash on the inside of his elbows and the back of his knees. He was forever scratching.

It seemed nothing gave him any relief. His classmates, teachers and coaches commented on the foul rash. His mom had to do something about it. She took him to a dermatologist.

Jacob has eczema.

Karina Parr, MD, Dermatologist at the Temple Northside Dermatology Clinic, discusses eczema and offers some skin care tips for reducing the risk of flare-ups.

What Is Eczema?

Eczema is a chronic skin disease, Dr. Parr says, that often arises in infancy and early childhood.

“The origin of eczema is still not completely understood, although we do know that genetic predisposition, defective skin barrier, and inflammation all play a role,” says Dr. Parr.

What Are the Symptoms of Eczema?

“Eczema is often called the ‘itch that rashes’ because itching is such a prominent component of this condition,” Dr. Parr says.

Along with scratching, other symptoms include:

  • Redness
  • Swelling
  • Scaling of the skin
  • Cracking of the skin
  • “Weeping” or oozing of clear fluid from the rash
  • Formation of crusts on the surface of the skin
  • Lichenification, or leather-like areas that develop after long-term itching and scratching

Who Is Most At Risk for Developing Eczema?

Eczema is most common in people who have a family history of allergies or asthma, Dr. Parr says. It’s most widespread in infants and children.

In infants, the itchy areas are most prevalent on the face, scalp, arms and legs. In children, the most common areas to find eczema are on the back of the neck, inside of the elbows and back of the knees.

“Treatment of eczema takes time and effort, but the result is well worth it.”

Teenagers with eczema often have these scaly, dry patches on their faces and eyelids. Adults can battle eczema, too, though it is seen with less frequency than in children. Adults may develop eczema on their wrists, hands, feet, ankles, forearms and upper chest.

In most cases, though eczema can be severe, it tends to improve with time and sometimes goes away completely, Dr. Parr says.

 What Is the Treatment for Eczema?

“Without proper medical diagnosis and treatment,” Dr. Parr says, “eczema can be bothersome, painful and chronic. It can even make everyday activities difficult to perform.”

Says Dr. Parr: “Treatment of eczema takes time and effort, but the result is well worth it.”

Treatment is directed at restoring the normal skin barrier and decreasing inflammation and itching, notes Dr. Parr.

Because eczema is a chronic condition, treatment and prevention go hand in hand.

Dr. Parr recommends a combination of drug therapy and behavior modification to break the cycle of skin irritation:

  • Use topical steroid creams or ointments prescribed by your physician, until the affected areas are itch-free, flat and no longer red
  • Take antihistamines such as Benadryl (at night) or Zyrtec (during the day), with your physician’s approval
  • Use warm, but not hot, water for bathing and then apply medicated ointments or moisturizes within three minutes of getting out of tub
  • Use mild soap or cleanser, and only as little as possible, only on underarms, groin and scalp
  • Never use bubble bath or allow children to sit in soapy water for long periods
  • Rinse with tap water after swimming in pool or lake and immediately apply moisturizer afterward
  • Wear gloves to protect against household cleansers and chemicals
  • Wear gloves in cold weather to prevent dry, chapped or scaly skin
  • Avoid very dry air, using an air humidifier during winter
  • Avoid wearing wool or synthetic fabrics, such as polyester

What Are Some Safe Products to Use?

Dr. Parr says many dermatologists recommend the following products for use by people with eczema:

  • Dove soap for Sensitive Skin
  • Aveeno mild soaps
  • Cetaphil Cleanser and Cetaphil Cream
  • Vanicream
  • Petroleum jelly
  • Free & Clear shampoo
  • Cheer Free & Gentle laundry detergent
  • Tide Free laundry detergent
  • All Free & Clear laundry detergent

“Creams and ointments are generally better tolerated,” Dr. Parr says, “as lotions can cause burning and stinging.”

Dr. Parr says the following products should not be used if you have eczema:

  • Fabric softener
  • Dryer sheets
  • Dreft
  • Burt’s Bees products
  • Johnson & Johnson Baby Shampoo
  • All skin-care products with heavy amounts of color or fragrance

“Eczema may be associated with food allergies, seasonal allergies and asthma. It’s not known to be caused by these,” Dr. Parr says, “but it may be worsened by them. Consequently, it’s a good idea to always follow the advice of your dermatologist or primary care physician.”

3 thoughts on “Eczema — “The itch that rashes””

  1. swwebservices

    There are many over-the-counter topical treatments for eczema, some heavily advertised. Many of the claims made in various commercials have not been evaluated by the Food and Drug Administration. Many of the advertised products have not been adequately studied in clinical settings. The general guidelines I recommend for choosing a moisturizer are as follows:

    – Use fragrance-free, dye-free creams
    – Cetaphil, Neutrogena, Aveeno, Eucerin, and Nivea are among well-known and trusted brands in skin care
    – Always apply a small amount of cream to the test site on the forearm to make sure you are not allergic to any of the ingredients. If you develop a rash at the site of application, you should not use that cream.
    – Inform your physician of any over-the-counter treatments you are using

    Thanks for asking,

    Karina Parr, MD

  2. Annemarie Kepler

    I’ve been hearing a lot about this new body wash treatment for Eczema called CLn. A friend forwarded me a video of it with a doctor talking about how well it works and I’m curious to try it.  Here’s the video: http://youtu.be/sIY2HqidSzE  Do you have any experience with it or know  anyone who’s tried it?  I’ll try anything at this point and really like that I don’t have to get a prescription for it.  Thanks!

    1. swwebservices

       There are many over-the-counter topical treatments for eczema, some heavily advertised. Many of the claims made in various commercials have not been evaluated by the Food and Drug Administration. Many of the advertised products have not been adequately studied in clinical settings. The general guidelines I recommend for choosing a moisturizer are as follows:

      – Use fragrance-free, dye-free creams
      – Cetaphil, Neutrogena, Aveeno, Eucerin, and Nivea are among well-known and trusted brands in skin care
      – Always apply a small amount of cream to the test site on the forearm to make sure you are not allergic to any of the ingredients. If you develop a rash at the site of application, you should not use that cream.
      – Inform your physician of any over-the-counter treatments you are using

      Thanks for asking,

      Karina Parr, MD
       

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Eczema — “The itch that rashes”