Monday Medical: Eliminating eczema
For Steamboat Pilot & Today
STEAMBOAT SPRINGS — If you or your child are dealing with dry, itchy skin accompanied by a rash, you might have eczema.
Though it can be painful and annoying, it can be treated. Below, Dr. Barbara Novotny, a family medicine physician in Steamboat Springs and member of the medical staff at UCHealth Yampa Valley Medical Center, outlines what you need to know about eczema.
What does it looks like?
Eczema results when the immune system overreacts to a skin irritant or allergen and can be diagnosed by the presence of two symptoms: itchy skin and a rash.
“If you have a rash that isn’t itchy, it’s probably not eczema,” Novotny said. “But if it’s red, dry and itchy and has been there for a month or two, it’s very likely it’s eczema.”
In more severe cases, the rash can get scaly and crust and ooze.
Babies typically get eczema on their cheeks and the outside of their arms, while older children are more likely to have it on their wrists, backs of their hands and, possibly, their elbows and fronts of legs.
“Most of the time, it’s in these specific places,” Novotny said. “But when it’s severe, you can get it all over.”
Who does it affect?
Eczema is fairly common, impacting 10% to 15% of children and about 5% of adults. Children with eczema are also more likely to develop allergies and asthma.
There is a genetic component: If a parent has eczema, allergies or asthma, a child is two to three times more likely to have eczema. If both parents have had any of those issues, the child is three to five times more likely to have eczema.
Most people who have eczema will experience it for the first time as a child.
“Sixty percent start showing symptoms within the first year of life, and 85% show symptoms by age 5,” Novotny said.
How is it treated?
The first step is to eliminate irritants causing the eczema. Choose mild or soap-free cleansers and detergents that don’t have added fragrances. A double rinse on your wash can help get detergents out.
Also avoid known allergens. “Every kid is different — for some, dust mites might set it off. For others, dogs might,” Novotny said. “If a child has a known food allergy and eats that food, it can make the eczema worse.”
Living in a dry climate like Colorado worsens the condition, so Novotny recommends using a humidifier.
Keep skin moist with thick creams and ointments and avoid using hot water in showers or baths, which can further dry out skin.
“Hydrating the skin is the base of treatment no matter how mild or severe it is,” Novotny said. “Many people can avoid steroids by really concentrating on hydrating the skin and eliminating irritants.”
Benadryl or other prescription antihistamines may be used to reduce itchiness. Wet wrapping, in which cool, damp cloths are left on the skin, can also help.
In more severe cases, in which a child’s sleep and quality of life are impacted, steroids may be necessary.
“We try to use the lowest potency steroid possible to control the eczema,” Novotny said. “Once it’s under control, we may try a milder steroid or decrease or stop steroid use.”
Alternative treatments that may help include taking melatonin, probiotics and vitamin D, as well as acupuncture.
Eczema should be treated, as severe cases can result in scarring and changes in skin pigmentation. Dry and cracked skin can also result in a higher risk of skin infections.
“It can be really distracting, and severe cases can have a big impact on quality of life and sleep,” Novotny said. “That’s why we want to treat and control it.”
For more information about eczema and to find lists of products, such as skin cleansers and laundry detergents that have received the National Eczema Association Seal of Acceptance, visit nationaleczema.org.
Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at email@example.com.
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