Eczema
What is Eczema?
Eczema is a common disease which affects millions of people. Eczema prone skin constantly loses moisture, over-dries and becomes inflamed. Eczema flares when you or your child’s skin becomes so dry that itchy, flaky lesions appear. While there is not yet a cure for eczema, many children will outgrow it by adolescence. It is highly treatable with moisturizer and topical steroid in those who continue to struggle with it.
Moisturizers:
- Ointments – (ie Petroleum Jelly, Aquaphor, CeraVe ointments) are the strongest moisturizers due to their greasy nature.
- Creams – (ie Cetaphil cream, CeraVe cream) are mid-potency moisturizers.
- Lotions – Lotions are the weakest moisturizers
Helpful Products:
- MILD SOAP – A mild soap like Dove, Cetaphil or CeraVe is the foundation of eczema home care. Vanicream Free & Clear Sensitive Skin or DHS Clear shampoos work well for the scalp. Harsh soaps (Dial, Irish Spring or Ivory) strip valuable moisture and oil from the skin.
- COTTON PAJAMAS – Purchase 100% thin white cotton, long sleeve pajamas (at Walmart or Target).
- Cool mist humidifier for the bedroom by Crane or Honeywell
Showering/Bathing Recommendations:
The wet-to-dry nature of cleansing removes valuable moisture and oil. Limit your showers and baths to once daily or every other day. Showers should last a maximum of 10 minutes, ideally. Apply soap only to the following areas; soiled skin, underarms and groin area. Choose lukewarm water over hot water. Avoid washcloths, Loofah sponges and bubble baths. Pat your skin dry with a towel and avoid rubbing.
Moisturizing Recommendations:
If your skin feels dry, flaky or itchy, it needs to be moisturized.
- IN THE DAYTIME, generously apply cream to eczema prone skin 2-6 times daily. Even normal appearing skin in eczema prone areas constantly loses moisture.
- AT NIGHT, liberally apply Cerave Healing ointment or Petroleum Jelly to your eczema prone skin. Afterwards, put on 100% cotton, long sleeve pajamas. For the best results, wear the same greasy, unwashed pajamas for several nights in a row.
- TWO-MINUTE RULE: Apply a moisturizer to eczema prone skin within 2 minutes of getting out of the shower/bath. The only exception to this rule is when applying a topical steroid during an eczema flare. Apply steroid to eczema lesions within 2 minutes of showering, then apply moisturizer. Proactively moisturizing normal appearing skin in eczema prone areas will prevent flares.
Medication Instructions:
Do not be afraid to use topical steroids, but do not over-use them either! Misuse of topical steroids can harm skin with thinning, scarring, dilated vessels and even eye glaucoma. These side effects are exceedingly unlikely if steroid ointments are used as directed. Avoid using topical steroids on the eyelids or near the eyes, underarms, upper thighs and groin. Low potency steroids can be applied to the face cautiously and with a physician’s direction. Examples of low potency steroids include Desonide 0.05% or Hydrocortisone 1% to 2.5%.
When you or your child’s eczema flares, apply topical steroids to lesions 1-2 times daily for 2-3 weeks, then taper or take a break as directed by your provider. A break allows the skin to recover from steroid use and minimizes the above risks. Meanwhile, aggressively moisturize skin to prevent further fares. You or your child should be examined for improvements or complications every 1-3 months depending on severity.
Other Tips:
- Limit exposure to pets.
- 100% cotton is the best choice for clothing.
- Avoid fuzzy stuffed animals or toys.
- Sweating increases itching. Try to stay cool in air conditioned environments if possible.
- A humidifier is helpful during the wintertime and in dry climates.
Bleach Baths (OPTIONAL, ASK YOUR PROVIDER)
Other resources
https://pedsderm.net/site/assets/files/1028/spd_atopic_dermatitis_color_web_final2.pdf
http://www.rchsd.org/documents/2014/02/eczema-handout.pdf
http://www.acadderm.com/Eczema.pdf
https://nationaleczema.org/