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Is That Persistent Itch Eczema?

We’ve all had bouts of dry, itchy skin that can usually be remedied by the application of a good skin cream or lotion. However, for those with a common skin condition called atopic dermatitis, or eczema, relief from dry, itchy skin can be harder to achieve.

What Is Eczema?

Eczema is a broad category of inflammatory skin conditions. Atopic dermatitis, or AD, is the most common form of eczema that affects one in ten people of all ages. This skin condition, which often starts in childhood, causes very dry, itchy skin, which can lead to rashes or scaly, bumpy patches on the skin. In white skin, the rash is commonly red in color, while in brown or black skin, the rash tends to be a gray to violet-brown color.

“Eczema can occur anywhere on the skin, affecting the outer layer, called the epidermis. The epidermis protects the body from losing too much water and prevents germs from entering through the skin. With eczema there are gaps in this outer layer causing a persistent underlying inflammation to the outer skin. Sometimes, you can see this inflammation, but not always,” said Somphone Beasley, family nurse practitioner with SamCare Mobile Medicine.

Itching and pain with eczema can range from uncomfortable to extreme. While eczema is not life-threatening, it is often chronic, disappearing at times and then flaring up again. You cannot catch eczema from someone else.

Causes of Eczema

The exact cause of eczema is not known. However, eczema can be affected by one’s environment, such as exposure to extreme temperatures or harsh chemicals, as well as diet, family history and allergies. There also seems to be a link between eczema and the immune system.

“When the immune system is extra sensitive to common environmental triggers such as pollen, pollution or pet hair, for example, a person can be more susceptible to allergies and to eczema flare-ups. In fact, people who have asthma, hay fever or other allergies are at a higher risk for getting eczema,” Beasley noted.

While everyone is different, people who have eczema may notice that certain conditions or foods can trigger a flare-up for them. Exposure to cold weather, washing in hot water or using scented laundry soap can affect some, while eating certain foods can cause a flare-up in others.

“Learning to avoid what triggers eczema for you is part of the treatment plan,” she said.

Avoid Triggers

To understand what causes eczema in your skin, Beasley suggests paying attention to some common issues that are known to trigger eczema in others.

Avoid hot baths or showers. Hot water can strip the skin of vital, moisturizing oils, so bathe in warm water instead. Spend shorter time in the water – 5 to 10 minutes only – and, if you don’t need to shower each day, try going every other day instead.

Go with mild soap. Choose soaps and detergents that are formulated for sensitive skin or labeled “hypoallergenic,” and opt for “fragrance-free” over “unscented.” Unscented products often contain chemicals used to mask the scent, which can dry out skin.

Mind the weather. For some, heat and humidity can trigger eczema, for others, cold temperatures bring it on. Or it might be those windy days that blow pollen around. Pay attention to what type of weather, if any, triggers eczema for you and limit exposure as much as possible.

Note the fabric content of your clothes. Some fabrics are scratchy to skin. Wool and polyester are common irritants. Opt for cotton fabrics instead.

Watch for potential food allergens. Eggs, wheat, soy and milk are common allergens, but not the only ones. Note what happens for you when you eat certain foods by keeping a food and symptoms log to pinpoint if any foods are causing outbreaks in you.

Treatment for Eczema

For most people, eczema can be controlled through trigger management, topical medications and a skin care routine that uses mild soaps and daily moisturizing.

“Moisturizing the skin daily – even multiple times a day -- is very important to help reduce eczema symptoms. Choose a cream or ointment, which are thicker than lotions, to apply to the skin a few minutes after bathing to help trap in the moisture,” Beasley explained. “Some find relief with petroleum jelly or mineral oil. Whatever product you choose, remember to select a brand that is fragrance-free and formulated for sensitive skin.”

Over-the-counter medication options can bring relief from pain and itching. Try an oral antihistamine such as generic Zyrtec or topical, generic Benadryl cream. Both medications will help with itching and red skin.

Additionally, alternative treatments may also help, like applying coconut or sunflower oil to the skin, acupuncture, or bleach bath therapy, which involves short soaks in lukewarm water mixed with a small amount of bleach. The American Academy of Dermatology reports that bleach baths can improve the symptoms of eczema and reduce the risk of skin infections.

Staying hydrated by drinking eight glasses of water daily, as well as using a humidifier in the home to add moisture to the air can also make a difference.

“If your symptoms are not relieved by these at-home remedies, if your skin becomes infected, or if the itching is keeping you from sleep or normal daily activities, talk with your health care professional about other options,” said Beasley.

Your clinician may prescribe a topical steroid cream, an oral immunosuppressant, or phototherapy, which involves exposing the skin to different wavelengths of ultraviolet (UV) light, usually done in the clinician’s office.

No Cure for Eczema

There is no cure for eczema. And while children often outgrow it, the skin condition can also be a lifelong condition or one that develops in adulthood. With regular treatment, following a good skin care routine and avoiding potential triggers, eczema can be managed, and flare-ups minimized.

If you are concerned you may have a skin condition like eczema, contact your primary care clinician for an appointment.

Somphone “Sam” Beasley, FNP, serves patients at Samaritan Express clinics in Albany and Corvallis, as well as SamCare Mobile Medicine. You can reach her at 541-768-5166.