Eczema
What is "eczema"?
About 20% of the population fall into a category called an atopic diathesis. In an atopic diathesis, your threshold for allergies is set much more sensitive than everyone else. Becuse of this, you can release histamines. If you release histamines into your skin, it itches, and you scratch yourself into a rash. If you release them in your nose, it runs, and if you release them in your lungs, you wheeze. It's a systemic process that presents in the skin as a rash, but it's the same process that's causing rhinorrhea, allergic rhinitis and wheezing.
What causes eczema?
Usually when a patient comes in with bad eczema, there's a couple of things that need to be done. One is to treat the acute flare with inflammation of the skin. The second and probably the more important one is patient education, in order to learn management techniques to keep from having any more acute flares. The mainstead of that chronic management is moisture, because dry skin flares much more easily. This is an inborn condition that you have or you don't. You didn't catch it from anybody, you can't give it to anybody and there's no cure as it's a condition. But if you can keep your skin from being really dry, you can really stack the odds in your favor and keep from flaring.
How does a dermatologist diagnose eczema?
Eczema can look like a number of other things. For instance, ring worm and eczema can look alike. Often a person that has eczema has a family history of others in the family that have had the same skin reaction and also either a personal or family history of asthma or allergic rhinitis.
What are some of the available treatments for eczema?
There are treatments for eczema. This is sort of a two tiered thing. You want to use something for an acute flare that will bring down the inflammation and the irritation associated with that rash. You want to use something productly to sort of reinforce your skin's ability to resist a flare. With an acute flare, topical treatment with cortico steroids and moisturizers is very helpful. Because histamine release is sort of the trigger, antihistamines can also be very helpful; both non-sedating and sedating histamines.
How can I prevent eczema flare-ups?
How you can prevent these flare-ups is a very important question, because it is easier to keep you from getting eczema than it is to get rid of the eczema flares. And in some patients with very severe eczema that flares constantly, they tend to get secondary infections and they itch so much that they could win the lottery and not even care. So it's very, very important to know that there are some very, very simply steps that you can use to keep that from happening, in particular, keeping your skin from being dry. What makes skin dry is loss of water, not lack of oil. But oil is what holds water in the skin, so anything that takes oil off the skin is not the friend of a patient with eczema. So, hot water and soap aren't really doing you that much good. I wouldn't live without hot water, I wouldn't expect you to live without hot water, but if you can shorten your bath or you shower and limit your soap use to those areas where you really have to soap up every day, that will go, that will help a lot. In addition, as soon as you dry off and your skin is still really damp, literally the minute that towel hits the rack, that's the time to put cream or lotion on. It's probably a good idea to use a cream or lotion without a smell or a color, as fragrances and dyes can really set off the skin of patients with eczema.
