By SAAD SANYURAH, M.D. and ERIK WHITE, M.D.
Atopic dermatitis is a common chronic skin disease characterized by severe itching and a skin rash. Many cases start in infancy, but atopic dermatitis can begin at any age. There is generally a familial tendency to this disease. Also several immediate family members are found to have either asthma or hay fever. The skin is usually dry and scaly. Scratching and rubbing cause the typical eczema rash. For this reason eczema is referred to as "the itch that rashes". Itching often worsens at night and is provoked by temperature changes, sweating, exertion, emotional stress and embarrassment. Irritants (such as wool) and drying agents (such as some soaps) can worsen the itching.
50%-70% of children with eczema outgrow their disease. It is not a curable disease, but certain measures can be taken that may improve its symptoms. These include:
- Avoid local irritants like wool or fur garments; soft cotton fabrics are preferable. Wash clothing and bed sheets in a mild detergent and rinse well. Avoid bleaches, starch and fabric softeners.
- Keep fingernails short; use mittens or socks on hands of small children.
- Keep severely affected areas covered.
- Keep ambient temperature at 68 -72 F. Humidify dry heat in winter.
- Avoid animals, dust, sprays, and perfumes.
- Daily baths (not showers) will moisten the skin. Use mild neutral soaps or no soap at all. Avoid deodorant and perfumed soaps. Apply moisturizer right after the bath.
- Use skin moisturizers as frequently as needed to keep the skin moist. Dry skin is a very strong cause for itching.
- Ointments are better than creams, which in turn are better than lotions in their lubrication. However, ointments can stain the clothes and many patients can not tolerate their stickiness.
- Bath oils and oilated oatmeal products may be soothing.
- Dr. Sanyurah or Dr. White may advise oral medications for itching and other prescription ointments or creams.
- Bathe in tepid water for 30 minutes about twice a week. May add baby oil or oatmeal. Pat dry. DO NOT rub. Use a soft towel. Keep skin wet then apply steroid ointment and emollient.
- Avoid heat or too much clothing because sweating in this condition induces severe itching.
- Avoid ingestion of spicy foods.
- Avoid or limit swimming in chlorinated pools.