Dealing with Dry Skin

Patients with AD lack an essential oil in their skin. This means that their skin has a reduced water-holding capacity. Dry skin is more sensitive to irritants and makes it more difficult to control the eczema. Therefore management of dry skin is essential for treatment success. Daily dry skin management should include gentle cleansing and moisturizing.

Cleansing
Regular soaps can irritate skin and worsen the condition. Use a mild liquid cleanser or gentle bar soap. Liquid agents are often better choices for patients with sensitive skin, as they are less abrasive and are more easily and effectively rinsed off.

Bathing
This is a critical component of dry skin management and hydration. Take one or more baths daily in lukewarm water for approximately five minutes. Adding a capful of emulsifying oil will help the skin retain moisture.

Moisturizers
After bathing, leave the skin moist and apply a greasy moisturizer within three minutes to trap moisture on the skin. The choice of moisturizer depends on the degree of dryness and scaling of the skin.  Greasy moisture creams are best for very dry, cracked and sensitive skin. They do not sting. Moisturizing creams and lotions containing urea, alpha hydroxy acids (lactic and glycolic acids) smooth out scaly dry skin. 

Caring for Your Skin  

Avoid irritants and triggers to reduce flare-ups
AD and ACD can worsen with exposure to allergens and irritants. Avoid the common ones, such as dust, animal dander, smoke and grass. Allergy testing can often identify specific environmental allergens. If you have ACD a dermatologist will do patch testing to try to determine the cause.

Do:

• Use mild detergents to wash clothing, with no bleach or fabric softener
• Double-rinse clothing
• Moisturize often, especially in colder weather
• Choose cotton for bed linens and clothing
• Reduce stress as much as possible

Don’t:

• Expose skin to very hot or very cold water
• Expose skin to excessive heat or low humidity
• Dress in synthetic fabrics or wear wool next to the skin
• Use harsh detergents or perfumed products

ECZEMA Treatment

Most types of eczema require a combination of treatments and medications.  Your dermatologist will choose the ones that will work the best to control your condition.

Nonprescription Medications

Antihistamines relieve itching and help sleep.

Moisturizers and emollients decrease dryness and scaling, leaving the skin feeling more comfortable.  Barrier repair moisturizers also known as physiologic moisturizers, contain some of the essential oils that are missing from eczematous skin, most commonly ceramide.

Coal tar is an old remedy but still effective. It soothes inflamed skin and helps reduce itching, flaking and redness. It is available in bath oils, shampoos, gels, creams, ointments and in combination with corticosteroids.

Cool compresses relieve inflammation and itching.

Prescription Medications

Antibiotics are used to treat secondary skin infection, which is a common complication of any type of eczema. The skin barrier is broken both by scratching and the inflammation allowing bacteria to penetrate the skin. 

Corticosteroids are the most effective anti-inflammatory agents. They come in a variety of strengths, ranging from mild to extremely potent. They should be applied regularly until the inflammation has resolved.

Topical Calcineurin Inhibitors specifically inhibit the cells of the immune system in the skin. They are very effective at reducing itch and preventing flare-ups if applied regularly.

Phototherapy:  In those who have severe eczema, regular exposure to specific rays of ultraviolet light is very effective in reducing symptoms. This treatment should only be done under the supervision of a dermatologist.