Eczema, or atopic dermatitis, is a skin condition that causes itchy, dry, scaly patches on the skin. Sometimes atopic dermatitis can cause small bumps on the skin that leak fluid, or thickened and cracked dry skin, or brown patches on the skin. The skin symptoms can come and go. Sometimes the skin can get so inflamed that an infection can develop on top.
Atopic dermatitis is more commonly seen in babies and children, but adults can also develop it.
We don’t know the exact cause of atopic dermatitis but we know there are several factors that contribute to getting it. Genetics is one of these factors. Atopic dermatitis tends to run in families. We also know that there is a protein (filaggrin) on the top layer of the skin, the epidermis, that doesn’t work right in some people with atopic dermatitis.
Children with atopic dermatitis are much more likely to develop food allergies. Children with atopic dermatitis are more likely to develop asthma and allergic rhinitis later in childhood. This is called the “Allergic March”. It starts as atopic dermatitis in infancy and then “marches on” to cause allergic rhinitis in childhood and young adulthood, and then even later can lead to asthma.
What can you do at home to help atopic dermatitis?
- Eliminate things that worsen it. If there are infections on the skin like Staphylococcus aureus and herpes simples, these must be treated completely. Stress and anxiety can worsen atopic dermatitis, so stress relieving exercises can help calm the skin. Using antihistamines regularly can help control the itching and lessen the amount of trauma to the skin from scratching. If ingestion of foods or inhalation of environmental allergies (this is rare) are thought to be contributing to the atopic dermatitis, these can be avoided. Make sure there is no allergic contact dermatitis (like a nickel allergy) that is worsening the atopic dermatitis.
- Moisturize, Moisturize, Moisturize! Since a breakdown in the skins natural barrier is a main problem in atopic dermatitis, it is important to keep the skin moist. Creams and ointments are better than lotions for this purpose. Moisturizers that contain the ingredient ceramide are especially beneficial in helping rebuild the skin barrier. Emollients are creams and ointments that moisturize the skin and prevent it from drying out. The best emollients for people with atopic dermatitis are thick creams (such as Eucerin, Cetaphil, and Nutraderm) or ointments (such as petroleum jelly, Aquaphor, and Vaseline), which contain little to no water. Emollients are best applied immediately after bathing when the skin is well hydrated
- Take a bleach bath 1-2 times a week. A diluted bleach bath decreases bacteria on the skin and can help infections of the skin. Add ½ cup of household bleach (not concentrated bleach) to a 40 gallon bathtub of warm water. Soak from the neck down for about 10 minutes. Do not put your head in this water.
- Use gentle soaps. Choose a non-soap cleanser because they are usually free of sodium lauryl sulfate. This chemical creates soap’s foaming action and can irritate skin. Examples of non-soap cleansers include Dove® Sensitive Skin Unscented Beauty Bar, Aquaphor®Gentle Wash, AVEENO® Advanced Care Wash, Basis® Sensitive Skin Bar, CeraVe™ Hydrating Cleanser, and Cetaphil® Gentle Cleansing Bar.
- Dry your skin gently. When drying off, pat (don’t rub) your skin dry with a soft towel and immediately apply moisturizer.
- If all else fails, visit a Board-Certified Allergist/Immunologist to help manage symptoms.