Eczema is an umbrella term for a group of conditions that cause your skin to become inflamed. The most common type is atopic dermatitis, which causes your skin to itch, scale, swell, and sometimes blister. This type of eczema usually runs in families and is often associated with allergic asthma and hay fever. Defects in your skin barrier, allowing moisture out and germs in, may also come into play. Some babies who develop the condition outgrow it by their tenth birthday. Although there is no cure, everyone can effectively manage eczema with continuous maintenance.
ECZEMA ACTION PLAN
1. DAILY SKIN CARE ROUTINE TO PREVENT FLARES AND ITCH
1.1 a) BODY CLEANSER
Avoid regular soap since it may strip your skin of moisture and essential oils. Instead, please consider gentle soap substitutes such as
Liquid Face & Body Wash (Sebamed)
Restoraderm Gentle Body Wash (Cetaphil)
Choose bath oils rather than bath bubbles.
1.1 b) FACE CLEANSER
Extragentle do-it-all cleanser, removes even mascara, free of parabens, sulfates, phthalates
Rosehip Cleanser (Indie Lee)
This gentle yet indulgent cleanser and eye makeup remover slows the signs of aging, preserves moisture, and improves the appearance of redness and rosacea prone skin
Lipikar Syndet AP+ – Lipid Replenishing Wash Cream (La Roche-Posay)
This soap-free, fragrance-free and paraben-free creamy gel was designed for use on extremely dry skin. It can be used on babies, children and adults, as it is so gentle.
1.2 a) BODY MOISTURIZER
Steroid-free barrier repair moisturizers ease dryness, redness, and itching:
Intensive Moisturizing Cream (Atopalm)
PRO Restoraderm Gentle Body Moisturizer (Cetaphil)
Healing ointment (Aquaphor)
Eczema therapy moisturizing cream (Aveeno)
Itch defense lotion (Curel)
Advanced repair lotion, ceramide enriched (Eucerin)
Moisturizing body lotion for sensitive skin (Sebamed)
Shea butter hand cream (L’Occitane)
The rich texture leaves hands soft and smooth with no oily traces, and can be applied as often as needed.
1.2 b) FACE MOISTURIZER:
Liquid Gold 24 Hour Moisture Repair Cream (Alpha-H)
For mature, parched skin
Ceramidin Oil Balm (Dr. Jart)
A multitasking oil that contains condensed ceramide and nine vegetable oils to provide intense hydration and protection
Hydra-Essentiel Silky Cream – Normal to Dry Skin (Clarins)
Moisture Surge Intense Skin Fortifying Hydrator (Clinique)
For very dry to dry combination skin
Rich Compensating Cream (Eau Thermale Avene)
Aqualia Thermal Rich Cream (Vichy)
Hyaluronic acid and lipid infused
Choose an anti-inflammatory diet rich in omega-3 fatty acids, flax seeds, borage seeds, fish oil or evening primrose oil supplements. The most natural approach would be adding salmon and other sources of free fatty acids to the diet. Eczema-healthy foods also include banana, fresh beets, Brussels sprouts, green onions (contain histamine-lowering, anti-inflammatory quercetin), potato, and whole-grain oats.
Karen Fischer: The eczema diet: Discover how to stop & prevent the itch of eczema through diet & nutrition.
1.4 VITAMIN D
Patients with difficult to treat eczema tend to be vitamin D deficient. Supplementation based on screening blood level tends to improve eczema. Most national brands are fine. We endorse Vital Choice Wild Alaskan Sockeye Salmon Oil with vitamin D3, 2,000 I.U. since the vitamin D comes from wild caught salmon.
1.5 VITAMIN E
Vitamin E is an antioxidant with the capability to decrease the serum levels of immunoglobulin E (IgE) in eczema patients. Adults should take 400 I.U per day.
Vitamin B12 cream twice daily frequently works for mild to moderate flares
Wet wrap therapy
-Soak in lukewarm bath water for 10 minutes.
-Seal the skin with moisturizer and cover with wet cotton wraps for a minimum of 20 minutes.
Epsom salt or dead sea salt bathes frequently work for maintenance.
Corticosteroid creams, ointments, solutions, and foams reduce inflammation. Side effects include skin thinning and stretch marks.
Calcineurin inhibiters. Pimecrolimus (Elidel) cream and tacrolimus (Protopic) ointment treat moderate to severe eczema by easing inflammation. The FDA feels that they may increase the risk of skin cancer and non-Hodgkin’s lymphoma.
NSAID ointment. The non-steroidal anti-inflammatory crisaborole (Eucrisa) ointment can be used twice daily for mild to moderate eczema in patients that are at least 2 years old.
Drugs that turn down your immune system include mycophenolate mofetil, methotrexate and cyclosporine. Serious side effects are possible. We therefore tend to use these medications only for a short time.
Injectables. Dupilumab (Duxipent) is an injectable medicine for moderate to severe atopic dermatitis that cannot be adequately controlled otherwise. It works by controlling the body’s inflammatory response. The drug can cause serious allergic reactions. A year’s worth of Duxipent costs more than $35,000.
FOR INSTANT ITCH RELIEF
Itch Relief Moisturizing Lotion (Cerave)
Itch-X Fast-Acting Anti-Itch Gel
Soothing Steroid-Free Anti-Itch Hydrogel (TriCalm)
Sensitive Anti-Itch Lotion (Sarna)
IF INFECTION IS PRESENT
Option 1: Dakins solution 0.25% or CLN spray
Option 2: Bleach baths are generally recommended 2 to 3 times per week:
Fill the bathtub with lukewarm water (approximately 40 gallons for a standard bathtub)
Add ½ cup unconcentrated household bleach (5.25% sodium hypochlorite)
Mix bleach in the water thoroughly (or add bleach while the tub is filling).
Soak for 10 minutes
Rinse completely with lukewarm or warm tap water
Apply topical medications or moisturizers