Eczema: Getting relief from the itch

The itch, the itch! Our Nordic climate can sometimes be difficult to bear for individuals with eczema. However, eczema sufferers can reduce the condition’s impact on their appearance, comfort and quality of life by understanding what aggravates or relieves its symptoms.

The itch, the itch! Our Nordic climate can sometimes be difficult to bear for individuals with eczema. However, eczema sufferers can reduce the condition’s impact on their appearance, comfort and quality of life by understanding what aggravates or relieves its symptoms.

What is eczema?

Eczema, also called atopic dermatitis, is a skin inflammation that can affect any part of the body, although the most commonly affected areas are the hands, feet, elbows, back of the knees, ankles, wrists, face, neck and upper chest. The eyelids and the skin around the eyes can also become irritated. The inflammation tends to worsen periodically and then fade, sometimes for several years. While eczema usually develops in babies and children, it can also develop or persist in adulthood.

The symptoms of eczema include:
- Red to brownish-grey skin patches
- Itching that can sometimes become severe, especially at night
- Small blisters that may ooze some liquid and form crusts
- Skin that may appear thicker, cracked or scaly
- Raw skin due to scratching

The complications of eczema are mainly due to scratching in response to intense itching. The individual';s skin can then become thicker and leathery, producing scars or even discolouring the skin permanently. Skin fissures can also form, which opens the door to infection-causing bacteria.

What causes eczema?

The exact cause of eczema is unknown, but it is believed that an immune system dysfunction, combined with dry and irritated skin, usually triggers episodes. It is more common in families where certain individuals suffer from asthma or seasonal allergies. Stress and affective disorders can aggravate eczema, but they do not cause it.

Several factors are known to worsen eczema symptoms, including:


- Long, hot baths and showers
- Stress
- Dry skin
- Sweating
- Rapid changes in temperature
- Dry air
- Skin contact with a rough materials (such as wool products)
- Solvents, cleaning products, soaps and detergents
- Dust or sand
- Cigarette smoke
- Certain foods such as soy, milk, eggs, fish or wheat

Not all eczema sufferers are sensitive to all of the above factors. It is therefore important for individuals to identify the factors that aggravate their own condition.

Treatment

It can be difficult to break the cycle of itching and scratching. The treatment for eczema aims to reduce the inflammation, relieve the itching and prevent exacerbations. The cornerstone of treatment is to keep the skin well hydrated.

Good tips and habits for relieving the discomfort


- When taking a bath, avoid using very hot water. You can try sprinkling some oat flakes, baking soda or colloidal oatmeal (finely ground oat flakes for bath use, with the most widely-known brand being Aveeno®) in your bath, or adding 125 mL (1/2 cup) of bleach to a bathtub filled with approximately 150 L of water. Diluted bleach partly eliminates the bacteria that proliferate on the skin.


- In the winter, the hot and dry air in our homes can aggravate skin itching and flaking, so you may obtain some relief by using a humidifier to maintain the humidity level around 50 percent.


- Avoid scratching. Try covering the itchy area if the urge to scratch is too strong. Keep your nails short and wear gloves at night if necessary.


- Apply cold, damp compresses and/or a soothing cream on the lesions.

Medicated products Moisturizing creams and ointments

Keeping your skin well hydrated is essential when treating eczema. Thicker products yield better results in terms of maintaining an acceptable humidity level. More expensive products are not necessarily better than over-the-counter products.

Apply the product liberally and massage it into the skin. If your skin is extremely dry, applying an oil (e.g. baby oil) after a bath or shower while your skin is still humid can be helpful in preventing the water from evaporating off the surface of your skin.

Corticosteroid creams and ointments

Products containing corticosteroids are very effective in relieving the itch and reducing skin flaking. Low-concentration over-the-counter products are available in drugstores, while regular- and extra strength corticosteroid products require a doctor';s prescription.

Creams and ointments should be used as indicated by the pharmacist or physician, in a thin coat and only on affected areas. While they are very effective, they can cause the skin to become thinner, discoloured or irritated with long-term use.

Antihistamines

When the itch is intense, taking an oral antihistamine such as diphenhydramine (Benadryl®) may provide some relief. Since certain antihistamines may cause somnolence, they are usually taken at bedtime.

Other products may also be used if the above-mentioned products have not been sufficiently effective or if there is an infection.

Light therapy

This technique, also called phototherapy, uses a natural or artificial light to treat eczema. The simplest form involves exposing your skin to natural light. Other forms of phototherapy include the use of artificial rays. While effective, phototherapy does pose a risk of adverse effects such as premature aging of the skin and an increased risk of skin cancer. Your doctor can help you evaluate the possible advantages and disadvantages of phototherapy in your particular case.

Preventing exacerbations

Prevent eczema exacerbations by keeping your skin well hydrated and avoiding the drying effects of hot baths and showers.


- Identify and avoid the factors that aggravate inflammation, such as rapid changes in temperature, sweating, stress and direct contact with wool products.


- Unless your work is very physical or you exercise every day, it isn';t essential that you take a bath or shower every day. Skipping a day or two can alleviate your skin irritation. Showers should be brief and the water should be lukewarm.


- After showering or bathing, apply a generous layer of moisturizing cream.


- Use only mild soaps. Deodorant and so-called antibacterial soaps, shower gels and bubble bath can irritate the skin.


- Usually, you only need to use soap on your face, armpits, genital area, hands and feet. The rest of the body can be washed with just water.

When should you see a doctor?

If your symptoms prevent you from sleeping or carrying out your day-to-day routine, you should see a doctor. The same applies if you think that your skin is infected or if your usual treatment approach is not working.

In conclusion, eczema is a skin inflammation that can have an impact on the affected individual’s comfort, appearance and quality of life. You can reduce the frequency of exacerbations by keeping your skin hydrated and avoiding triggers. Don';t hesitate to consult your pharmacist, whose judicious advice can help you better control your eczema.

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