Eczema

“When the itch is inside the boot, scratching outside provides little consolation”-Chinese Proverb

I suppose, as one gets older, it’s only natural to experience new diseases and conditions. For myself, the newest experience is Eczema, also called dermatitis, a dry skin condition that can result in recurring rashes, itching, flaking, etc. Apparently scratching can lead to permanent scarring.

Eczema covers a wide range of dry, red skin situations and is perhaps over used as the diagnoses of skin rashes. My case could be Contact dermatitis – perhaps our cat rubbed against something that then rubbed onto me, or Xerotic eczema – a dry skin that worsens in dry winter weather affecting mostly arms and legs, or Discoid eczema – rounds spots of dry rash on the lower legs in winter weather.

Sadly, there is no “cure” for dermatitis. It is often treated with corticosteroids which suppress the symptoms but it never goes away completely. If the condition is extreme with skin cracks, the normal protective barrier of the skin is disrupted which allows easy entry for bacteria. Scratching can introduce infection and spread it about which just makes the eczema flare up more, causing more cracks, more scratching, more infection in a nasty deteriorating spiral. If this occurs a doctor should perscribe an antibiotic and an anti-itch drug like antihistamine.

The best way to avoid or limit eczema is to prevent dry skin. My dermatologist asked if I used skin creams. No, I said. Well you will from now on, he replied. Here are some skin care recommendations:

1. Soap removes oil and will dry out skin. When showering, use a moisturizing body wash on dry areas like arms & legs instead of soap.
2. Don’t use a washcloth, sponge or loofah on the dry area. These will abrade the skin.
3. Pat the dermatitis area dry, never rub it dry with a towel.
4. Apply skin creams (emollients) twice daily. Look for a heavy cream that is recommended for eczema. Light creams may be too weak to be effective.
5. Use the skin cream within 3 mintues after taking a bath/shower to trap in the moisture.
6. There is a disagreement whether baths are desirable or a necessary evil. For example, the Mayo Clinic advises against daily baths to avoid skin drying. while the American Academy of Dermatology claims "it is a common misconception that bathing dries the skin and should be kept to a bare minimum" and recommends bathing to hydrate skin.
7. Hard water is harsh on the skin. Try using a water softener.
8. Avoid scratchy materials like wool.
9. Avoid environmental factors that trigger allergies (for example, pollen, mold, dust mites, and animal dander) [Right, shall I live in a bubble?]
10. My dermatologist said I should avoid long, hot showers. [Rats, that’s one of my favorite parts of the day]

Bottom Line

The exact cause of eczema is not known. Although it is activated by the immune system and is related to allergic reactions, it is not the same as other allergic reactions. According to the National Institute of Allergy and Infectious Disease, the prevalence of atopic eczema is increasing and affects 9 to 30% of the U.S. population [20% of children and 2% of adults]. For some, the disease will improve with time. For others, however, eczema is a chronic or recurrent disorder that will last a lifetime.

Resources

http://en.wikipedia.org/wiki/Eczema
http://www.webmd.com/allergies/guide/eczema
http://www.emedicinehealth.com/eczema/article_em.htm
http://www.nlm.nih.gov/medlineplus/eczema.html
http://www.medicinenet.com/eczema/article.htm