Eczema

The Skin Center

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Atopic dermatitis appears as a chronic, itching, superficial inflammation or redness of the skin. The typical skin lesions begin as a red rash with multiple small bumps and/or blisters. The most distinguishing features of the disease are the location and distribution of the skin lesions. In infants, the rash commonly begins on the face and scalp with red, dry spots. In adolescents and young adults, the rash typically occurs on the elbow bends (front of elbows) and back of knees. It is also seen on the face, neck, and upper chest in areas of skin folds. Many patients also have dry skin all over their body. The initial skin rash can become intensely red, blister, ooze and form scabs.A common complication of the disease is secondary bacterial infection, which may often necessitate antibiotic treatment. Severe itching leads to repeat scratching of lesions – hence the “itch-scratch-rash-itch cycle.”, Because of the persistence of this itch-scratch cycle, the skin may become very thickened in these areas from rubbing. Severe and constant itching is the grand hallmark of the disease. The cause of the disease remains largely unknown, but an inherited or genetic pattern is often seen in families. Fortunately, there have been some recent innovations in this field by the introduction of dynamic, new therapies which involve non-steroid type of medications like Elidel cream and Protopic ointment. There is also new narrowband UVB light treatment to help with very resistant cases. These therapies have the advantage of avoiding some of the common bad side effects with steroid creams like skin thinning and long term skin changes.

General recommendations for patients with atopic dermatitis:

Do’s:
• Bathe with lukewarm water
• Lubricate skin frequently with moisturizers like Aquaphor

• Use a soapless cleanser like Dove Non soap cleanser

• Maintain a comfortable room temperature
• Avoid excess stress
• Keep fingernails short and clean
• Wear light, smooth, nonbinding cotton clothingDon’t:
• Wear rough, scratchy clothes or woolens
• Bathe too often with hot water and soap
• Use harsh skin cleansing products or soaps
• Rapidly change temperatures
• Use fragrances lotions or body washes

• Cerave lotion
• Vaseline
• Crisco vegetable shortening
• Topical cortisone creams like hydrocortisone cream over the counter ( Cortizone 10, Cortaid, etc.)
• Prescription strength cortisone creams like clobetasol cream
• Evening  time antihistamines like Benadryl or Atarax pills each night
• Morning antihistamines like Claritin pills every morning
• Dilute clorox baths 1-2x/week ( 1/4 cup clorox in 1 bath tub of water)- similar to swimming pool water

 

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