Eczema

Eczema is a word that means irritated skin. Doctors don't really know why some kids and adults get eczema, and others don't. They think it might happen for a bunch of reasons:

  • Family: If your mom, dad, brothers, or sisters have eczema, you might get it too.
  • Asthma and allergies: If you have asthma (a disease that can make it hard to breathe) or allergies (when your immune system tries to protect you from normal things that aren't hurting you), you're more likely to get eczema.
  • Where you live: Eczema is more common in cities, polluted areas and in the northern part of the world.

When you have eczema, it means your immune system is working too hard. Your immune system usually is good, because it tries to protect you from bad stuff like infections and diseases. For some reason, when you have eczema, your immune system kind of goes crazy. So that makes your skin overreact to something and get all itchy and rashy. Weird, huh?

If you have eczema, you might not itch all the time. It's sort of like eczema goes to sleep. Certain things wake it up and make you start itching. These things are called triggers and you should try to avoid them if you can, especially if you've noticed that they make your skin itchy.

Common triggers are:

  • Animal dander and saliva (when a pet licks you).
  • Scratchy clothes (such as wool).
  • Sweating a lot.
  • Soaps.
  • Household cleaning products.
  • Fruit juices.
  • Dust.
  • A cough, cold, or the flu.

How is Eczema diagnosed?

When dyshidrotic eczema (DE) flares, your provider can diagnose it by looking at your skin. We will also ask about your medical history, work, hobbies, and recent stress level.

If we think that the eczema could be due to an allergy, an allergy test called patch testing may be recommended. During patch testing, small amounts of substances that you may be allergic to are placed on your skin — often the skin on your back.

How do we treat Eczema?

Your treatment plan will be designed to treat your signs and symptoms. You may be responsible for doing much of the treatment at home. It is important to carefully follow your treatment plan, which may include several of the following:

  • Soaks and cool compresses: Soaks or cool compresses that you apply 2 to 4 times a day can be very effective for drying blisters. You apply these for 15 minutes at a time.
  • After each soak or cool compress, you’ll likely need to apply a medicated cream or ointment, such as a corticosteroid.
  • Corticosteroid that you apply to your skin: This can reduce the inflammation and clear the blisters.
  • Anti-itch medicine: An antihistamine pill or other anti-itch medicine can reduce scratching. Anything you can do to reduce scratching is helpful because scratching tends to worsen eczema.
  • Pramoxine (pra mox’ een): A cream or lotion containing this can relieve itch and pain.
  • Moisturizer or a barrier repair cream: Your dermatologist will recommend a moisturizer or barrier repair cream. These can reduce dryness and flares of eczema.
  • It’s important to apply the product after each shower, bath, and hand washing.
  • Medicine to treat an infection: The skin with eczema can get infected. Before prescribing this medicine, your provider will first determine what type of infection you have.

Having an infection can stop eczema rom clearing.

If the above treatments fail to work or you have severe eczema, your provider may recommend one of the following:

  • Botulinum toxin: These injections, which are given at Gardens Dermatology, bring some patients relief because botulinum toxin temporarily relaxes the muscles and stops excessive sweating.
  • Botulinum toxin is FDA approved to treat wrinkles and excessive sweating in the underarms — but not eczema. It’s legal to prescribe a medicine for a condition other than its FDA-approved use. This is called “off-label” use, which can be very helpful for some patients.
  • Draining large blisters in the office. Draining blisters is safe and effective when performed at the Gardens Dermatology office, but you should not drain your own blisters. Attempting this at home can lead to an infection, which can worsen eczema and prevent clearing.
  • Corticosteroid that works throughout the body: For a severe case, a corticosteroid pill or injection may be prescribed.
  • Light treatments: This treatment exposes the skin with eczema to ultraviolet (UV) light for a prescribed amount of time. Under your Gardens Dermatology provider’s care, light treatment can be a safe and effective treatment for eczema. In one study, more than 90% of patients report good to excellent results after 6 to 8 weeks of treatment.
  • It’s extremely important to get these treatments at a hospital, clinic, or your provider’s office. Trying to treat your skin by using a tanning bed is not recommended.
  • Changing your diet: Sometimes, eczema continues to flare despite all you do to treat it. If this happens, your provider may recommend a change to your diet.
  • Eliminating foods that contain nickel or cobalt helps some people.
  • Many foods contain nickel or cobalt. If you are allergic to either, your provider can tell you how to change your diet.  

Other treatments than the ones listed here can also be helpful. Your provider can tell you what treatment may be best for you.

Some people have one mild outbreak that clears without treatment. It’s much more common to have flares throughout your life. Treatment can help control eczema, which cannot be cured.

  • Folliculitis 

Every hair on your body grows out of an opening called a follicle. When follicles get infected, you develop folliculitis. Infected hair follicles look like pimples, but they tend to be itchy and tender.

To reduce your risk of getting folliculitis:

  • Immediately after your workout, change out of tight workout clothes like biking shorts and shower.
  • Stay out of hot tubs and whirlpools if you’re unsure whether the acid and chlorine levels are properly controlled. Many people get folliculitis from a hot tub that there is actually a condition called “hot tub folliculitis.” 
  • Wear light-weight, loose-fitting clothes when it’s hot and humid.