The Derma Corner: What you need to know about eczema and how to manage it
We’re happy to introduce our columnist, dermatologist Nikki Paderna! She will be answering some of our burning skincare questions, so if you have one, feel free to email it to liz [at] projectvanity.com so we can take a look at it!
Part of the new normal now includes proper hand hygiene and stringent disinfection rules around the home and work area. That means frequent hand washing, use of alcohol, and cleaning – all of which will have your skin in contact with either a detergent, soap, or other irritating solvents. Some can tolerate these harsh chemicals and not have any reaction to them. On the other hand, some with sensitive and dry skin can develop a scaly, itchy and red reaction as a consequence which leads to me to today’s topic, eczemas.
Eczemas are inflammatory skin conditions wherein the skin barrier is compromised and the skin becomes dry, rough, itchy and red. They may present with bleeding, crusting or oozing in severe and neglected cases. They are not infectious but some have a genetic component to them. Eczemas are influenced by various environmental factors and the typical ones are harsh soaps, detergents, climate, weather, perspiration and allergens. Other factors in the form of mental and emotional stress, skin infections and diet may also be an influence.
There are several types but the most common ones I see in my practice are atopic dermatitis, contact dermatitis and hand eczemas.
Atopic dermatitis is often associated with asthma, allergic rhinitis, food sensitivity and other eczemas, presenting with recurrent and/or persistent rashes on the arms, legs, neck and trunk. Their skins are inherently dry owing to its reduced lipid content and an increase in water loss.
Contact dermatitis can be classified on whether the trigger will cause an allergic or irritant reaction on the skin. An allergic contact dermatitis will be itchier but an irritant contact dermatitis will have a stinging painful reaction on the skin.
Hand eczema presents as tiny water-filled blisters under the skin of the fingers and palms that are so itchy, some usually prick them. I see this form of eczema frequently accompanying atopic dermatitis.
For the treatment, antihistamines and topical steroids are the commonly prescribed medications together with frequent application of emollients or moisturizing lotions. Other medical options would include other topical alternatives, oral treatment and phototherapy. Because of their chronic and relapsing nature, educating patients and family members alike about basic eczema information is crucial in preventing future flares. These information are the following:
Avoid eczema triggers as much as possible like too much sweating, rough fabrics, and being exposed to irritating solvents or allergens.
Recurrences are common during summer and extreme cold weather so be prepared to take measures like being in airy or cool spaces and wearing loose, cotton clothes in the summer, and applying hydrating layers with occlusives on the skin in the winter.
Scratching only worsens the eczema. Dermatologists call atopic dermatitis as the “itch that rashes” because scratching or even rubbing perpetuates a cycle of inflammation and an increase in itchiness, making patients want to scratch at the rashes more.
Regular and frequent use of emollients helps by reducing the skin’s water loss, itchiness, irritation, redness and decreases the amount of medication needed by the skin.
Use a low pH wash or soap when bathing and shower once daily. Frequent bathing is discouraged because they dry up the skin even more unless a moisturizer/emollient is immediately applied after.
I hope that the information I provided will be of help to anyone with these skin conditions. Until my next article guys, stay safe!
Dr. Nikki Paderna is currently available for online consultations thru the HealthNow app on Google Play for Android devices and on the Apple store for iOS devices, or thru the FB page, Vivestrata Dermatology Clinic.
