The Itch That Rashes!

Atopic dermatitis, or eczema, is a chronic allergic skin disorder.  It starts as an itch and develops into a rash if scratched.  The rash is characterized by dry, itchy, scaly skin commonly found on the cheeks, arms, legs, creases behind the ears, and buttocks.  The more the skin is scratched the worse the rash becomes and may become infected.  If a bacterial or viral infection is introduced, the affected lesions will ooze.  Scratching the skin can lead to weeping or crusted sores. Eczema can affect approximately 10% of children and most often begins when children are very young (between 2 and 6 months of age).  More than 90% of eczema cases have developed by age 5. There is greater chance of eczema when family members have allergic conditions. Up to 50% of children with atopic dermatitis will eventually develop hay fever or asthma. Although chronic, most children will outgrow it by their teen years though some will have it follow them in adulthood.

What To Do?

An allergist or dermatologist will be able to determine if your rash is atopic dermatitis.  Often times we work together to seek identification of triggers that are making your skin worse.

Since eczema is characterized by dry, itchy skin, daily HYDRATION with moisturizers is critical.

Bathe or shower daily (10 to 15 minutes in lukewarm water).

  • Do not use a washcloth, loofah, etc.  Do not use bubble baths or bath oils with fragrance or perfume.
  • Recommended: Dove, Lubriderm, Oil of Olay, Tone, Cetaphil bar or liquid, Basis, Aveeno, Neutrogena or Oilatum to name a few.

After stepping out of the bath or shower, allow the water to run off the skin and then PAT do not rub the skin dry.

Follow the three-minute rule:

After getting out of the bath or shower, apply to the DAMP skin topical medication or a thick layer or moisturizer immediately.  These include: Vaseline petroleum jelly, Aquaphor ointment, Eucerin, Cetaphil, Moisturel, Aveeno, or a lactic acid containing product like Lac Hydrin, Aquacare, or Carmol. Cocoa butter or Crisco could also be used. Do not use lotions as they can contain water and/or alcohol can be irritating to sensitive skin.

What Else Can I Do?

Identifying allergens (triggers) and irritants that can lead to flares is the first step to getting eczema under control. Skin testing to allergens may be done to help identify allergic factors. If a trigger can be identified, then treatment is directed toward eliminating it.

  • Wear cotton clothing. Use bedding that is 100% cotton. Avoid fabrics of wool or nylon, as these can irritate the skin.
  • Prewash items before wearing them and remove tags from clothing. Avoid detergents and fabric softeners that contain perfumes or dyes.
  • Keep household temperatures on the cool side especially at night to reduce overheating and sweating.
  • Keep fingernails trimmed short and smooth to reduce damage done by scratching. Cotton gloves may be worn to decrease nighttime scratching and to hold medications/moisturizers in overnight.
  • Antihistamines may be used to decrease itching. Application of a cold, wet washcloth can also be soothing.
  • Use sunscreen regularly and shower immediately after exposure to chlorine or bromine on skin. Avoid hot tubs.
  • Avoid stress: It is not uncommon to experience anxiety, anger and frustration. An eczema sufferer may do everything “right” and still have flare-ups. This also may be compounded by a lack of understanding from extended family, friends, school, and day care.
  • As with other chronic diseases, EDUCATION is the KEY to UNDERSTANDING.  Other patient resources include: National Eczema Association and American Academy of Asthma, Allergy & Immunology