Eczema Management
Eczema and Atopic Dermatitis
People with eczema have very dry, sensitive skin that needs to be protected from irritation. Some forms of eczema will respond to moisturizer use alone, but most require short term use of a topical steroid that your physician will prescribe. The following recommendations will help guard against dryness and irritation that makes people with eczema itch and break out. Most children with eczema will improve as they grow older. There is no cure for eczema, but treatment outlined below decreases the frequency and severity of flares.
General points for people with sensitive, dry, eczema-prone skin:
Wear 100% cotton clothing, especially those clothes that are in direct contact with the skin. Avoid polyester or other synthetic fabrics. Remove clothing tags that may irritate the skin.
When bathing or showering, use lukewarm water and limit the time to 10 minutes; no bubble baths.
Use a mild soap for bathing and washing hands. Vanicream Gentle Body Wash is the best. Other options are Cetaphil Skin Cleanser, CeraVe Hydrating cleanser, and Aveeno Eczema Care.
After bathing or washing, pat dry. While still damp, moisturize all over with a heavy cream, lotion or emollient (see below for more specific recommendations).
Wash all clothing in an unscented powder detergent (All Free Clear). Avoid fabric softeners and dryer sheets.
Avoid scratching. Keep fingernails filed and smooth.
Moisturize your skin once or twice a day, every day!
The best time to moisturize your skin is after bathing. You can decrease the severity and frequency of flares of eczema by keeping your skin well hydrated. This prevents dryness and cracks which lead to a flare. Avoid lotions and oils with heavy scents and perfumes. In general, moisturizers that you scoop out of a tub are better than ones you pump out of a bottle. Vanicream Moisturizing Skin Cream is the best. Other examples are Eucerin Original Moisturizing Cream, Cetaphil Moisturizing Cream, and CeraVe Moisturizing Cream. For hands and severely dry skin, Aquaphor Healing Ointment is the best. Low cost generic products are available at most pharmacies. Vaseline is very effective and is probably the best low-cost option.
Limit use of topical steroids to several weeks at a time during flares
Your doctor has prescribed you a topical steroid cream, lotion or ointment that should be used during periods of flare. After bathing, apply the medicated creams to affected areas instead of your moisturizer. Apply twice daily for 2-4 weeks, then weekends only for 2-4 weeks, then stop. You may repeat this every 6-8 weeks as needed. If you are improved after 1 week of twice daily use, decrease to weekends only for 1-2 weeks then stop. Do not use these prescription steroid creams every day for longer than several weeks at a time – if you overuse them you will thin the skin and the cream will no longer work. Call your doctor if your rash does not improve after several weeks of twice daily treatment.
Other comments:
Eczema can affect all areas of skin including the scalp, eyelids, underarm and genital skin areas. Make sure you tell your doctor if you have itchy rashes in these locations, as they require special treatment with specific creams for sensitive skin. Do not apply a cream prescribed for eczema at other locations to these special, sensitive skin areas without discussing it with your doctor.
