Eczema and skin care in Atopic dermatitis

Atopic Dermatitis, commonly know as Eczema, is a common, chronic, recurring skin disorder.
Eczema results in dry, easily irritated, sensitive, itchy shin that becomes inflamed and rashes. There is no cure for Eczema. The mainstay of treatment is to relieve symptoms and control inflammation and skin rash. This treament is usually done by applying topical steroidal agents. (Ointments, creams, lotions and gels.)
Just as important — if not more important — is the proper care of the Atopic skin. It’s been known for some time that infants and children with atopic dermatitis have a skin abnormality: it fails to retain water. Recent research has shown that that this skin is deficient in a protein called Filaggrin, which is associated with the growth, repair, and maintenance of skin cells. It is also deficient in lipids (fats) called Ceramides 1 and 3.
The deficiency of these two factors leads to increased water loss through the skin, which leads to dry and/or damaged skin. This compromises the barrier function, leaving the skin vulnerable to irritants and allergens.
How Do I Take Care of This Dry & Damaged Skin?
The most important treatment for dry skin is to PUT WATER BACK INTO IT. The best way to do this is to briefly soak the skin in a bath or shower. Water should be warm, but NOT HOT. Moisturize immediately afterwards, while the skin is damp. DO NOT use harsh soaps, and avoid rubbing and scrubbing the skin. Use mild, non-soap cleansers that are fragrance free, dye free, and have a ph less than 5.
Examples of Good Moisturizers
- Aquaphor Healing Ointment
- Aveeno Advanced Care Moisturizing Cream
- Cerave Moisturizing Cream
- Cetaphil Restoraderm Moisturizing Cream
- Vanicream
- Vaseline Petroleum Jelly (inexpensive, but very greasy)
- Epiceram (requires a prescription)
Application of Moisturizers
Take a bath or shower, preferably at night before bed. Gently dab the skin with a soft towel and apply moisturizer within three minutes to help trap the water into the skin. Moisturizer must be applied at least twice daily — and more often if the skin gets dry. This process improves skin hydration and barrier function.
Dispense the moisturizer from the jar with a clean spoon or butter knife to avoid contamination. Take a dollop of moisturizer, soften it by rubbing it between your hands, and apply it using the palm of your hand, stroking in a downward direction. DO NOT rub by stroking up and down or around in circles. Try different products until you find the one that feels comfortable to your child.
To prevent recurrence, continue to use moisturizers even after the affected areas heal.
Other Recommended Treatments
Bleach Baths: 2-3 times a week, for those whose eczema gets infected (usually due to scratching). Use 1/2 cup household bleach for a full bathtub, 1/4 for a half-bath.
Salt Baths: One cup of table salt to bath water for a soothing “ocean at home” effect.
Oatmeal Baths: Add to bath water, to relieve itching
Also: wash all new clothes before wearing them. Add a second rinse cycle to ensure the removal of soap, and use mild detergent that is dye-free and fragrance free.
All this can be a little time-consuming, but it goes a long way in keeping this sensitive, vulnerable skin from drying and result in itching, inflammation, and rash.
REMEMBER: LUBRICATE, LUBRICATE and LUBRICATE!!
Medications
Eczema medications can relieve your symptoms and help the skin heal when you take them as directed. The treatments may not have the same effects on everyone, though. So you and your doctor may need to try a few different options to see what works best for you.
Corticosteroid creams, solutions, foams, and ointments. These treatments made with hydrocortisone steroids can quickly relieve itching and reduce inflammation. They come in different strengths, from mild over-the-counter (OTC) treatments to stronger prescription medicines.
OTC hydrocortisone is often the first thing doctors recommend to treat mild eczema. You may need different strengths of these steroids depending on where and how bad your rash is. For example, a doctor may prescribe a more potent one for thick, scaly skin. Side effects from these meds, such as thinning skin and stretch marks, are rare when you take them as directed.
Barrier repair moisturizers. You can get these over the counter and by prescription. They help lock water into your skin, repair damage, and ease dryness, redness, and itching. Some products may have irritating fragrances or other ingredients, so ask your doctor or pharmacist which ones you should try or avoid.
Pimecrolimus and tacrolimus, medicines you rub on your skin, treat moderate-to-severe eczema for some people. They ease inflammation, but they aren’t steroids. They may increase the risk of skin cancer and non-Hodgkin’s lymphoma, so the FDA issued a special warning for them. Talk to your doctor about these risks before you take the drugs.
Corticosteroid pills, liquids, or shots. These powerful drugs help relieve symptoms of severe or hard-to-treat eczema. Because of the risk for side effects such as skin damage and bone loss, you should take them only for a short time.
Drugs that turn down your immune system, including cyclosporine, methotrexate, and mycophenolate mofetil. They help keep your body’s defenses from overreacting. You can take them as pills, liquids, or as a shot. They can help people with moderate-to-severe eczema when other treatments haven’t worked. Serious side effects include high blood pressure and kidney problems. You should take these medicines only for a short time to limit the risk for these problems.
Antibiotics. Scratching damages your skin, which allows bacteria to get under it and cause an infection. These medicines treat bacterial skin infections.
Antihistamines. When you take them at night, these drugs relieve itching and can help you sleep.
Simple skin care can prevent eczema flares.
What we can do at Thechildplus children’s hospital?
We can help you manage eczema that can improve overall quality of your life. Also Eczema and atopic dermatitis is chronic disease and required proper treatment to prevent flare up. Also we help you to identify associated factors that can precipitate such allergies.Feel free to visit us. We are happy to treat.