Eczema is more than just dry skin. Flares erupt unpredictably: dry, scaly, irritated spots on the face or hands, or inside the crease of the elbow or knee. The itch is almost unbearable — and scratching makes it worse, resulting in an endless cycle. Broken skin can become infected.
Preventing the flares is tricky. There are different types of eczema, but the most common is atopic dermatitis, or AD, which is allergy-related. Allergens or irritants that commonly set it off include some food or environmental allergens, irritating soap or detergent, scratchy or synthetic clothing, cold or dry air, sweat and stress. To make things more complicated, many people with eczema lack a specific protein in the skin that helps keep it hydrated.
Eczema has no cure, so managing the flares becomes a priority.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
The trick is figuring out how to get moisture back into the skin and keep it there. Slathering on moisturizer by itself won’t do it; neither will simply soaking in a bath.
In fact, some people think bathing will dry out the skin and make it worse: We all know how frequent hand-washing dries out our hands. The reason for this is not the water itself, however, but the harsh soaps we use and the fact that we often just wash and dry — forgetting to add a moisturizer to seal in the water.
It may be true that bathing too frequently can dry out skin and exacerbate eczema, but rather than skipping baths, I recommend shorter ones.
There are a variety of prescription medications that help eczema, but the best answer we have to ease the itch of eczema and rehydrate the skin is a tried-and true method called “soak and seal” — soaking the skin to allow water to absorb, then using a moisturizer to seal the wetness in.
[See: 8 Surprising Facts About Asthma and Seasonal Allergies.]
Three-Step “Soak and Seal”
1. Soak your skin in lukewarm water, either a bath or a shower, for 10 minutes or so. Skip the soap or bubble bath: Stick to clear water. If necessary, use a gentle cleanser free of fragrances and chemicals. For areas like your face that can’t be soaked in a tub, apply a wet washcloth for at least five minutes.
2. Pat your skin dry with a soft towel — don’t rub, as that will irritate the sensitive areas.
3. Apply moisturizer immediately (the rule is within three minutes) to seal the water in. If you have a prescription skin medication, use that first on affected areas. Then use a high-oil-content ointment. Petroleum jelly may be messy, but it’s often the best solution for eczema flares. In general, stick to fragrance-free, dye-free, clear ointments or serums. Lotions contain too much water and easily evaporate, while some creams have preservatives or fragrances you may be sensitive to.
What About Bleach?
Evidence for the benefits of bleach baths isn’t clear. The theory is that a bit of bleach in the bath water may help kill bacteria and prevent infection. Just one tablespoon is enough. It’s not for everyone, though: Bleach fumes can irritate the lungs, so don’t try this if you have asthma or other lung conditions.
[See: How to Survive Ragweed Allergy Season.]
Expert Advice
Eczema is a complicated condition that may be related to other conditions such as food allergy and asthma. As such, it requires expert advice and treatment. A board-certified allergist can perform tests to help identify your particular set of triggers and develop a management plan based on your individual needs.
Some patients with environmental or pet allergies will benefit from immunotherapy, or allergy shots. Others may qualify for new biologic medications approved in recent years that target moderate-to-severe atopic dermatitis.
Every person’s eczema is different, and effective relief requires expert evaluation and a targeted treatment plan.
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Managing Eczema: To Bathe or Not to Bathe? originally appeared on usnews.com
