Avoidance of the triggers for itchiness is the main priority for those who have atopic dermatitis or eczema. The environmental triggers should be reduced by avoiding nylon or wool which is rigid clothing that can irritate the skin and promote sweating. Instead, the individual should wear cotton-based clothing that has been washed using a mild detergent or undergone a double-rinse cycle.
Considerations during season changes
During the summer season, it is recommended to use an air conditioning unit to prevent sweating as well as removing excess humidity. As for the winter season, utilize a humidifier to prevent extreme dryness of the skin.
It is also important to avoid getting sunburned by using sunscreens. Remember that several prescription medications such as topical steroids can make the skin more sensitive to sunlight, thus worsening the skin condition.
Those who have significant atopic dermatitis should undergo proper evaluation for allergy testing to common airborne allergens and food allergens. Avoidance of common allergens such as animal dander, cockroaches and dust mites can help improve the skin condition. Elimination of trigger foods from the diet can also improve the eczema.
Proper maintenance of the skin
Always bear in mind that good skin care starts with proper moisturizing and hydration which reduces the itchiness and formation of eczema.
The hydration of the skin is maintained by daily application of skin moisturizing creams. Even vegetable shortening is also a good and inexpensive moisturizer.
If possible, avoid lotions that contain too much water since they can cause drying of the skin. The difference between a lotion and a cream is that creams have a slightly greasy feel even after it has been applied to the skin. Avoid using pure petroleum jelly which does not moisturize the skin unless applied on top of a moisturizer or moist skin.
Remember that bathing can be helpful if done properly but harmful if not correctly done. Avoid extremely hot or cold water baths or showers. It is best to bathe on a daily basis and soak in the water until the fingertips start to wrinkle. Pat dry with a towel and apply a moisturizing cream all over the body within 3 minutes of getting out while the skin is still moist. In case the skin is allowed to air-dry before a moisturizer is applied, the eczema can worsen.
The itchiness can be partially controlled with low-sedating antihistamines during the day or with sedating antihistamines at night.
Treatment of atopic dermatitis
In case eczema worsened due to uncontrolled itchiness and scratching, there are medications that can be used to manage the condition.
- Topical steroids are the first line of treatment for atopic dermatitis and available in cream, lotion, ointment or solution form. Most require a prescription from a doctor.
- Topical calcineurin inhibitors are given for short-term use in children older than 2 years old.
- Oral steroids are given on a short-term basis to control severe flare-ups of atopic dermatitis. Remember that oral steroids can cause a “rebound effect” with worsening of the skin soon after the steroids are no longer used.
- Oral and topical antibiotics are required in severe cases of atopic dermatitis that leads to an infection. The topical variants are used for localized infections while oral antibiotics are required for infections involving large areas of skin.