Eczema is a chronic skin disorder that involves scaly and itchy rashes. Atopic dermatitis is the most common type.
Atopic dermatitis is due to a hypersensitivity reaction (similar to an allergy) in the skin, leading to long-term inflammation of the skin.
Taking care of your skin at home may reduce the need for medications.
Help with Itching and Scratching
Avoid scratching the rash or skin if you can:
Relieve the itch by using moisturizers, topical steroids, or other prescribed creams and taking antihistamines to reduce severe itching.
Keep your child's fingernails cut short. Consider light gloves if nighttime scratching is a problem.
Antihistamines taken by mouth may help with itching or if you have allergies. Often you can buy them yourself over the counter.
Some antihistamines can cause sleepiness, but they may help with scratching while sleeping.
Newer antihistamines cause little or no sleepiness. These include fexofenadine (Allegra), loratadine (Claritin, Alavert), and cetirizine (Zyrtec).
Day-to-day Skin Care
Keep the skin moist (called lubricating or moisturizing the skin). Use ointments (such as petroleum jelly), creams, or lotions 2 - 3 times a day. Moisturizers should be free of alcohol, scents, dyes, fragrances, or other chemicals. A humidifier in the home will also help.
Moisturizers and emollients work best when they're applied to skin that is wet or damp. After washing or bathing, pat the skin dry and then apply the moisturizer right away.
Different types of emollients or moisturizers may be used at different times of the day. For the most part, you can apply these substances as often as you need, to keep your skin soft.
Avoid anything that makes your symptoms worse. This may include:
Foods such as eggs in a very young child (always discuss with your doctor first)
Wool, lanolin, and other scratchy fabrics. Use smooth, textured clothing and bedding, such as cotton.
Sweating by being careful not to over dress during warmer weather
Strong soaps or detergents, as well as chemicals and solvents
Sudden changes in body temperature and stress, which may cause sweating and worsen your condition
Triggers that cause allergy symptoms
When washing or bathing:
Bathe less often and keep water contact as brief as possible. Short, cooler baths are better than long, hot baths.
Use gentle skin care cleansers rather than traditional soaps and only on your face, underarms, genital areas, hands, feet.
Do not scrub or dry the skin too hard or for too long.
After bathing, it is important to apply lubricating creams, lotions, or ointments on the skin while it is damp. This will help trap moisture in the skin.
The skin rash itself, as well as the scratching, often cause a break in the skin and may lead to an infection. Learn to keep an eye out for redness, warmth, swelling or other signs of infection.
Medicines from Your Health Care Provider
Topical corticosteroids are medicines used to treat conditions where your skin becomes red, sore, or inflamed. Topical means you place it on the skin. Topical corticosteroids may also be called topical steroids or topical cortisones.
Topical steroids contain a hormone that helps “calm” your skin when it is swollen or inflamed. Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor advises you to..
Your health care provider may give you other medicines to use on your skin or take by mouth. Be sure to follow directions carefully.
When to Call the Doctor
Call for an appointment with your health care provider if:
Eczema does not respond to moisturizers or avoiding allergens.
Symptoms worsen or treatment is ineffective.
You have signs of infection (such as fever, redness, pain).
Breternitz M. Placebo-controlled, double-blind, randomized, prospective study of a glycerol-based emollient on eczematous skin in atopic dermatitis: biophysical and clinical evaluation. Skin Pharmacol Physiol. 2008 Jan; 21(1): 39-45
Wollenberg A, Schnopp C. Evolution of conventional therapy in atopic dermatitis. Immunology and Allergy Clinics of North America. 2010 Aug;30(3).
Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.