Winter can cause a flaring up of many skin conditions. In this blog post we discuss one such condition called atopic eczema.
What is atopic eczema?
Atopic Eczema or atopic dermatitis is an inflammatory condition of the skin which is characterised by redness, itching and dryness of skin. Atopic eczema causes blistering of the skin occasionally. Due to the excessive dryness of skin in this condition, scaling and flaking of the skin is also observed. This type of eczema commonly affects children, with the presence of symptoms being noticed before five years of age, and continuing up to adulthood. Sometimes, the onset of the disease also occurs in adults. Worldwide, 20% of children and 3% of adults are affected with this condition. The lesion can present anywhere on the skin, with a specific predilection for the fossa of the elbows and knees and nape of neck, in affected adults.
Eczema often presents in phases, where the symptoms flare up, followed by phases of remission. These changes are observed seasonally in the affected individuals, with the symptoms flaring up during the seasons of spring and autumn. This occurs because of the drastic change in weather conditions during these seasons. The symptoms of eczema also flare up during winters due to the dry weather conditions in this season. Familial associations are commonly noted in this condition.
Although, eczema is not contagious and does not spread from person to person or site to site, the symptoms of eczema are distressing to the patient and thus, the condition requires proper treatment and care. Taking good care of the skin is the key to the treatment of eczema, especially during the initial stages of the disease. Eczema is usually associated with dry skin. So, preventing the skin from getting dry will help to reduce the symptoms.
Treatment, care and prevention of eczema:
- Reducing the dryness of skin
- Use a mild soap or cleanser to avoid dryness of skin. Mild cleansers with PH balance are gentle to the skin and help in maintaining the skin’s natural oils and moistures.
- Use warm or cold water for bathing. The use of hot water worsens the symptoms of dryness and eczema.
- Duration of showers must be kept short and it must be essentially followed by a regular moisturising routine, with a good quality moisturiser. Use of moisturiser helps to lock in the skin’s moistures. Application of a moisturising agent immediately after a shower helps in locking extra hydration.
- While going out, the skin must be covered and protected from sun, dust and pollution, to avoid worsening of the symptoms.
- Touching, scratching or peeling the lesion must be avoided at all times to prevent deterioration of symptoms and to avoid bleeding at the site.
- While being indoors, the use of a humidifier is recommended, as it helps in adding moisture to the air, which avoids dryness of skin.
- Lifestyle modifications
- In addition to the above measures, lifestyle modifications, including the avoidance of trigger foods and reduction of stress levels of an individual, assist in the management of the symptoms of eczema.
- The individual triggers must be identified and eliminated from the diet. The possible food triggers include peanuts, milk, soy, eggs, wheat and fish.
- Stress reduction can be done through the practice of yoga and meditation in the individual. Walking is also known to be beneficial in the process of stress reduction. Reassurance of the patient, about the improvement of symptoms and treatment of eczema also helps in reduction in the individual’s stress levels.
The above measures help in reducing the dryness of skin and diminishing the symptoms of eczema. However, in advanced stages of the disease, a dermatologist must be visited for proper treatment of the condition.
Treatment of the condition:
The following medications and topical applications are known to be useful in the treatment of the condition.
Anti-histamines are the known to successfully treat allergic and inflammatory conditions. They are often prescribed as topical applicants in the treatment of eczema, and help in the treatment of inflammatory outcomes of the patient. Oral antihistamines are also used to keep the allergies in check
Hydrocortisone, the mildest topical corticosteroid is also available as a topical application. It is commonly prescribed in the treatment of eczema, to reduce pain, itching, swelling and discomfort of the patient. The affected area or the lesion is first cleaned with mild soap and water, to remove dust and dirt, before the application of the cream.
Hydrocortisone is a topical corticosteroid although the mild variety.
- Topical steroids
Topical steroid applications in the form of gels, creams and lotions are prescribed to the patient. Topical steroids, particularly in the form of ointments are known to be effective in the treatment of various skin conditions, like eczema. When applied on the lesion, they penetrate deep into the skin, through the creases and micro disruptions present due to eczema. However, they are immunosuppressive in nature and are not prescribed as the first line treatment of the disease. They are prescribed only when the patient’s symptoms are severe.
- Systemic medications
Systemic medications including immunosuppressants can also be prescribed to the patient for the management of the condition.
If the prescribed medications and topical applications fail to treat the condition, phototherapy with UV-B radiation is employed, to reduce itching and inflammation of the skin. The radiations help in increasing the production of vitamin D and improving the bactericidal mechanism of the body.
Thus, eczema, which is an inflammatory condition of skin, presenting with itching, pain and discomfort to the patient, is completely manageable by taking good care of the skin and the use of medications. corticosteroids and anti-histamines are often prescribed as topical applications to reduce the symptoms of eczema. Certain systemic medications and phototherapy have also been proved successful in the treatment of this condition. Stress reduction and management of diet are equally beneficial in the process of treatment. With the help of these measures and avoidance of scratching of the lesion, eczema can be successfully treated in affected individuals!
If you have eczema, we suggest consulting a dermatologist to get your treatment started. With Remedico, all you have to do is answer a few questions, take some photos with your smartphone, and you’re done. From start to finish in as little as 5 minutes.