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Eczema

Frequently Asked Questions (FAQs)

 

Has hypnotherapy ever been used to effectively treat Eczema?

Eczema is primarily a disease of the epidermal barrier function, and at the moment still has no cure. Many people respond favorably to topical treatments with prescription corticosteroids and proper skin care, which includes constant hydration with emollient moisturizers. Since the skin is heavily innervated, emotions and stress can exacerbate and trigger eczema symptoms. Mindfulness, relaxation and even hypnotherapy have all been used to successfully help with the treatment of eczema symptoms, especially in controlling the itch-scratch cycle.

 

Can eczema be cured?

There are a variety of different treatments for eczema, but what works best for one person does not necessarily mean it will work best for another. According to Central Dermatology Center's website, treatment can include a mild skin care regimen, topical corticosteroids, topical non-steroidal treatments, antihistamines, antibiotics, oral corticosteroids, and immunosuppressants.

I had my first eczema outbreak when I was 18. My GP thought I had ringworm for 4 years and refused to refer me to a dermatologist (hooray for HMOs - can't see a specialist without a referral from your GP unless you want to pay out of pocket). When he FINALLY agreed to send me to a dermatologist, the dermatologist took one look at me and said, "That's not ringworm." He took a biopsy just in case, but finally diagnosed me with nummular eczema. The creams have never really worked for me, but I've learned that as long as I keep my stress level down, I really don't have many flare-ups.

 

What are alternative treatments for eczema?

As far as I know, only herbal treatment as part of Traditional Chinese Medicine has been scientifically shown to be effective in treating atopic dermatitis, a form of eczema usually seen at the hairline and in the folds of your limbs, under your breasts etc.

As a western trained doctor I have no personal experience with this kind of treatment, but our dermatologists do refer their hard to treat eczema patients to the chinese practitioners of Traditional Chinese Medicine in China town Amsterdam.

 

What are the most effective ways to treat eczema?

There are many different eczematous skin conditions. The most common form of eczema is atopic dermatitis (AD), a chronic, intensely itchy skin condition that is very common in children but may occur at any age. Scratching leads to redness, scaling, crusting, swelling and weeping of the skin. Scratching can also lead to infection as people with AD tend to have more bacteria on their skin. Atopic dermatitis can be localized or wide-spread.

Eczema is a chronic skin condition that has no cure. The most effective way to treat eczema (atopic dermatitis) depends on what form it takes and where it is located. Generally, prevention of eczema outbreaks plays the biggest role in controlling the disease.

Treatments of eczema are divided into several categories:

Personal care

Use lukewarm, not hot water for bathing

Use a mild, soap-free cleanser

Don’t use washcloths, buffpuffs or any other object to scrub the skin

Wear soft, cotton clothing that was washed in a fragrance-free, dye-free mild detergent without chlorine bleach.

Avoid wool clothing as it tends to irritate skin

Moisturize often with a

fragrance-free cream or ointment made for sensitive skin. Avoid

lotions as they tend to dry the skin. Applying a moisturizer

immediately after bathing helps retain moisture in the skin.

Avoid foods that may cause irritation of the skin, like citrus and tomatoes

Reduce exposure to dust and smoke

Medical Treatments

Topical treatments

Topical creams or ointments should be applied shortly after bathing to increase their effectiveness. It is recommended to wait approximately 15 minutes after bathing when applying topical calcineurin inhibitors (see below) to minimize the tingling sensation they may produce on wet skin.

Corticosteroid creams or ointments (choice depends on whether the eczema is dry and crusted or weeping) must be used sparingly if at all on the face. Particular caution must be used around the eyes because steroid creams may increase intraocular pressure leading to glaucoma. Applying steroid creams anywhere in the eye area must be done under the supervision of a physician.

Topical calcineurin inhibitors (tacrolimus ointment and pimecrolimus cream) are non-steroid topical eczema treatments. They work by suppressing the action of lymphocytes (a type of white blood cell that is responsible for eczema eruptions). Lymphocytes are also responsible for detecting and removing sun damaged cells from our skin. Inactivating them can result in accumulating sun damage at a faster rate, therefore strict sun protection and avoidance must be exercised when using these products.

Antihistamines – to reduce itching

Control of infection with antibiotics, anti-viral or anti-fungal medications. Patients with atopic dermatitis are prone to bacterial infections with Staphylococcus aureus (and others) as their skin tends to be more heavily colonized with bacteria. Skin lesions are often intensely itchy. Scratching breaks the skin and allows bacteria to infect the broken areas. Proteins produced by the bacteria further inflame and irritate the affected skin.

People with severe eczema are also prone to widespread viral infections, such as Herpes simplex. Eczema herpeticum (infection with the Herpes simplex virus that spreads over skin with eczema) is more painful than itchy and has small punched out ulcers. That requires immediate medical attention and treatment with antiviral medications.

For severe atopic dermatitis, unresponsive to topical and emollient treatment:

Phototherapy with ultraviolet light

Systemic medications, such as cyclosporine, azathioprine, systemic steroids. Systemic steroids are rarely used to control eczema. They, unfortunately work extremely well in improving eczema, however cannot be used long-term due to severe side effects. And if used short term, eczema tends to flare when steroids are discontinued. All the other factors, such as personal care, topical treatments, antihistamines must be used concurrently.

Biologic therapies are being tested for atopic dermatitis.

 

Is showering good for eczema?

Yes. Showering less frequently is often good for eczema.

Although showering moisturizes the skin, it also strips the oils off your skin. When the moisture evaporates, your skin is left dryer than it was before. Showering too much or using harsh soaps makes eczema worse and worse over time.

The best thing to do is to take a lukewarm bath or shower (hot water removes more needed oils), use only non-soap cleansers, then apply a moisturizer immediately after, while your skin is still damp. This locks the moisture in your skin, preventing evaporation and helps heal dry, eczema skin.

 

Can anyone offer any advice on how I can seek treatment for eczema on my face and lips?

Thanks for requesting my answer. There certainly are other options besides prescription steroid creams.

It sounds like you have atopic dermatitis, since you got it from an early age. Typically, this is seen in families with asthma or allergies.This is a disease of the epidermal barrier, meaning it does not function properly. If you allow skin to dehydrate, the barrier won't be able to prevent bacteria, viruses, chemicals from entering your skin, causing inflammation. The first thing you should do is find out your personal trigger factors. Low humidity means the atmosphere sucks water out of your skin, so you get worse during fall/winters. Do you have food allergies? It may be best to avoid them. Do you get enough Vitamin D? Research shows this helps eczema skin. Other things like harsh soaps, strong skin products can also trigger symptoms. You will need a skin care routine with gentle products that help your barrier repair and protect it from future damage.

Look for clinical colloidal oatmeal- this is a natural ingredient that controls itch and inflammation. Sometimes Borage oil supplements can help, as well as oolong tea. The best thing you can do is keep your skin hydrated and allow it to heal. Steroid use can thin out skin and they can have long-lasting side effects.

 

What are some off-the-shelf drugs that can soothe eczema symptoms?

There are a few good products available over the counter that are helpful with eczema symptoms.

Hydrocortisone cream has to be used carefully and for a short time because it may think the skin and cause stretch marks if used for too long. It also should not be used on the face or in body folds without the supervision of a physician, as these areas are more susceptible to its side effects.

Moisturizers with ceramides, like the CeraVe line of products, help restore the skin barrier and decrease both water loss and penetration of irritants into the skin

Baths with oatmeal powder. Adding 1/4 cup of plain bleach to a full bathtub and stirring well to make sure it's completely mixed in is a must. The combination of soothing oatmeal and the small amount of bleach that decreases numbers of bacteria, usually Staph, that are increased on the skin of people with eczema and contribute to flares. Soaking in warm, not hot, water with this combination for 5-10 minutes daily will help with itching. Make sure to moisturize immediately afterwards.

Do not use antihistamine sprays or creams to calm itching. First they don't help, and second, they may cause an allergic contact dermatitis.

If there is broken skin, weeping, crusting or ulcers, please see your dermatologist immediately. Eczema is often infected by bacteria like Staph aureus, and can even be infected with Herpes simplex (eczema herpeticum). Those infections cannot be treated with over the counter products and must be treated with oral medications.

 

What is the best treatment for eczema?

Eczema can be a life-long problem for some and requires constant attention. In fact, hand eczema affects about 10% of the population and is as diverse in causes as it is in those afflicted. First off it's important to see a dermatologist for a proper diagnosis, who will then provide her with treatment options. Generally speaking, eczema does not need to get so bad that it bleeds. Proper moisturization is key. Just as important is knowing what is triggering the dermatitis. Does the person work with their hands, touching harsh chemicals? This can be as innocent-sounding as soap and water - which can be irritating on their own, especially when used over and over for a long period of time. So avoiding this trigger factor if possible will help skin heal. Vaseline is a good occlusive barrier, but the problem is that it will not let skin breathe on its own, so a better option is a moisturizer rich in essential fatty acids and silicones. Making sure the skin never dries is important in hand eczema, so she must moisturize immediately after washing and reapply often. Also wearing gloves in winter should help. Sweat can actually exacerbate hand eczema, so perhaps a treatment to control excessive sweating will also help. Hope your friend gets the treatment she needs!

 

How can I treat eczema on my arms?

Here are some simple tips to help relieve and prevent eczema you should consider trying and that have helped me to relieve and prevent eczema.

Skincare

Good condition of the skin is essential. The skin condition of people with atopic dermatitis is usually very dry. Dry skin becomes more irritable and itchy. Proper skin care can prevent further aggravations of eczema.

• cold and dry air have a drying effect on the skin. Make sure to “bundle up” to reduce skin exposer to the cold.

• sunlight often has a positive effect on eczema. Beware however that you are not too exposed to sunlight and certainly not to burn. In most cases, the eczema responds well to sunlight, so ultraviolet light therapy (PUVA or UVB) with artificial sunlight may be beneficial .

• Water and soap especially dry out the skin. Do not use to much laundry soap when washing your clothes, and when bathing make surethe water temperature is not too warm. The warmer the water, the more drying effect it has on the skin. Also detergents' without soap that is pH-neutral (pH 5) or is a hypoallergenic natural product, can cause allergies. Bath oils are a good substitute for soap. A suitable bath oil will not irritate the skin and provides an oil film on the skin. Nowadays there are also special oils for the shower (shower oil). Rub the skin after using bath or shower oil with your hands and not a towel as the oil will disappear in the towel. Pat lightly with towel to remove excess oil.

• After washing, it is wise to lubricate the skin with a suitable ointment. It must be a neutral, soothing ointment usually based on Vaseline / paraffin or zinc oxide.

i hope this was informative enough for you and these tips help you like they helped me. i have one more personally recomended tip for you, this has helped me to where i have been totally preventing anymore dry skin and eczema out breaks.