Types of Eczema and Things that May Help- Larisa Lehmer,M.D.

Eczema

• Eczema is a generic term for a group of medical conditions that cause the skin to become inflamed, irritated, and/or itchy.
• There are two major types of eczema: contact dermatitis (allergic and irritant) and atopic dermatitis. Allergic contact dermatitis occurs when the skin becomes sensitized to a specific agent, known as an allergen. Irritant contact dermatitis occurs when the skin is repeatedly exposed to an irritant, such as a soap, detergent, or solvent. Atopic dermatitis is the most common type of eczema, and many people use these terms interchangeably.
• Eczema can have many causes, including allergic reactions, friction, prolonged exposure to heat and moisture, or contact with irritants, such as harsh chemicals. A board-certified dermatologist can help determine what’s causing your eczema and recommend an appropriate treatment.

Allergic contact dermatitis

• An itchy, sometimes blistering rash typically appears within a few days of contact with an allergen.
• Most common causes in the United States: Poison ivy, poison oak and poison sumac. 
• Other common causes of allergic contact dermatitis include metals (such as nickel), rubber, dyes, cosmetics, preservatives, and fragrances.
• Patch testing can be performed to determine what compounds the skin is sensitive to.

Irritant contact dermatitis

• Cause: repeated contact with irritating substances such as water, soap, acid, or bleach.
• Irritating compounds break down the skin’s barrier resulting in a painful or itchy rash.
• 90-95% of all cases of work-related skin disorders are due to irritant contact dermatitis [1].
• Avoiding the causative irritant is the mainstay of therapy; however, for more severe cases, a board-certified dermatologist may prescribe further treatment.

Atopic dermatitis

Atopic dermatitis is characterized by patches of dry, red skin that may have scales and/or crust. It is often intensely itchy.

• Cause: A combination of genes, immune and environmental factors [2].
• Common areas involved: face, neck, hands and the insides of the elbows, knees and ankles.
• Nearly 1 in 10 Americans are affected including 20% of those < 18years old [3].
• While atopic dermatitis can develop at any age, over half of individuals are diagnosed by age 1, and 90% by age 5 [4-5]
• Presently there is no cure, but most cases can be controlled with proper treatment. Flares can be avoided by supporting the skin by keeping it clean and moisturized to reduce risk for infection and irritation. Effective treatment often includes medication, skin care, and trigger avoidance.

Bathe with luke-warm water using fragrance free wash for sensitive skin (Dove for Sensitive Skin Bar – moisturizing, great for hands too, CLn Body Wash – gently antibacterial, Avene Cleansing Oil – anti-itch).

Apply fragrance-free, hypoallergenic moisturizer to damp skin immediately after bathing to lock-in hydration. (Examples: Avene Xera Calm, Vanicream, CeraVe, Cetaphil).

Use a fragrance-free wash for laundry and avoid the use of fabric softeners/dryer sheets. 

Avoid products with fragrances that can worsen irritation and itch. 

Wear gloves when washing dishes to prevent irritation from harsh detergents and water.

Drink plenty of water (64 oz, or 8 cups per day) to hydrate from within.

Avoid caffeine since it dehydrates the skin. 

Eat 2-3 tsp ground flaxseed daily. 

Get 7-8 hours of sleep a night.

Reduce stress focus on mental wellbeing [6].

See a dermatologist to discuss further tests or treatments available to help optimize your skin!