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Eczema (cont.)

What Is the Treatment for Early and Mild Eczema?

Treatment for eczema can be managed at home by changing laundry detergents or soaps that may be causing the irritant. Avoid tight-fitting or rough clothing. Avoid scratching the affected area. Medical treatment include prescription anti-inflammatory medications, and steroid creams. Antibiotics may have to be prescribed to clear the affected irritation. Anti-itch creams, especially those containing hydrocortisone, may be helpful, but many experts recommend avoiding topical diphenhydramine and topical anesthetics because of concern of becoming sensitized and developing a secondary allergic contact dermatitis in reaction to these medications. Anti-itch creams containing pramoxine and menthol may be safer in this regard.

Are There Home Remedies for Eczema?

Removing exacerbating factors is a good place to start. This may be as simple as changing the laundry detergent to one that is fragrance free or as difficult as moving to a new climate or changing jobs.

Long baths in soapy water or long hot showers may worsen eczema. On the other hand, soaking in warm, non-soapy water followed immediately by moisturizers to "seal in the moisture" is helpful. Prevent dry skin by taking short lukewarm showers or baths. Use a mild soap or body cleanser. Short contact of the skin with a shampoo is generally not a problem, but prolonged contact may worsen the rash on the neck and face. Prior to drying off, apply an effective emollient to wet skin. Emollients are substances that inhibit the evaporation of water. Generally, they are available in jars and have a "stiff" consistency. They do not flow and ought to leave a shine with a slightly greasy feel on the skin. Most good emollients contain petroleum jelly although certain solid vegetable shortenings do a more than creditable job. The thicker, the better, although patient preference is usually toward thinner lotions because of ease of application and avoidance of a greasy feel. Oatmeal baths (Aveeno and others) may be soothing to itchy, fissured skin although best outcomes will still result from applying moisturizers after rinsing off.

A patient with longstanding eczema may become sensitized to the products they are putting on the skin and develop allergic contact dermatitis that may be identical in clinical appearance. Skin allergy may develop to over-the-counter (OTC) products such as topical anesthetics, topical diphenhydramine (Benadryl), lanolin (an ingredient in Eucerin and other common moisturizers), coconut oil, and tea tree oil or even prescription medications such as topical steroid creams.

Avoid wearing tight-fitting, rough, or scratchy clothing.

Avoid scratching the rash. If it's not possible to stop scratching, cover the area with a dressing. Wear gloves at night to minimize skin damage from scratching.

Anything that causes sweating can irritate the rash. Avoid strenuous exercise during a flare.

An anti-inflammatory topical cream may be necessary to control a flare of atopic dermatitis.

  • Apply a nonprescription steroid cream (1% hydrocortisone). The cream must be applied two to four times a day without skipping days until the rash is gone.
  • Diphenhydramine (Benadryl) in pill form may be taken for the itching. Caution: This medication may make people too drowsy to drive a car or operate machinery safely. The topical form may sensitize people and cause allergic contact dermatitis.
  • Clean the area with a hypoallergenic soap as necessary. Most antibacterial soaps are too irritating for eczema patients. Apply an emollient over the topical steroid.
  • Calamine lotion may also be soothing to the itch but will tend to dry out the skin. For this reason, it may be more useful in the management of an acute flare-up of the condition rather than a good long-term therapy.

Avoid physical and mental stress. Eating right, light activity, and adequate sleep will help someone stay healthy, which can help prevent flares.

A variety of home remedies such as apple cider vinegar and tea tree oil are frequently touted as cures for eczema, but there is little or no scientific basis for these claims. Bleach baths, on the other hand, may help. The goal of bleach baths is to suppress colonization by Staphylococcus aureus bacteria with the resulting flare that may cause. Several formulas exist, but a ½ cup of bleach for a full bathtub full of water (or ¼ cup for a half bath) is a good balance between getting the desired effect and generating an irritant dermatitis. A summer substitution for bleach baths would be regular use of overchlorinated community swimming pools.

Do not expect a quick response. Atopic dermatitis is controllable but consistency in application of treatment products is necessary.

Medically Reviewed by a Doctor on 6/7/2016
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Read What Your Physician is Reading on Medscape

Dyshidrotic Eczema »

Dyshidrotic eczema is a recurrent or chronic relapsing form of vesicular palmoplantar dermatitis of unknown etiology.

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