Eczema and Dermatitis

Eczema and Dermatitis

Some people know it as eczema. Others know it as dermatitis, the newer classification for any of several different types of skin inflammation. But anyone who's ever had these bothersome skin rashes--characterized by red, oozing, scaly and itchy patches--has probably referred to them by names that would make a sailor blush.

That's a lot of @$^®&#^®! and even more scratching, since untold tens of millions suffer some form of eczema/dermatitis each year. There are at least five different "groupings" of these skin irritations. The symptoms for each group are a little different, but all have one thing in common--misery.

Get clean--without soaps. "The smartest thing you can do is to use the most gentle cleanser you can find--definitely not regular toilet soaps," advises Nelson Lee Novick, M.D., associate clinical professor of dermatology at Mount Sinai School of Medicine in New York City. "They clean just as well and are much less irritating to the skin. You'll find them in your drugstore labeled as cleansing 'bars' or 'cakes,' or you can go with a liquid cleanser that's labeled as 'non-irritating,' such as Moisturel sensitive skin cleanser."

The same goes for shampoos: "Use baby shampoo or other mild types," suggests Dr. Novick.

Heal with oatmeal. "Oatmeal baths made from powders such as Aveeno provide effective but temporary relief from the itching of eczema and dermatitis," says Stephen M, Purcell, D.O., chairman of the Department of Dermatology at Philadelphia College of Osteopathic Medicine and assistant clinical professor at Hahnemann University School of Medicine in Philadelphia.

Relieve the itch with ice. "An ice pack made by putting ice cubes in a plastic bag and placing it on the itchy area makes an inexpensive and effective itch fighter," adds Michael Ramsey, M.D., clinical instructor of dermatology at Baylor College of Medicine in Houston. Make sure that the ice pack is wrapped in a towel.

And milk is "udderly" effective. For weeping eczema, which "oozes," a compress of cold milk is another way to soothe itchy skin, suggests John F. Romano, M.D., a dermatologist and clinical assistant professor of medicine at The New York Hospital-Cornell Medical Center in New York City. Pour some cold milk onto a gauze pad or thin piece of cotton and apply it to the skin for about three minutes. Resoak the cloth and reapply at least two more times for three-minute soaks. Repeat several times a day, but make sure to rinse your skin in cool water after each application, because the milk will smell.

Avoid most antiperspirants. The active "drying" ingredients found in most antiperspirants-aluminum chloride, aluminum sulfate and zirconium chlorohydrates-are too irritating to those with dry, sensitive skin, cautions Howard Donsky, M.D., associate professor of medicine at the University of Toronto and author of Beauty Is Skin Deep. "I recommend that people use an antiseptic soap such as Dial or Zest. Also, Tom's of Maine natural deodorant is a very gentle product."

But stay dry and odor-free. Baking soda is an excellent alternative to commercially sold antiperspirants, adds Dr. Novick. Besides being less expensive, it absorbs excess moisture without irritating dry or sensitive skin.

Keep nails short and clean. Short nails are less effective at scratching--and you don't want to scratch. "Not only will scratching aggravate your skin, but it can break and damage it, contributing to secondary bacterial infections," says Jerome Z. Litt, M.D., assistant clinical professor of dermatology at Case Western Reserve University School of Medicine in Cleveland. Clean, short nails are less likely to irritate or cause infection in case you do scratch.

Sit on your hands. In Sweden, where the cold winter air makes skin incredibly dry, researchers have been very successful in teaching eczema patients "antiscratching therapy." In the first of two sessions, patients were taught to press firmly on the itchy area for one minute whenever they had an urge to scratch--and then immediately move their hands to their thighs or to an object. In the second session, patients avoided the itchy area entirely--instead moving their hands directly to their thighs or an object. After four weeks, patients given this therapy and a hydrocortisone cream had twice the improvement, compared with those given only the cream.

Humidify your surroundings. As with winter itch or any form of dry skin, "anything you can do to add moisture to the air is going to help," explains Dr. Novick. "I recommend either buying a cold-air humidifier or placing shallow pans of water near radiators and on wood stoves to add humidity."

Keep showers extra short. "Your showers should last about three minutes-and no longer than five minutes," adds Dr. Novick. "The only baths you should take are oatmeal baths, because baths encourage you to stay in the tub longer--and water adds to your dryness. Hot water is especially drying, so keep the water as cool as possible."

And use only your fingertips to wash--not washcloths or sponges--and then pat yourself dry.

Don't forget your emollients. Those containing urea or lactic acid are best for relieving itching, says Hillard H. Pearlstein, M.D., assistant clinical professor of dermatology at Mount Sinai School of Medicine. Carmol 10, Carmol 20 and Ultra Mide 25 contain urea, and Lac-Hydrin Five contains lactic acid.

Wash once, rinse twice. Laundry detergents are another no-no, because these powerful soaps are especially irritating, adds Dr. Purcell. "It's wise to double-rinse your laundry to make sure the detergent rinses out and won't come in contact with your skin."

Don't use dryer sheets. "Some of the chemicals in fabric-softening dryer sheets remain on the skin and can be irritating to people with eczema," says Rodney Basler, M.D., a dermatologist and assistant professor of internal medicine at the University of Nebraska Medical Center in Omaha. "However, fabric softeners you add to the washing machine don't seem to irritate."

Don't be a fool if you use a pool. "If you do a lot of swimming in chlorine-filled pools, you have to take even more precautions," according to Dr. Novick. "Immediately after leaving the pool, rinse off your body in cool water and apply a moisturizer."

Buy American when it comes to cosmetics. The general rule is, avoid cosmetics if you're bothered by eczema or dermatitis. But if you must wear them, buy American. That's because some cosmetics made in Japan, Italy, France and other foreign countries contain formaldehyde, which can cause allergic dermatitis in many people, says Mary Ellen Brademas, M.D., chief of dermatology at St. Vincent's Hospital and assistant clinical professor of dermatology at New York University Medical Center, both in New York City.

Relax. "Stress is a definite contributing factor in eczema as well as other skin conditions," says Dr. Basler. "If you are feeling stressed out or are particularly worried about something, it will only aggravate your condition."