Helping Your Child Feel Better
If your child has eczema, keep their fingernails short and their skin moisturized. Dress them in loose-fitting clothes and make sure they don’t get overheated. Depending on how severe their eczema is, your doctor may recommend wet wraps, a diluted bleach bath, over-the-counter or prescription medications, and/or light therapy to help.
Trigger : Exposure To Allergens Or Irritants
Hand eczema is often caused or worsened by exposure to a substance thats irritating think alcohol, bleach, cleansers or solvents or one that causes an allergic reaction, such as perfume or certain plants. Florists often get dermatitis on their thumb and forefinger when clipping chrysanthemums and tulips . In the kitchen, vegetables particularly garlic and onion can lead to a flare-up, especially on the fingertips. Even fabric can exacerbate hand eczema. Rough, coarse materials such as wool and stiff synthetics such as polyester can trigger an itch-scratch cycle that worsens the condition.
How to dodge it: Pay attention to what sets off your eczema. Whether youre at home or on the job, learn what irritates your skin and avoid or limit contact with those things, advised Dr. OBrien. Use a washing machine, dishwasher, and food processor when possible and ask other family members for help with housework, cooking and gardening to give your hands a break. Protect your hands from irritants and allergens by wearing vinyl or cotton gloves while you do chores. Wear heavy-duty vinyl or neoprene gloves at work if youre exposed to triggers there. If the gloves you have irritate your skin, ask your dermatologist for recommendations.
How Is Eczema Treated What Medications Are Used
Treating eczema can be difficult if the cause is something you cant control, like genetics. Fortunately, you may have some influence over your environment and stress levels. Do your best to figure out what triggers or worsens your eczema, and then avoid it. The goal is to reduce itching and discomfort and prevent infection and additional flare-ups.
Consider these treatment tips:
If your child has skin problems, such as eczema, you can:
- Avoid long, hot baths, which can dry the skin. Use lukewarm water instead and give your child sponge baths.
- Apply lotion immediately after bathing while the skin is still moist. This will help trap moisture in the skin.
- Keep the room temperature as regular as possible. Changes in room temperature and humidity can dry the skin.
- Keep your child dressed in cotton. Wool, silk and manmade fabrics such as polyester can irritate the skin.
- Use mild laundry soap and make sure that clothes are well rinsed.
- Watch for skin infections. Contact your healthcare provider if you notice an infection.
- Help them avoid rubbing or scratching the rash.
- Use moisturizers several times daily. In infants with eczema, moisturizing on a regular basis is extremely helpful.
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General Tips For Coping With Eczema
Other tips to manage your eczema include:
- Keep your fingernails short longer nails are more likely to injure your skin when you scratch.
- If the water in your area is hard or alkaline, consider installing a water-softening device.
- Swim in the sea in warm weather whenever you can seawater is known to reduce the symptoms of eczema.
- Use sun exposure for limited periods for example, when swimming at the beach. This can help relieve eczema symptoms. But be aware that ultraviolet radiation is a risk factor for skin cancer and premature ageing of the skin. Also, if sun exposure causes overheating, this can also aggravate eczema.
Eczema Coping Tips Avoid Changes In Temperature
Abrupt temperature and humidity changes can sometimes irritate the skin for example, going in and out of air-conditioned buildings on hot days or heated buildings on cold days.Hard physical activity or exercise that makes you sweat heavily can also trigger the itch of eczema.Suggestions include:
- In winter, dont overheat your house. Dress warmly when going outdoors and remove the extra layers as soon as you return.
- In summer, dont over cool your house. Air conditioners can dry out the air and irritate your skin.
- Avoid hard physical activity in hot weather. For example, do your gardening first thing in the morning, or in the evening when the sun is lower in the sky.
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What Questions Might My Healthcare Provider Ask To Diagnose Eczema
The conversation with your healthcare provider will need to cover a lot of information. Be sure to be specific about your symptoms.
- Where is your eczema located?
- What have you used to try to treat your eczema?
- What medical conditions do you have? Allergies? Asthma?
- Is there a history of eczema in your family?
- How long have you had symptoms of eczema?
- Do you take hot showers?
- Is there anything that makes your symptoms worse?
- Have you noticed that something triggers or worsens your eczema? Soaps? Detergents? Cigarette smoke?
- Is there so much itchiness that you have trouble sleeping? Working? Living your normal life?
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What Questions Should I Ask My Healthcare Provider About Eczema
- How can you tell that I have eczema?
- If I dont have eczema, what other skin condition might I have?
- Is there a specific brand of moisturizer that you recommend?
- Is there a prescription cream that you can prescribe?
- How often should I see a dermatologist regarding my eczema?
- What soaps, lotions, makeup, etc. should I avoid?
- What medications do you recommend?
- What at-home treatments do you recommend?
A note from Cleveland Clinic
Eczema is very normal, very common, and very, very uncomfortable. It can affect your quality of life. At its worse it can keep you from sleeping, distract you and make you feel self-conscious in public. See your dermatologist or other healthcare provider as soon as you start to see signs of it. Explore at-home remedies and prescribed treatments.
Youre not alone! 15% to 20% of people experience eczema or another type of dermatitis at some point in their lives.
What Else Is Happening At Johns Hopkins Today
We go out of our way to provide the comprehensive care our patients with eczema need. On a case-by-case basis, we communicate with one another whether in allergy, dermatology, psychology or infectious disease to put together the best course of treatment for each child.We are optimistic that future therapies and approaches to care for those with even severe eczema are going to be greatly improved with more research and that the creation of the Eczema Day Treatment Unit will help us conduct cutting edge research and answer questions we face every day seeing and treating patients.
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What Causes Hand Dermatitis
Hand dermatitis often results from a combination of causes, including:
- Genetic and unknown factors
- Immune reactions .
Hand dermatitis is frequently caused or aggravated by work when it is known as occupational dermatitis.
Irritants include water, detergents, solvents, acids, alkalis, cold, heat and friction. These can damage the outer stratum corneum, removing lipids and disturbing the skins barrier function. Water loss and inflammation lead to further impairment of barrier function.
In atopic dermatitis, a deficiency in or defective function of the filaggrin protein in the stratum corneum leads to barrier dysfunction resulting in water loss and easy penetration by irritants and allergens .
Contact allergy is a delayed hypersensitivity reaction with elicitation and memory phases involving T lymphocytes and release of cytokines .
Nummular Eczema Vs Ringworm
As they progress, nummular eczema lesions can resemble another condition caused by the ringworm fungus.
Ringworm also tends to present itchy bumps that turn into round, itchy, and scaly patches with a clear center. They may look red or pink on lighter skin, or brown and gray on darker skin. Both types of lesions will be very itchy. Ringworm lesions tend to heal from the center first.
A dermatologist is a specialist trained in knowing the difference between these two conditions, and other conditions, like psoriasis, that have similar presentations.
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Eczema Coping Tips Diet
In most cases, eczema isnt caused or made worse by diet. If you notice that your eczema seems to get worse after eating a particular food, you may be an exception to this. See your doctor or dietitian for proper allergy testing and dietary advice.Never self-diagnose or you risk depriving yourself of enjoyable and nutritious foods for no good reason. Unnecessarily avoiding certain foods can lead to nutritional deficiencies.
How Is Asteatotic Eczema Treated
Like many other types of eczema, asteatotic eczema is treated with topical and oral medications and lifestyle changes.
Generally, treatment for eczema begins with daily use of moisturizers and other emollient-containing products. This helps restore moisture to your skin barrier and reduce inflammation and other symptoms.
Medicated ointments and creams can also help speed up recovery during a flare-up. Topical treatment options for asteatotic eczema may include:
- Corticosteroids. Topical steroids are often the first treatment prescribed for atopic dermatitis.
- Calcineurin inhibitors. Calcineurin inhibitors help reduce inflammation and are often prescribed with corticosteroids. Pimecrolimus and tacrolimus are two commonly prescribed calcineurin inhibitors.
- Lipids. Lipids play an important role in maintaining the protective barrier of the skin. One found that topical application of two endogenous lipids, N-palmitoylethanolamine and N-acetylethanolamine , greatly improved skin function and hydration.
In some cases, oral antihistamines can help prevent the itching associated with an asteatotic eczema flare-up.
For more severe asteatotic eczema, stronger medications may be prescribed, such as oral steroids or other anti-inflammatory medications. However, these are prescribed only in rare cases for asteatotic eczema.
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Guidelines For People With Atopy
What is atopy?
Atopy refers to having a personal or family history of eczema, asthma or hay-fever.
Atopy and dermatitis
Having a history of these conditions as a baby or in childhood, even when they have gone away, increases the risk of developing work-related dermatitis, particularly affecting the hands. In fact, those who have had eczema at any age anywhere on the skin are four times more likely to develop work-related dermatitis. A history of eczema affecting the hands but not elsewhere especially increases an individuals susceptibility to develop occupational contact dermatitis.
People with atopy are more likely to have problems with their skin being able to repair itself therefore the barrier function is often compromised, allowing greater opportunity for the development of irritation and allergy.
Work and atopy
People with a history of atopy, and that work in certain industries are at higher risk of developing skin problems at work. These include those working in:
- Mechanical and metal working
If you have an atopic background, you should minimise contact with skin irritants which are known to cause dermatitis, right from the beginning of your employment. These include:
- Wet work including frequent hand washing
- Soaps and detergents
- Heat and sweating
- Dusts and fibre
- Solvents and thinners
Wearing cotton gloves under occlusive gloves can reduce sweating.
People at very high risk
Ultraviolet Radiation Therapy For Eczema
Exposure to ultraviolet radiation can help reduce the symptoms of chronic eczema. Exposure under medical supervision can be carefully monitored with the use of specially designed cabinets the person stands naked in the cabinet and fluorescent tubes emit ultraviolet radiation.A person with stubborn eczema may need up to 30 sessions. The risks of unsupervised ultraviolet radiation therapy can be the same as for sunbathing faster ageing of the skin and greater risk of skin cancer.
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Other Causes For Hand Dermatitis:
Latex or non-sterile gloves are essential in the hospital or clinical settings. They are used to protect healthcare workers and their patients from germs, chemicals, and other dangerous substances.
In the same study published in the British Journal of Dermatology, 54% of the responders stated that they use non-sterile gloves for longer than two hours each day.
Unfortunately, there are individuals with true allergy to latex, rubber additives, preservatives or color dyes in the gloves. Wearing gloves every day can trigger an allergic reaction and bring on a hand eczema flare for these individuals.
Wearing gloves for a prolonged period can also trigger hand dermatitis in individuals who do not have a true allergy.
How can this happen?
When your skin has intact skin barrier and a healthy level of lipids, you can prevent limit the level of the latex, allergens or irritants passing beyond the stratum corneum layer of the skin. So the exposure level to these irritants is very low, and do not trigger any inflammation. However, after excessive and frequent hand washings, the skin barriers are weakened and breached. Now your skin is open and exposed, which allow a higher level of irritants penetrate and reach the inner layer of the skin. This can trigger an inflammation and lead to a flare of hand dermatitis.
What we just described is two-part phenomenon allergy vs. irritant. This is a subtle but important point in the management of hand dermatitis.
When To Connect With Your Doctor
If your symptoms don’t improve or you keep getting frequent flare-ups despite trying the above treatments for eczema, Fishman recommends reaching out to a dermatologist or your regular doctor.
Some signs that you should connect with a doctor as soon as possible are:
- Pain and discomfort that affects daily activities and sleep
Not only can a doctor help to identify allergens and irritants through skin and blood tests, but they can also prescribe medication, including:
- Topical steroids that are stronger than over-the-counter hydrocortisone.
- Topical calcineurin inhibitors, such as tacrolimus and pimecrolimus . These nonsteroidal medications prevent some immune cells from activating and triggering eczema symptoms.
- Oral steroids and steroid injections may be prescribed for particularly severe or resistant cases.
“For some resistant cases, other interventions, like light therapy, may be considered,” says Ilyas.
, also known as light therapy, is an FDA-approved intervention that exposes your skin to ultraviolet light. UV light exposure can suppress the inflammatory responses that trigger eczema and reduce your risk of infection.
Light therapy typically involves:
- Four weeks to three months of treatment
- An appointment at a dermatology practice, hospital, or doctor’s office.
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Tips To Prevent Hand Eczema
Now you know about the causes. What can you do to prevent it? Here are some helpful tips to prevent hand dermatitis.
1. Reduce the frequency and exposure to water. This is perhaps the easiest but difficult task for healthcare providers. As stated above, frequent and excessive washing is the leading cause of hand dermatitis. Obviously, if you can reduce the length and frequency of hand exposure to water, you can prevent the severity and the frequency of hand dermatitis.
You may not be able to reduce the frequency of hand washing at work, but you can limit the duration of each hand washing.
Also, you can reduce exposure to water at home. For example, use a dishwasher to wash dishes. Reduce the frequency and time you spent in the shower. Ask your family members to wash the fruits and vegetables.
2. Do not use hot water. Only wash hands with warm or lukewarm water. Hot water can really strip away the natural lipids and break down the skin barrier.
3. Wash hands with hand disinfectants, instead of water and soap. In the same study published in British Journal of Dermatology, use of hand disinfectant was not associated with self-reported hand eczema.
However, it is important to remember that nearly all hand disinfectants are made of alcohol. They can also dry up your hands quickly. So use less per application.
5. Carry a bottle of moisturizers in your pocket and apply it immediately after each hand washing. Apply ample amount of lotions, creams or ointment to both hands.
What Causes Eczema To Wax To Flare
Different “triggers” can make eczema worse. For infants, these can be irritants such as wool, certain detergents or extreme temperatures, or other immune triggers, such as food allergies and asthma, and even pet dander.
Most kids with the condition have the hardest time in winter, when the air is cold and dry. A small percentage has a harder time in the summer, when it is hot and humid.
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Are There Things You Can Do At Home To Feel Better
Here are some home remedies that may help reduce the symptoms and severity of an asteatotic eczema flare-up at home:
- Oatmeal. Colloidal oatmeal is beneficial for a variety of skin conditions, including xerosis and atopic dermatitis. It can be used in the bath to create a soothing mixture for inflamed skin.
- Plant oils. One 2012 study found that sunflower oil can help improve the stratum corneum or outermost layer of your skin. Similar benefits have been observed with coconut oil, which has a host of positive benefits for people with eczema.
- Botanicals. Herbal preparations and essential oils have been used for thousands of years as alternative medicine. Some people report that certain essential oils, such as tea tree and calendula, may help reduce the symptoms of severe eczema. However, herbal preparations and essential oils can be common causes of allergic contact dermatitis. Always speak with your doctor or healthcare professional before using them.
Reach out to a healthcare professional or dermatologist for more suggestions on easing your asteatotic eczema symptoms at home.