How Is Eczema Diagnosed What Tests Are Done
Your healthcare provider will take a close look at your skin. They will look for classic signs of eczema such as a redness and dryness. They will ask about the symptoms youre experiencing.
Usually your healthcare provider will be able to diagnose eczema based on examining your skin. However, when there is doubt, they may perform the following tests:
- An allergy skin test.
- Blood tests to check for causes of the rash that might be unrelated to dermatitis.
- A skin biopsy to distinguish one type of dermatitis from another.
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How Do Dermatologists Treat Dyshidrotic Eczema
Your dermatologist will create a treatment plan for you to follow at home. This treatment plan will be tailored to your individual needs and may include the following:
Soaks and cool compresses: Medicated soaks and cool compresses can be very effective for drying blisters. You will apply these two to four times a day for 15 minutes at a time.
Corticosteroid that you apply to your skin: After each soak or cool compress, youll likely need to apply a medicated cream or ointment, such as a prescription corticosteroid. This helps to reduce the inflammation and clear the blisters.
Anti-itch medicine: An antihistamine pill or other anti-itch medicine can reduce your discomfort. Anything you can do to reduce scratching is helpful because scratching tends to worsen dyshidrotic eczema. One anti-itch medication that dermatologists frequently include in a treatment plan is pramoxine . Available as a cream or lotion, this medication helps to relieve itch and pain.
Moisturizer or a barrier repair cream: Dyshidrotic eczema can make your skin extremely dry. To reduce dryness and decrease flare-ups, your dermatologist will recommend a moisturizer or barrier repair cream.
Be sure to use the moisturizer or barrier repair cream that your dermatologist recommends
You want to apply it when your skin is still damp after every:
Emollients For Treating Eczema
Emollient creams add moisture to the skin. Apply moisturisers each day to clean, dry skin. It is especially important to moisturise after showering and bathing, and when living or working in an air-conditioned or heated environment. You may need to try several different brands until you find the emollient that works best for you. Ask your doctor, dermatologist or pharmacist for advice.
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Moisturization In Atopic Dermatitis
Depending on the climate, patients usually benefit from 5-minute, lukewarm baths followed by the application of a moisturizer such as white petrolatum. Frequent baths with the addition of emulsifying oils for 5-10 minutes hydrate the skin. The oil keeps the water on the skin and prevents evaporation to the outside environment. In infants, 3 times a day is not a great burden in adults, once or twice a day is usually all that can be achieved. Leave the body wet after bathing.
Advise patients to apply an emollient such as petrolatum or Aquaphor all over the body while wet, to seal in moisture and allow water to be absorbed through the stratum corneum. The ointment spreads well on wet skin. The active ingredient should be applied before the emollient. Newer emollients such as Atopiclair and Mimyx have been advocated as having superior results, but they are expensive and need further evaluation.
Are There Medical Treatments And Medications For Eczema
Once a health care professional is sure someone has atopic dermatitis, the mainstays of therapy are anti-inflammatory medications and relief from the itching.
Prescription-strength steroid cream and antihistamine medications are the usual treatments. The topical calcineurin inhibitor pimecrolimus cream treats mild to moderate eczema and tacrolimus ointment treats moderate to severe eczema. An injectable biologic called dupilumab treats severe cases of eczema that haven’t responded to other treatments.
If a health care professional determines that someone has a secondary bacterial infection complicating their rash, an oral antibiotic may be prescribed.
For severe cases not responding to high-potency steroid cream, alternate treatments may be tried. These include coal tar, ultraviolet light exposure, and systemic anti-inflammatory agents.
Allergy shots usually do not work in eczema.
A variety of diets have been proposed for eczema relief. These may be structured on the results of allergy testing or may be chosen for their content of foods that tend not to provoke allergic responses. Not everyone put on restrictive eczema diets improves, and many patients with severe eczema show no testing evidence of food allergies. For that reason, a change in diet, if desired, should be considered as an additional step in treatment rather than a primary one, and if patients notice they itch more when eating any identified food or drink, it would be best if they avoid it.
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Courtesy of Wild Naturals
Contains manuka honey for moisturizing and soothing properties
pH balanced at 5.5 to support skin’s natural barrier function
Not endorsed by the National Eczema Society
While some dermatologists will only recommend products formulated with well-studied ingredients, some people with eczema want an all-natural option to relieve some of their symptoms, such as dry skin and redness. Wild Naturals Eczema & Psoriasis is not endorsed by the National Eczema Association, but it does contain manuka honey, which studies have found to have antibacterial benefits. It also contains aloe vera, which can help soothe irritated skin.
This moisturizing cream has a lightweight, non-greasy texture, and users report that they only need a little product to target affected areas.
Price at time of publish: $22
Active Ingredients: Aloe vera, manuka honey | Scent: Fragrance-free, but users report a slight scent of honey | Usage: Patch test on skin before applying to all affected areas or as recommended by doctor
Systemic And Ultraviolet Phototherapy
For patients with conditions that are refractory to treatment with topical agents or who have severe widespread atopic dermatitis, options such as ultraviolet phototherapy and systemic immunomodulatory agents can be prescribed under the guidance of a dermatologist.12,25 Rarely, short-term oral courses or intramuscular injections of corticosteroids can be used to treat severe atopic dermatitis flare-ups.13
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What Types Of Moisturizers Are Used To Treat Eczema
When considering a moisturizer, the first thing to look for is how much oil it contains. The more oil in a moisturizer, the better it is for treating eczema. If your skin feels greasy or sticky after applying a moisturizer, that means the product likely contains plenty of oil.
Look for products that do not contain added ingredients such as fragrances, dyes or alcohols that can irritate the skin.
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Vanicream Moisturizing Skin Cream $14 Original Price: $16
As one of Dr. Chans favorites for those with allergies especially, Vanicreams Moisturizing Cream comes in an easy-to-use pump, is fragrance-free and is non-comedogenic, so it wont clog your pores.
The lotion formulation makes this product cosmetically elegant for the face, while still being effective to minimize eczema flares, Dr. Mack said.
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Gentle Soaps And Detergents
Laundry detergent can contain harsh chemicals that aggravate eczema.
Many body washes and cleansers contain detergents, which help provide a soapy lather. Detergents and other lathering agents can dry out the skin, especially in people with eczema.
Bar soaps can also be harsh on the skin because of their alkalinity.
Try using a gentle, no-lather, fragrance-free cleanser. Avoid products with rough particles for scrubbing or exfoliating, as these can further irritate the skin.
Many people with eczema also find that switching to a more gentle, fragrance- or color-free laundry detergent can help improve symptoms.
Additionally, try skipping fabric softener, which lingers on clothes and often contains fragrances and chemicals that can irritate the skin.
Sitting next to a fireplace or near a furnace may feel good, but it can worsen eczema symptoms. The hot, dry air can dehydrate the skin and aggravate the itchiness of eczema.
Use a humidifier during the dry winter months and avoid getting too close to heaters and fireplaces.
Consult With A Dermatologist
Doctors can help patients deal with chronic eczema via a number of prescription medications and over-the-counter effective treatments. These include:
- Topical corticosteroids. Over-the-counter and prescription topical corticosteroids are available but a dermatologist will be better able to recommend what you may need for your specific situation. Hydrocortisone is one such example of a lotion-based steroidal cream that can improve eczema conditions quickly and effectively.
- Systemic corticosteroids. If the topical application of steroidal creams fails to heal the affected skin, a dermatologist may prescribe oral tablets. These drugs can affect the immune system and cause a host of additional symptoms and should be closely monitored by a medical professional.
- Antihistamines. Various allergy medications can reduce the feelings of itchiness and stave off unknown night-time itching. Antihistamines block histamines which can cause the reaction of itchiness and redness. Pairing an antihistamine with supple moisturizers can help eczema sufferers wake up without itchy, red skin.
- Antibiotics. If a bacterial infection forms as the result of an open wound, your doctor may prescribe an antibiotic to prevent further infection.
- Antifungal prescriptions. Sometimes, eczema can be prompted by a fungus living on the skin. To eliminate this fungus, a prescription antifungal can be effective.
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Enter one of Cetaphils newest launches and one Dr. Libby is excited about. Making the sensitive skin line complete, this fragrance-free, hypoallergenic healing ointment is lanolin-free and is formulated with 71.5% petrolatum, shea butter, and vitamin E to protect and heal dry, irritated without leaving behind a greasy residue, she explains.
Oh, and Dr. Libby labels it her new favorite petrolatum ointment, too.
When To Seek Professional Help
Eczema that continues to worsen over time and does not improve with usual treatment like steroid medication can be an indicator of a bacterial or viral infection, especially when accompanied by pain, warmth, swelling, increased redness, blisters, and pus.
If any of these signs and symptoms are present, see your doctor immediately to determine if you have an infection. Early diagnosis and treatment are crucial to prevent serious complications.
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What Ingredients Are Best To Help Treat Eczema
Eczema is a clinical dysfunction of the skin barrier, Dr. Libby notes. As such, genetic, environmental, and immunologic factors contribute to its flare-up, but its a priority to repair the skin barrier. Namely, ingredients to help reverse eczematic effects are humectants, emollients and occlusive moisturizers.
According to Dr. Libby, humectants help add moisture back to the skin, while emollients add back oils, lubricating and softening the skin. Occlusive moisturizers work to prevent transepidermal water loss .
Common humectants are glycerin, lactic acid, urea and hyaluronic acid, Dr. Libby adds. Emollients examples are glycol and glyceryl stearate, soy sterols, squalane, and oils like jojoba, sweet almond, etc. Common occlusives are petrolatum, dimethicone, shea butter and mineral oil.
How Can Parents Help
Help prevent or treat eczema by keeping your child’s skin from getting dry or itchy and avoiding triggers that cause flare-ups. Try these suggestions:
- Kids should take short baths or showers in warm water. Use mild unscented soaps or non-soap cleansers and pat the skin dry before putting on cream or ointment. Teens should use unscented makeup and oil-free facial moisturizers.
- Ask your doctor if it’s OK to use oatmeal soaking products in the bath to help control itching.
- Kids should wear soft clothes that “breathe,” such as those made from cotton. Wool or polyester may be too harsh or irritating.
- Keep your child’s fingernails short to prevent skin damage from scratching. Try having your child wear comfortable, light gloves to bed if scratching at night is a problem.
- Kids should avoid becoming overheated, which can lead to flare-ups.
- Kids should drink plenty of water, which adds moisture to the skin.
- Get rid of known allergens in your household and help your child avoid others, like pollen, mold, and tobacco smoke.
- Stress can make eczema worse. Help your child find ways to deal with stress .
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Why Trust Verywell Health
Stephanie Valera has written and edited articles for Mashable, Everyday Health, Weather.com, HuffPost, and CBSNewYork.com, among other publications. She has also held editorial positions at CBS, NBC, and BBC America. She is passionate about climate and environmental issues, health, and wellness.
10 Best Lotions for Eczema, According to Dermatologists. Good Housekeeping. https://www.goodhousekeeping.com/beauty/anti-aging/g30274542/best-lotion-for-eczema/
The 11 Very Best Treatments for Eczema. The Strategist. https://nymag.com/strategist/article/best-eczema-treatments.html
Dermatologists Say These Are the Absolute Best Lotions for Eczema. . https://www.byrdie.com/best-lotions-for-eczema
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Dr. Chan recommends Avenes XeraCalm A.D. Lipid-Replenishing Balm as one of her favorite eczema creams. Why? It nourishes that itchy feeling, helps rebalance the skins microbiome and seals in moisture for up to 48 hours.
It helps calm dry, irritated and sensitive skin by helping to reduce itching, and alleviating redness and inflammation, Dr. Libby notes, too, as one of her favorite eczema creams.
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Complementary And Alternative Treatments
Many people with eczema use skincare products and practices that are outside Western or conventional medical advice to help manage their symptoms. If you use these natural therapies or home remedies with doctor-prescribed medications, you are using a complementary method to manage your eczema. If you are using natural therapies in place of conventional medicine, you are using an alternative method of self-care for your eczema treatment.
Before you consider any kind of treatment, its important to understand what triggers your eczema. Learning about the skin irritants in your everyday surroundings can help you better manage the condition whether you use traditional medications, alternative therapies or both. The following complementary and alternative therapies have been studied and found to benefit certain symptoms of eczema in adults. Check with your healthcare provider if you are interested in trying alternative therapies on your childs eczema.
What Do I Need To Know About Oral Or Topical Antibiotics Used To Treat Eczema
- Topical antibiotics are used for small, localized bacterial infections oral antibiotics are used for more extensive or severe skin infections.
- Topical antibiotics are sometimes not recommended, as they can be associated with contact dermatitis and may contribute to antibiotic drug resistance.
- Mupirocin is a prescription topical antibiotic usually applied to the affected area three times per day for 1-2 weeks.
- Bleach baths may also be effective in treating and preventing infection.
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How To Use It
People can buy aloe vera gel in health stores or online, or they can purchase an aloe vera plant and use the gel directly from its leaves.
Individuals should aim to use aloe gel products with few ingredients others can contain preservatives, alcohol, fragrances, and colors, which can irritate sensitive skin. Additionally, alcohol and other drying ingredients could make eczema worse.
However, start with a small amount of gel to check for skin sensitivity, as sometimes, aloe vera can cause burning or stinging. However, it is generally safe and effective for adults and children.
Balancing The Skins Acidity Levels
Vinegar is highly acidic. The skin is naturally acidic, but people with eczema may have less acidic skin than others, which can weaken the skins defenses.
Applying diluted apple cider vinegar could help balance the skins acidity levels, but vinegar can cause burns if it is not diluted.
In contrast, many soaps, detergents, and cleansers are alkaline. They can disrupt the acidity of the skin, which can leave the skin vulnerable to damage. This may explain why washing with certain soaps can cause eczema flares.
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What The Experts Say
Cetaphil Daily Hydrating Lotions formula has hyaluronic acid, an ingredient recommended for building up the skins moisture barrierit can retain up to 1,000 times its weight in water, so it will keep skin hydrated throughout the day. Angie Seelal, registered physicians assistant at Advanced Dermatology PC
Oral And Injectable Medications
In addition to topical medications that keep the skin hydrated as a means of managing dry skin and itchiness, oral and injectable medications have been approved to help manage symptoms such as itching. These include biologics , immunosuppressants , and JAK inhibitors .
Dupilumab is the first FDA-approved biologic drug for the treatment of moderate to severe eczema in people who have not responded well to topical approaches. A self-administered injectable drug, dupilumab works by blocking the activity of certain inflammatory chemicals in the body, and it is sometimes used in conjunction with light therapy.
The side effects of dupilumab are generally mild, and they include pink eye, injection site reactions, and cold sores.
Tralokinumab-ldrm is the second injectable biologic approved by the FDA.
It works by blocking a protein that plays a role in the bodys immune response that leads to inflammation of the skin.
In especially severe eczema cases, doctors may prescribe an oral immunosuppressant, such as cyclosporine , methotrexate , or mycophenolate .
These drugs carry potentially serious side effects, such as an increased risk of developing dangerous infections and cancers.
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