Winter time can wreak havoc on your skin. As ambient humidity in the air drops and we turn the heat on in our homes, our skin can get dry very easily. For many of us, our skin just gets tight and flaky looking. But children and adults who suffer with atopic dermatitis or eczema can have full blown flares of red, scaly and cracked patches all over their entire body. The itching associated with these flare ups can be intense.
Atopic dermatitis usually occurs on certain body parts (common) or it be generalized affecting the whole body (rare). Most often, the creases of the elbows and knees, hands, wrists, ankles and face, and the eyelids are affected. Most people develop symptoms of the disorder before the age of 5. People with eczema tend to have drier skin and commonly have other “atopic” diseases like seasonal allergies and/or asthma. Seventy five percent of those affected will outgrow the disease by the time they are teenagers, but a quarter of people continue to have problems into adulthood.
Atopic dermatitis commonly runs in families. While the exact genetic mechanism is unknown, it is believed that people with it have “epidermal barrier dysfunction”. The outer layer of their skin is defective in preventing common, everyday irritants from activating their immune system. So things like chemicals (even those found in soap and shampoos), animal dander, pollens, dust and even sweat can trigger an eczema flare. Internal triggers can also include stress, fatigue and foods such as dairy, wheat, nuts, soy, tomatoes and corn.
Treatment of eczema focuses on prevention of flares. Limiting or eliminating any of the above triggers is a good start. Using special skin care products designed to correct epidermal barrier dysfunction is critical. Many new OTC cleansers and moisturizers are available and should be used routinely (CeraVe or Cetaphil Restoraderm). Daily bathing is acceptable as long as the water is tepid or lukewarm. Showers or baths should be as short as possible. Immediate application of moisturizer from head to toe helps to seal in moisture. This should be repeated 2-3 times daily. “Free and Clear” laundry products should be used and avoid bleaches, fabric softeners and other products that leave a residue on clothing.
When flares do happen, using prescription corticosteroids creams and ointments, oral antihistamines, oral antibiotics and other medications under the guidance of a dermatology provider will usually calm things down quickly. It’s important to establish a good relationship with your medical provider as a “team approach” is often necessary in developing a treatment plan for this chronic problem. Although winter may exacerbate atopic dermatitis, it doesn’t have to keep you or your child from everyday activities and holiday fun. If you or a loved one is struggling with this common skin condition, consider seeking evaluation and treatment today.