What is Eczema?
Eczema is a condition that some people are born with, where some of the skin connecting proteins are missing. When the skin is dry, there are tiny cracks in the skin where the connecting proteins should have been. Moisture can get out, leading to severe dryness, skin damage and itching. The itching can lead to excessive scratching which further damages the skin.
Germs can get in through the cracks, leading to skin infections, which looks like oozing and crusting sores. The body tries to heal the damaged skin with scar tissue, but it keeps building up and makes very thick patches.
When the skin is well-hydrated or moisturized, the skin cells swell up a little, pressing together so they block up these cracks (a GOOD thing!). Keeping the skin very well hydrated 24 hours a day is the main way to control eczema.
Washing the oils out of the skin makes you smell cleaner, but it also opens up the cracks wider, and can lead to more dryness. This can be avoided by using very mild soap (unscented Dove or Cetaphil Restoraderm) and by replacing the moisture IMMEDIATELY after the bath. After getting out of the tub, quickly pat the skin dry but don’t rub or completely dry the skin. It should stay a little damp. Then you have only 5 minutes to get the whole body covered with moisturizing lotion (Curel, Cetaphil, Lubraderm, etc).
It’s OK to bathe once a day but no more than that, and for only 10-15 minutes in the water. Use luke warm water, not hot. Use the soap last, then rinse off well. A shower is OK if no eczema breakouts, but be sure to “lotion-up” right after!
If using medication, apply the cream or ointment to the affected areas right after the lotion. This allows it to work better than applying it to dry skin. Use the medication 2-3 times a day, and put on lotion first each time. Use only a small dab of the medicated creams, they are very concentrated!
If signs of infection (oozing or yellow-crusted sores) use mupirocin ointment (prescription) 3 times a day. It’s OK to use the mupirocin ointment right after applying other medications. If infections are frequent, we might recommend a dilute bleach bath once a week. Put ½ cup (4 ounces) of Clorox in a half tub of luke warm water. This will make it like swimming pool water. Soak for 15 minutes, then pat dry and IMMEDIATELY put on lotion.
Scratching itchy areas causes the most damage in eczema. Try to eliminate scratching as much as possible. The steroid medicated cream or ointment can help, but it is often necessary to take some oral Benadryl, or do some cold compresses (washrag with cold water) to stop the itching.