Atopic Dermatitis (Eczema)
Dermatitis means inflammation of the skin, while atopic describes a familial tendency towards developing dermatitis, along with allergies (such as hay fever) and/or asthma. Eczema can occur at any age but is more common in infants and young adults. The rash can be either all over the body or in specific areas and can range from minor skin irritation to severe rashes. In dark skinned individuals, eczema may appear as dry brown or gray patches rather than the red flaky patches seen in lighter skinned individuals.
Eczema and South Asians
Eczema is very common in South Asians, especially in infants and children. It is particularly concerning to South Asians and other dark-skinned ethnic groups since it can lead to disorders in skin color known as pigmentary disorders.
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- Genetics-eczema or atopic dermatitis can run in families
- Excessive dry skin (hyperlink to separate topic)
- Extreme temperatures, such as cold and dry or hot and humid weather
- Emotional stress
- Skin irritants including harsh soaps, detergents, cosmetics and other skin care products
- Allergies including food, plants, medications, pollen, and dust or dust mites
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- Keep your skin well moisturized
- Emollients help your skin retain moisture. Creams (such as Eucerin® and Cetaphil®) and ointments (such as Aquaphor® and petroleum jelly) are effective emollients.
- Avoid hot water
- Hot water removes natural oils in the skin. Warm water is preferred for showers and baths.
- Limit bathing time
- Keep bathing time between five and 10 minutes to prevent dry skin due to the combination of evaporation and towel drying.
- Moisturize after bathing
- It is best to use an emollient (see above) right after bathing while the skin is still moist to help trap the water in the skin. Be sure to pat dry to avoid further irritation to the skin.
- Minimize soap use
- Even the mildest soaps remove natural emollients from the skin. Most areas are adequately cleaned with water alone. When using soaps, choose milder ones such as Neutrogena® or Dove®.
- Limit central heating and air conditioning
- These can contribute to dry skin. Consider using a portable humidifier if you spend time in a dry environment.
- Do not scratch or rub skin
- Keep fingernails short.
- Avoid chemicals and harsh irritants
- Wear protective gloves when necessary (washing dishes, using household cleaners, etc.).
- Wear clothes that are cotton or cotton blend
- Loose-fitting clothes help reduce skin contact with fabric. Avoid wool.
- Avoid excessive heat and sweat
- These factors can increase itching.
- Use cold compresses
- This can soothe itchy areas and help prevent scratching.
- Control dust mites
- Reduce stress
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If you have a persistent rash that is not improving with the above measures, you should see a physician. Some of the treatments that may be recommended by your doctor or a dermatologist include:
- Following the skin care tips listed in the "Prevention" section.
- Topical steroid ointments, which can reduce inflammation and itching. Hydrocortisone 1% is an over-the-counter medication, but with more severe rashes, stronger prescription steroids may be indicated.
- Topical immunomodulators, such as Elidel® and Protopic®, that are prescription medications applied to the skin.
- Oral antihistamines, such as Benadryl® and hydroxyzine, that can control itching and reduce skin irritation
- Light therapy (phototherapy) performed by a dermatologist.
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