By Purvi Parikh, MD
If you’ve ever had it, you know it: the dry, red, unbearably itchy skin condition called eczema. And you’re not alone – one out of every 10 people in the United States has it. It’s most common among children, but often found in adults as well.
“Eczema” actually refers to a number of skin conditions, many of which are related to allergy. The most common is atopic dermatitis, or AD, which is often triggered by food or environmental allergens. Contact dermatitis is a reaction to allergens and irritants such as soap, detergent, scratchy clothes or nickel jewelry.
An important part of an eczema treatment plan is preventing exposure to allergens and irritants that set off skin problems.
The 6 most common triggers for eczema:
1. Dry skin – The best way to prevent an eczema flare is to keep skin well moisturized. Recent research suggests that moisturizing a baby’s skin from birth may help prevent eczema from developing. In addition, some people have a genetic condition associated with a skin protein called filaggrin that causes their skin to lose moisture and absorb bacteria more easily than others.
2. Food allergies – Among children under the age of 2, eczema is most often related to milk or egg allergy – but it can occur with any food. Doctors put together a diagnosis based on physical symptoms, family and medical history, and allergy tests.
3. Environmental allergies – Children over the age of 2 tend to have eczema related to pollen, mold, pets or dust mites. Since these allergens are often difficult to avoid, the most important treatment is aggressive moisturizing, along with antihistamines and topical skin corticosteroids, if necessary. Skin testing will help identify specific allergies so you can avoid the allergens. Some patients do well with allergen immunotherapy (allergy shots or tablets).
4. Contact allergies – Adult-onset eczema is usually set off by something a person is in contact with on a regular basis. It could be a piece of jewelry, latex or chemicals used in cosmetics, skin products or in the workplace. If necessary, an allergist can do a patch test to identify specific allergens causing the problem.
5. Skin irritants – While they are not allergens, some soaps, detergents, fragrances and wool or synthetic clothing can significantly irritate sensitive skin. Cigarette smoke can also irritate skin, the same way it irritates lungs and eyes.
6. Heat – Whether because it dries out skin or causes sweating, heat is a common eczema trigger.
No matter what the trigger, the most effective way to fight eczema is to moisturize, moisturize, moisturize. Bathe in lukewarm water, dry skin gently by patting with a towel, then apply an ointment or cream to seal in the moisture. Reapply if necessary.
Prescription ointments, pills and injectable medications may be necessary for severe cases.
Though it’s extremely difficult to avoid scratching, do the best you can, as broken skin is easily infected, and scratching starts the cycle all over again.
If you think you or your child has eczema, schedule an appointment with your doctor; for a specialist, contact an allergist or dermatologist to discuss treatment options.
Purvi Parikh, MD, is a board-certified allergist and immunologist in New York City. She is a member of the Board of Directors for the Advocacy Council of the American College of Allergy, Asthma & Immunology.
Reviewed by Neil MacIntyre MD