Coping with Eczema

 

Living with eczema is hard. It is a very uncomfortable condition to live with, and takes an emotional toll on both patient and family. Although there’s no cure, there are now better treatments available that can help manage eczema.

In addition to treatments, managing the itch-scratch cycle is the best thing to do to help cope with eczema and reduce symptoms. Also, be sure to practice good self care and seek out the support you need and deserve with this difficult condition.

Following are some tips on navigating day-to-day to help you cope with this challenging disease.

What is the itch-scratch cycle?

The eczema on your skin is itchy. You scratch. It itches again. You scratch again. The cycle seems unending. What doctors now realize is when you scratch skin impacted by eczema, you perpetuate the itch and worsen the condition.

This is called the itch-scratch cycle. Here’s how it happens: When you scratch, you break down the outer layer of skin, allowing allergens, irritants and bacteria to enter. Your immune system responds by sending signals to the surface of the skin, causing more inflammation, redness … and more itching. This increases your risk of infection.

Near-constant scratching can also affect quality of life and impact sleep, especially in children.

What are common triggers for itching with eczema?

Common triggers for itching with eczema include:
• sweating
• heat
• hot water
• exposure to allergens and irritant
• dust
• dry skin
• Wool fibers
• soaps and detergents
• stress

How do you break the itch-scratch cycle of eczema?

‘Just stop scratching’ is easier said than done. It may even cause unnecessary stress, worsening symptoms. Here are strategies and treatments to help relieve or minimize itch in patients with atopic dermatitis.

Frequent moisturization

Frequent moisturization can not only soothe the skin but also reduce the itch.

Medication

Medications to relieve the itch of eczema include:

  • topical corticosteroids
  • topical calcineurin inhibitors
  • immunomodulators.

Talk with your doctor about using these medications for your AD.

Antihistamines

Sedative antihistamines can help during sleep; non-sedating ones are available as well and may help relieve itching in some patients. Be sure to confirm the correct antihistamine dosage when administering it to a child.

Keep fingernails short

Keep fingernails cut very short – especially for infants and young children. Put eczema mittens on a baby’s hands; your baby still may try to scratch, but not with fingernails.

Wear loose-fitting clothes

Loose fitting clothes can keep the pressure off the skin.

Distraction

Keep yourself busy and your hands occupied so you don’t focus on itching. For children, distract them with games.

Cooling

Cooling can relieve itching. Keep cool packs stored in the refrigerator and place one on itchy areas as needed. Apply a cool compress to the skin or take a cool shower or bath.

If you prefer a bath, stir in colloidal oatmeal, apple cider vinegar or a half-cup of baking powder and bathe for 10 minutes.

Bathing and Moisturizing

  • Remember to pat yourself dry and use a moisturizer within 3 minutes of bathing.
  • It may be helpful to keep moisturizers or topical medications cool in the refrigerator as well.
  • For temporary relief, rub the skin with vinegar water (one tablespoon of vinegar to one quart of water).

Scratch with care

If you must scratch, try stroking the itchy area using the top side of the hand instead of your fingernails.

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How do you improve sleep with eczema?

Quality sleep is often elusive for people with eczema. It’s a sign that symptoms are not well controlled. Sleep disruption can have a significant impact on well-being, especially with kids, because it’s critical to overall health.

Itching is often at its worst at night, when there are no activities to distract your mind and body. Here are four tips to develop a bedtime routine and help ease the itch:

Moisturize the skin

When bathing, wet the skin with lukewarm water – just enough for the moisture to soak into the skin. Then, pat the skin dry – don’t wipe it dry. Apply hypoallergenic moisturizers immediately. This will help the skin trap the moisture. Hypoallergenic moisturizers are recommended because fragrance-based products can sometimes further irritate the skin.

Control the itch

Antihistamines, such as diphenhydramine, may help induce sleep and decrease the itch. It may reduce the amount of time it takes to fall asleep, as well as help you get a longer and better night’s sleep – which is also beneficial for the immune system. Always consult your doctor before taking or administering medication.

Use medication

Treat your symptoms with anti-inflammatories such as topical corticosteroids. The goal with anti-inflammatories is to break the itch-scratch cycle. Eczema is an inflammatory condition, so the more you scratch, the worse the inflammation. Topical corticosteroids are a very common eczema treatment.

There is a range of strengths (or potencies) depending on the location and severity of your AD; you can start with a mild-strength topical corticosteroid and then switch to a stronger one if mild is not working.

Some mild topical corticosteroids are available over-the-counter while higher-strength topical corticosteroids require a prescription from a doctor. Talk with your doctor about these medications.

Anti-inflammatories are typically used in conjunction with moisturizers. They control the inflammation when the skin is moisturized. An overnight wet wrap using cool or refrigerated clothing may also help relieve itching.

Photo of boy sleeping

Identify what is causing the itching

The triggers can be physical, such as getting hot and sweaty; contact with a fabric such as wool or polyester that irritates the skin; soaps or household cleaners; and even emotional stress.

The triggers could also be related to environmental allergies (seasonal pollen, mold, dust mites or pet dander) or food allergies.

Skin testing can help identify which environmental allergens are causing flare-ups; oral food challenges are used to diagnose food allergies.

Work with your doctor to identify triggers and develop avoidance strategies to better manage the condition.

How do you handle hot and cold weather with eczema?

Hot Weather

Dry heat and sweat are common factors in setting off symptoms. Summer wardrobes such as sleeveless tops and shorts expose it all. Control eczema in warm weather by conditioning the skin and soothing the itch.

Some tips:

Keep up with moisturizers

Just because summer humidity feels clammy doesn’t mean you can let up on keeping skin hydrated.

Follow the 3-minute rule: Apply moisturizers right after a warm (not hot!) bath to seal in water in your skin.

Skip harsh chemicals

Avoid using deodorizing soaps and products that contain alcohol, fragrances, retinoids or alpha-hydroxy acid (AHA).

Use sunscreen wisely

Sunshine eases eczema for some people, but skin cancer prevention remains crucial. Choose and use sunscreen without fragrances, dyes and alcohols. (If you’re a new parent, don’t put sunscreen on your baby until after 6 months of age.)

Moisturize frequently at the beach

The more you moisturize at the beach, pool or club, the better.

Rinse off

Rinse off periodically to wash away allergens, irritants (salt! sand! chlorine!) and sweat on your skin, then reapply moisturizing sunscreen.

Stay hydrated

Drink plenty of fluids to avoid becoming too hot.

Cold Weather

During the winter, our skin loses moisture much more quickly than in the summer, spring or fall. This is a problem for people with eczema.

Here are some preventive measures to keep your skin from over-drying in wintertime.

Increase your moisturizing routine.

If you normally moisturize once a day, such as after a bath or shower, do it two or even three times a day during winter so skin does not become dry and cracked.

Talk with your doctor

about using a stronger medication during wintertime.

Consider a humidifier

Running heaters during the winter makes indoor air even drier; humidifiers are designed to put moisture back in the air.

Avoid wool clothing

As you dress warmly for the outdoors, make sure you put on hats, scarves, sweaters and gloves that are not made from wool, as these can irritate and increase itching.

How can you handle the anxiety and depression that often happen with eczema?

If you’re struggling, here are some tips to help you emotionally cope with eczema:

Find a great support group

This includes finding people who can help you through this in real life or virtually. Talk to other eczema patients, join Facebook support groups or speak with a psychologist.

Use stress-coping techniques

Do something you love – for example, watch a movie, pray, take a nature walk, exercise or start writing in a journal – each of these activities can help reduce anxiety and depression.

Practice gratitude

It will help you focus on the positive things in your life, so that you can stop focusing on negativity. Use visualization, affirmations and meditation. These can all help you relax and reduce stress. Regular meditation can also help you control anxiety by redirecting your thoughts.

Don’t be afraid to cry

Let out your emotions, cry and scream if you need to. Do whatever it takes so you don’t suppress what you’re going through.

Many people may not understand how emotionally painful and draining eczema can be. If you or a loved one are suffering with eczema, remember that the more you support yourself emotionally, the more you can cope with the challenges that eczema.

Talk to your doctor about any depression or mental health concerns.

Are there other conditions that may look like eczema but are not eczema?

There are other conditions that are different than eczema, but the symptoms, diagnosis and treatment vary depending upon the condition. Here are some of them.

Hereditary Angioedema

Psoriasis

Chronic Idiopathic Urticaria (CIU)

Cold Urticaria

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