Atopic Dermatitis (Eczema Specialist)

Skin Conditions & Treatments > Atopic dermatitis (Eczema)

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            Atopic dermatitis (the medical term for “eczema”) is a commonly occurring inflammatory skin disease which can be very perplexing. It is a chronic disease of the skin—meaning it is an ongoing problem.It is NOT contagious.  It often occurs in patients and families who have a history of allergies and asthma, although this is certainly not always the case.  Our understanding of the cause of atopic dermatitis has improved in recent years.  It is now known that eczema is largely due to a damaged skin barrier.  The proper functioning of the skin barrier is essential, as it is responsible for many protective functions.  These include protecting against friction, protecting against infection (one of the more important functions), and protecting against inflammation.  Atopic dermatitis patients have a defect in these functions, causing loss of hydration from the skin and increased penetration of allergens and irritants, as well as increased risk of infection. Treatment of eczema has now shifted to a greater emphasis on normalization and repair of the damaged skin barrier.  There is no cure for eczema, but proper skin care can greatly improve the dry, itchy skin associated with it.  Most kids improve with age. Here are some tips:

1.  Bathing:

Decrease exposure to water with fewer, shorter, and cooler baths/showers
Soap is only needed in “dirty” areas i.e underarms, groin; see soap section below
Apply moisturizer immediately after bathing while skin is moist, to lock-in the moisture
Bleach bath recipe: ¼ cup bleach in full tub of bath 1-2 times per week, soak 10 minutes
These may help significantly to reduce the number of skin infections.

2. Clothing/Bedding:

Cotton clothing (non-synthetics) are less irritating than wool
Long sleeves /pants are best for children to protect skin from irritating substances/scratching
Mattress /Pillow cover to protect against dust mites

3. Irritants:

Try not to scratch skin, this will worsen itch
Avoid perfumes, fragrances, colors (“if it smells good, says ‘baby’ on it: don’t use it!”)
No bubble bath, bath and body works. No dryer sheets , No fabric softeners
Good Detergents: All Free and Clear
Bad Detergents: Dreft, Gain, Orange Tide, Honest Company (has Methylisothiazolinone), Seventh Generation (has flower oil as fragrance as well as Methylisothiazolinone)
Shag carpets, feather pillows, wool fabrics, dust, venetian blinds, stuffed animals, pets
The terms “organic/sensitive” do not mean they are ok for eczema.  “Poison ivy is organic.”
Watch for hidden ingredients: fragrance, parfum, lavender, geraniol, citrus, parabens, formaldehydes, plant/flower/fruit/nut oils, lanolin,cocamidopropyl betaine

4. Soaps:

Avoid harsh soaps like Lever 2000, Ivory, Irish Spring, Dial, etc
Recommended soaps:  Vanicream bar. Even “Dove sensitive” has fragrance

5. Moisturizers:  should be applied multiple times a day!

Vanicream and Vaniply: free of fragrances, dyes, formaldehyde, parabens, lanolin.
Plain Vaseline. Aquaphor if no lanolin sensitivity

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