Dry, itchy, flaky skin can cause significant distress in both adults and kids. Atopic dermatitis and atopic eczema are two terms used interchangeably – they are the same thing. When explaining the condition to patients I always point out a couple of key points. Firstly, usually people with eczema have a family history of allergic conditions such as hay fever, asthma, or eczema in their family history – someone, a parent or sibling, is usually a sufferer or one of many of the allergic conditions mentioned. Secondly, eczema skin is what I call “on edge” or hypervigilant skin – the skin is more reactive and likely to flare than normal skin – cold weather, dry air, soap products can all irritate the skin at the drop of a hat and make it flare – becoming itchy, red and flaky. Eczema is usually a chronic condition that can ebb and flare over time – for my patients, both children and adults, I suggest these key measures to manage the condition.
- Try and avoid using soap products on the skin – soap is a drying product and eczema affected skin can flare when dry. Soap free products are ideally used to bathe. For children – bubble bath should be avoided – these are filled with soap and can be horrendous for eczema affected skin. Aim for soap free washes (there are loads of options) and if skin is very sensitive then wash hair with these as well as shampoo products being rinsed off the head can flare the skin on the body.
- Moisturise the skin regularly – really regularly! This is one of the absolute keys to dermatitis management. Eczema skin can easily flare when dry – I explain to patients that dry eczema skin is “on edge” and more likely to crack it. Keep the skin moist and heavily hydrated. For mild eczema sufferers this might be applying a moisturiser daily – for those with severe symptoms I often prescribe moisturiser application multiple times a day – for babies with significant skin issues I will prescribe a whole-body moisturiser (or to affected areas) at every nappy change!
- Choose the right moisturiser! This is a big one that patients often don’t realise. Aim for a high oil, low water product as it hydrates the skin – there are plenty around.
- Avoid aggravating materials on the skin. Given eczema skin is “on edge” it can flare with exposure to particular fabrics such as wool. Natural fibres such as cotton against particularly volatile, hypervigilant skin.
- Avoid over heating of as this can cause the skin to readily flare. For adults ensure shower temperatures are not too hot. For infants and kids ensure baths are tepid and not too hot. Avoiding over heating with infants when dressing them can also prevent the skin from flaring.
There is a lot more to eczema management including the management of flares with steroid creams as needed. But above are the lifestyle factors that can really help with managing the skin and preventing flares.