What is eczema?

Eczema, also known as dermatitis, is a common condition related to dry skin.  Glands in the skin produce a high quality oil which holds the skin cells together.  Because of this oil, the skin is an effective barrier to chemicals, bacteria and ultraviolet light.  If the skin's integrity is compromised, either through inherited conditions, allergies or improper care, dermatitis can result. 

Inherited Conditions:

The most common condition in this group is atopic dermatitis, in which a genetic predisposition to dry skin occurs.  This can also be accompanied by hay fever or asthma.  The condition usually begins in childhood with an itchy rash appearing in the creases of the elbows or behind the knees and on the face, neck and trunk.  Most of the time, allergy to foods such as dairy, eggs, chocolate or nuts plays a significant role.  Recent research also points to deficiency of Vitamin D in the causation.

Another common inherited problem is varicose veins.  Chronic pooling of blood in the veins of the legs can result in a condition known as stasis dermatitis.  This is an eczema which can appear on one or both legs usually in the shin region and can begin as a small patch of red, itchy skin and enlarge to involve the entire calf area.  Treatment of the underlying varicose veins can improve or eliminate stasis dermatitis.

Allergies:

Many people develop allergies to specific chemicals throughout their life.  One of the most common allergies is to nickel, found in jewelry, coins and many other products.  Another common allergy is to rubber or latex.  An allergy to poison ivy is a well-known cause of eczema.  In all these allergies, the symptoms are one or more itchy red patches of skin on the trunk, arms, legs or eyelids.

Improper Care of the Skin:

Excessive use of soap or body washes, abrasive loofahs or brushes and application of cosmetics or lotions containing glycolic acids, propylene glycol or parabens can all remove the skin's oil and result in dry skin with compromised barrier function.  Environmental chemicals entering through the skin is thereby facilitated and eczema may ensue.

Treatment:

Eczema is an extreme dry-skin condition. The skin is losing its race to keep  up with the production of oils and new cells as they are lost.  For complete treatment information please see Dry Skin.  If you continue to have eczema, see your dermatologist.

Special Problem Areas:

Eyelid eczema is usually a result of direct contact with a chemical through makeup application, or touching the eyelids after the fingers have come in contact with the chemical.  Remember to wash the hands before touching the eyelids and if the eyelid eczema persists, it may be due to nail polish or other nail cosmetics, which will have to be discontinued.

The palms and soles are difficult areas to clear dermatitis.  One reason for this is that the skin is much thicker in these locations and takes about four times longer to heal.  If treatment is discontinued before complete healing occurs, eczema will return.  The following are guidelines for caring for eczema in these special sites:

1. Protect your hands or feet from direct contact with soaps, detergents, scouring powders and other irritating chemicals by wearing waterproof, heavy-duty, vinyl gloves.  This includes while shampooing your hair!  Vinyl gloves are better than rubber gloves since you may become allergic to rubber.  Keep a pair in the kitchen, bath and laundry areas.  If a glove develops a hole, discard it immediately!  Wearing a glove with a hole is worse than wearing no glove at all.  

2. Waterproof, heavy-duty vinyl gloves are unlined.  Washable cotton gloves should be used inside the vinyl gloves to keep your hands dry.  If the hands become wet inside the gloves, they should be changed.  

3. Wear waterproof gloves while peeling and squeezing lemons and other citrus, onions, potatoes, raw vegetables, and tomatoes.

4. Wear leather or heavy-duty fabric gloves when doing dry work and gardening.  Dirty your gloves-not your hands.  Scatter a dozen pairs of inexpensive cotton gloves about your home and use them while doing dry housework.  Wash your gloves-not your hands.

5. If you have an automatic dishwasher, use it as much as possible.  If you don't, let a member of your family do the dishes.  Do your laundry by machine, not by hand.

6. Avoid direct contact with turpentine, paint thinnner, paints and all polishes.  They contain irritating solvents. When using them, wear vinyl gloves, although it's best not to use them for at least 4 months.  

7. When washing your hands and feet, use lukewarm water and no soap.  All soaps are irritating.  No soap is "gentle to your skin" except in the minds of advertising writers, so don't waste your money on special soaps.  Cetaphil or Aquanil soap-free cleansers do not contain soaps so they are safe to use.  Keep a bottle of either of these products in your shower and at each sink so you will not be tempted to use a bar of soap or handwash. 

Remove your rings when doing housework and before washing your hands.

9. When outdoors in cold or windy weather, wear unlined leather gloves to protect your hands from drying and chapping.

10. Use only the prescribed medicines and lubricants.  Do not use other lotions, creams, or medications. They may irritate your skin.  Eucerin cream or lotion are very effective moisturizers for healing dry skin.  Wrapping your hands or feet with gloves or plastic wrap after applying your moisturizer at bedtime will be very beneficial in healing the skin.

11. Many foam shoe inserts contain chemicals that can cause rubber or latex allergies so you may have to wear sandals with socks until your feet are healed.