Atopic dermatitis; Dermatitis - atopic; Skin disorders - eczema
The most common signs of eczema are:
Eczema in children under 2 years old generally starts on the cheeks, elbows, or knees. In adults, it tends to be found on the inside surfaces of the knees and elbows.
Researchers do not know for sure what causes eczema. It may be a combination of hereditary (genetic) and environmental factors. In some people, allergies may trigger eczema. Exposure to certain irritants and allergens can make symptoms worse, as can dry skin, exposure to water, temperature changes, and stress.
Stress can make eczema worse. Other irritants that can make eczema worse include:
Your doctor will look at your skin and ask questions about your personal and family medical history before making a diagnosis. Your doctor may ask about stress in your life, your diet, drugs you are taking, soaps and detergents you use, and chemicals or materials you may be exposed to at work. Your doctor may perform a skin lesion biopsy (removal of a small piece of skin), but it is not always needed to make the diagnosis.
Reducing stress, nervousness, anxiety, and depression may help prevent flares of eczema. Mind-body techniques, including cognitive behavioral therapy and autogenic training, have been shown to help. Both techniques can also be combined with learning about eczema.
Avoiding eggs, fish, peanuts, and soy may help some people reduce flares. Ask your doctor to help you determine if avoiding these foods might reduce the frequency and severity of flares.
Some studies show that children who are exclusively breastfed for at least 4 months are less likely to get eczema. This is particularly true when the nursing mother has avoided cow's milk in her own diet.
Some studies also suggest that babies whose mothers took probiotics ("friendly bacteria") during pregnancy and while breastfeeding were less likely to have eczema at up to 2 years of age. One study found that children who were given probiotics for the first 2 years of life were less likely to develop eczema than those who did not take probiotics. Other studies found no association. More research is needed.
Preliminary studies suggest that using skin creams containing omega fatty acids can reduce the severity of eczema or prevent eczema entirely.
Other preliminary studies suggest that children who have a pet dog are significantly less likely to have eczema during the first 3 years of life than children who do not have a pet dog.
The goals when treating eczema are to heal the skin, reduce symptoms, prevent skin damage, and prevent flares. Developing skin care routines, identifying what triggers flares, and avoiding triggers are a large part of any treatment plan.
Dry skin often makes the condition worse. Remember to:
Parents can help their children by:
Phototherapy and Photochemotherapy
Treatment with ultraviolet light may help mild-to-moderate cases of eczema in children over age 12 and adults. Phototherapy or light therapy may be combined with a type of drug called psoralen. It is then called photochemotherapy.
People who have eczema often have food allergies, so eating a healthy diet may help reduce inflammation and allergic reactions.
Check with your doctor before giving a supplement to a child.
Avoid exposure to environmental or food allergens. Common foods that cause allergic reactions are dairy, soy, citrus, peanuts, wheat (sometimes all gluten-containing grains), fish, eggs, corn, and tomatoes. There is much controversy regarding the most effective way to test for food allergies or sensitivities.
Eat fewer refined foods and sugar. These foods contribute to inflammation in the body.
Eat more fresh vegetables, whole grains, and essential fatty acids (cold-water fish, nuts, and seeds).
Herbs are one way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting any treatment, and ask your doctor before taking any herbs. You may use herbs as dried extracts (capsules, powders, or teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. You may use tinctures alone or in combination as noted.
Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of eczema based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitution, includes your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual. Any remedy that causes aggravation of symptoms should be discontinued right away.
One clinical study looking at essential oils for treating children with eczema found that massage with and without essential oils helped improve dry, scaly skin lesions. Children with this scaly, itchy skin problem seem to have less redness, scaling, and other symptoms if they had massage between flares. DO NOT use massage when skin is actively inflamed. The essential oils most often chosen by the mothers in the study included sweet marjoram, frankincense, German chamomile, myrrh, thyme, benzoin, spike lavender, and Litsea cubeba.
In one clinical study, participating in regular group sporting activities for 3 weeks improved eczema symptoms. Exercise may improve symptoms because of the positive impact it has on emotions. Sports should be avoided during the worst stages of an outbreak.
Climatotherapy uses sunlight and water (such as the ocean) as therapy. The Dead Sea in Israel is known for its healing properties, and many people with eczema go there to sit in the sun and swim in the water. Scientific studies support the benefits. One clinical study looked at the experience of more than 1,500 people with eczema and found that 95% of skin was cleared in people who had stayed at the Dead Sea longer than 4 weeks.
Flares of eczema are associated with anxiety and stress. Several clinical studies show that relaxation techniques can reduce the number of flares and relieve symptoms of eczema. Biofeedback seems to be particularly useful.
Starting an infant on solid foods slowly and gradually may help prevent the food sensitivities that may contribute to eczema.
People who are allergic to ragweed, chrysanthemums, asters, echinacea, or feverfew should avoid chamomile because it is in the same plant family.
Avoid the use of burdock and sulfur during pregnancy.
Traditional Chinese Medicine (TCM) for eczema have been gaining popularity in both the United States and the United Kingdom, but you should be cautious. Some Chinese herbal creams have high amounts of steroid medications. In rare instances, the use of oral Chinese herbs (like a tea) for eczema has led to kidney damage. If you want to try TCM for your eczema, find a respected TCM practitioner and make sure your doctor knows about all herbs you are using, either orally or on your skin.
Although eczema can lead to complications, such as bacterial infections of the skin and permanent scar formation, in many cases is can be easily controlled by avoiding triggers and treating your dry, scaly patches. See your doctor if your eczema does not respond to treatment or if signs of infection (such as fever, redness, or pain) occur. Often children with eczema go into remission after a period of time. The remission may last the rest of their lives, although skin may remain sensitive and dry.
Preliminary studies suggest that eczema during infancy may lead to allergies and asthma later in childhood. Some studies also show a correlation between adult eczema and increased risk of heart disease.
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