The Doctor is In

By Doctor Damon Raskin, M.D.| Special to the Palisadian-Post

Q: I have had eczema since I was a baby. Some years are worse than others and this year seems to shaping up to be a really bad one! What are some things I can do to help make it go away and stay away? Are there things I should avoid eating? Creams I should try?

The expression “you scratch my back and I’ll scratch yours” does not apply when either person is suffering from eczema! That’s because scratching only makes this condition worse.

Eczema, also called atopic dermatitis, is a skin condition that commonly starts in early childhood and presents with very itchy, red rashes on the back of the neck and knees, in elbow creases, and can also be found on the face, wrists and forearms.

The affected areas are often scaly and flaky, can have small red bumps and can even weep clear fluid. Scratching the skin can lead to thickened, dark and scarred areas, and may even lead to infection.

The cause of this itchy skin condition is unknown, however it does run in families, so genes do seem to play a role. About half of eczema sufferers also have hay fever and asthma. Some other risk factors for developing this condition seem to be living in a colder climate or an urban polluted city.

The rashes may come and go, and are often associated with certain triggers, like strong soaps and detergents, pollens and mold, perfumes and other skin care products, and certain scratchy materials like wool.

For some, even taking long or hot showers can be a trigger, and for others, it could be stress or certain foods. If you can try to figure out your triggers, it can help with reducing the frequency of the rash outbreaks.

Unfortunately, there is no cure for eczema, although there are numerous options to ease flares and even reduce the frequency of these irritating episodes.

Keeping your skin moist is the first line of defense. That means not taking long or hot showers or baths, which dry out your skin. Applying a thick coat of moisturizing cream or ointment after bathing can help by keeping moisture in your skin.

Other treatments can include topical steroid creams or ointments, although these should not be used chronically or they can thin the skin. They also cannot be used on very sensitive areas like eyelids.

Non-steroid topical prescription treatments are also available, including Elidel, which decreases your body’s immune system to arrest the eczema flare, and Eucrisa, a newer ointment that can work by reducing the inflammatory response of this condition.

For more severe cases that are unresponsive to these treatments, a course of oral steroids may be necessary. There is even an injectable medicine called Dupixent, which you get twice per month that suppresses your body’s immune system that may be indicated for very severe cases.

Of course, many of these treatments also come with possible significant side effects, so you must speak to your doctor about how severe your case is so your health care provider can find the right treatment for you. Make sure you always understand the possible risks and benefits of any of these treatments.

Although this can be a very annoying condition that affects quality of life, it never hurts to have a positive outlook and a sense of humor. Therefore, I end with a joke:

What does the cloud with an itchy rash do? Find the nearest skyscraper!