Atopic dermatitis - self-care

Alternative names

Eczema - self-care

Help for itching and scratching

Try not to scratch the rash or your skin in the inflamed area.

• Relieve the itch by using moisturizers, topical steroids, or other prescribed creams.
• Keep your child's fingernails cut short. Consider light gloves if nighttime scratching is a problem.

Antihistamines taken by mouth may help with itching if you have allergies. Often you can buy them over-the-counter. Some antihistamines can cause sleepiness. But they may help with scratching while you sleep. Newer antihistamines cause little or no sleepiness. These include:

• Fexofenadine (Allegra)
• Loratadine (Claritin, Alavert)
• Cetirizine (Zyrtec)

Day-to-day skin care

Keep the skin lubricated or moisturized. Use ointment (such as petroleum jelly), cream, or lotion 2 to 3 times a day. Moisturizers should be free of alcohol, scents, dyes, fragrances, or other chemicals. Having a humidifier in the home may also help.

Moisturizers and emollients work best when they're applied to skin that is wet or damp. After washing or bathing, pat the skin dry and then apply the moisturizer right away.

Different types of emollients or moisturizers may be used at different times of the day. For the most part, you can apply these substances as often as you need to keep your skin soft. Avoid anything that makes your symptoms worse. This may include:

• Foods, such as eggs in a very young child. Always discuss with your doctor first.
• Wool, lanolin, and other scratchy fabrics. Use smooth, textured clothing and bedding, such as cotton.
• Sweating. Be careful not to over dress during warmer weather.
• Strong soaps or detergents, as well as chemicals and solvents.
• Sudden changes in body temperature and stress, which may cause sweating and worsen your condition.
• Triggers that cause allergy symptoms.

When washing or bathing:

• Bathe less often and keep water contact as brief as possible. Short, cooler baths are better than long, hot baths.
• Use gentle skin care cleansers rather than traditional soaps, and only on your face, underarms, genital areas, hands, and feet.
• Do not scrub or dry the skin too hard or for too long.
• After bathing, it is important to apply lubricating cream, lotion, or ointment on the skin while it is damp. This will help trap moisture in the skin.

The rash itself, as well as the scratching, often causes breaks in the skin and may lead to infection. Keep an eye out for redness, warmth, swelling, or other signs of infection.

Medicines from your doctor

Topical corticosteroids are medicines used to treat conditions where your skin becomes red, sore, or inflamed. "Topical" means you place it on the skin. Topical corticosteroids may also be called topical steroids or topical cortisones.

Topical steroids contain a hormone that helps "calm" your skin when it is swollen or inflamed. Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.

Your doctor may give you other medicines to use on your skin or take by mouth. Be sure to follow the directions carefully.

When to call the doctor

Call for an appointment with your doctor if:

• Eczema does not respond to moisturizers or avoiding allergens.
• Symptoms worsen or treatment is ineffective.
• You have signs of infection (such as fever, redness, or pain).

References

Breternitz M. Placebo-controlled, double-blind, randomized, prospective study of a glycerol-based emollient on eczematous skin in atopic dermatitis: biophysical and clinical evaluation. Skin Pharmacol Physiol. 2008 Jan; 21(1): 39-45.

Wollenberg A, Schnopp C. Evolution of conventional therapy in atopic dermatitis. Immunology and Allergy Clinics of North America. 2010 Aug; 30(3).

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