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– someone, a parent or sibling, is usually a sufferer of one or many of the allergic conditions mentioned. Secondly, eczema skin is what I call “on edge” or hyper-vigilant 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 – causing the skin to become 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.
Do not use soap products on the skin
Soap is a drying product and eczema affected skin is more likely to flare when dry. 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 opposed to shampoo products (shampoo can irritate the skin in the rinsing process).
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. Products such as sorbolene are high in water and can actually make dry skin worse. There are lots of brands that fit the bill of high oil, low water content– check at the pharmacy and buy in bulk whatever is on special to save some pennies!
Avoid aggravating materials on the skin
Given eczema skin is “on edge” it can flare with exposure to particular fabrics such as wool. Natural fibers such as cotton against the skin are best.
Avoid overheating as this can cause the skin to readily flare.
Ensure water temperatures are warm, and not too hot when bathing. Avoiding overheating when dressing infants 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. Good luck!