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Eczema: A Comprehensive Guide

Eczema: An Introduction

Eczema tends to be a common concern for little ones. As children grow and transition into adolescence, their skin undergoes changes—it thickens, becomes oilier, and their skin barrier strengthens. Fortunately, eczema often improves during this phase. However, aging brings new challenges.

As we get older, our skin becomes thinner and more prone to oiliness, making eczema more likely to resurface. It's a common story: you could tolerate various skincare products in your twenties, but suddenly, in your thirties and forties, they start irritating your skin. This is precisely why, as you age, you must be cautious about the products you use, especially if you have a history of eczema.

The Importance of a Healthy Skin Barrier

Ideally, your skin barrier remains strong and intact, allowing you to incorporate a wide range of skincare products from essentials like our Face Wash and Face Cream to the more advanced Day Preventive and Night Repair Treatments. However, stress, dietary choices, or allergies can trigger eczema flares and skin irritation, necessitating a change in your approach.

The moment a flare-up occurs, it's crucial to pause any advance treatment steps. No more day or night treatments. Instead, go back to basics—gentle cleansing, a supportive face cream, and zinc-based sunscreen should be your daily essentials. Stick to this routine until your skin calms down. Afterward, you can reintroduce active treatments. Often, we unknowingly exacerbate our skin problems by using products that don't agree with our skin.

Choosing the Right Products for Sensitive Skin

When selecting skincare products, particularly if you have sensitive skin, it's essential to steer clear of common allergens. Here are a few key culprits to avoid:

Fragrance: Fragrance is a top offender when it comes to skin irritation.
Essential Oils: These can also cause reactions in sensitive skin.
Lanolin: Recent studies have shown that lanolin, an allergen, is a common trigger for eczema.

If you're uncertain about a product, consider patch testing it on your arm before applying it to your face. Remember, our skin evolved in a world with minimal exposure to skincare ingredients. Today, we're inundating our skin with numerous products, each containing a multitude of ingredients. This increases the likelihood of irritation.

Interestingly, the rise of clean and plant-based beauty has led to an unexpected consequence—the increase in allergic reactions to skincare products. Many plant-based products contain ingredients that can irritate your skin.

The Doctor Rogers Difference

At Doctor Rogers Skin Care, we offer biodegradable products, but every ingredient is hypoallergenic. We aim to be part of the solution, not the problem. While you don't have to use our products, it's crucial to educate yourself about ingredients that may not agree with your skin. Using as few products as possible can minimize the risk of irritation or eczema flares caused by your beauty regimen.

Natural and At-Home Remedies for Eczema

There are a variety of home remedies that can ease discomfort and provide relief from the day to day symptoms of eczema. This includes castor oil, oatmeal baths, coconut oil, aloe vera, and sunflower seed oil. They serve as a safe and appropriate treatment to help restore the skin barrier and soothe angry skin.

-Oatmeal

Oatmeal baths have long been used as a natural remedy for various skin conditions, including eczema. Oatmeal contains compounds that have anti-inflammatory and anti-itching properties that can help soothe irritated skin. The American Academy of Dermatology (AAD) suggests that colloidal oatmeal baths can reduce itching and redness in individuals suffering from eczema [1]. There are a couple ways you can do this. If a large part of your body is affected, you’ll want to do this in a bathtub.

-Oatmeal Bath Recipe

First, you'll want to get plain oats from the grocery store. Blend up a cup in a food processor so it becomes a nice and fine powder (colloidal). Then draw a lukewarm tub full of water and mix the oatmeal into the bath water. Don’t use hot water, as that is likely to irritate and dry you out further. Then soak yourself in the tub for 15-20 minutes. The colloidal oatmeal will hydrate the skin by creating a little bit of an occlusive barrier that will prevent the skin from drying out. An alternative method would be just to mix up a small batch with a tablespoon or two of colloidal oatmeal into a pot of warm water and use a gentle towel soaked in the mixture on a smaller area.

-Castor Seed Oil

This is my favorite home remedy, and is the key ingredient in the Healing Balm I made. It is rich in ricinoleic acid, a potent anti-inflammatory compound, and has remarkable properties beneficial for managing eczema symptoms. Studies indicate its ability to reduce inflammation, alleviate itching, and promote skin hydration, all that work to soothe discomfort. Additionally, its antimicrobial properties may help prevent secondary infections common in eczematous skin. Lastly, its emollient nature forms a protective barrier on the skin, aiding in moisture retention and enhancing the skin's natural healing process.

-Coconut Oil

Coconut oil serves as a highly effective moisturizer for eczema patients and is likely to soothe irritated skin due to its anti-inflammatory properties. The fatty acids present in coconut oil can help hydrate the skin and improve its barrier function, which is often compromised in eczema. According to research, it has been shown that coconut oil is effective in minimizing the effects of inflammation and forms a protective coating for preventing irritants from contact with the skin [2]. It is a promising option to cope with the symptoms of eczema as regularly applying coconut oil yields effective results, heals irritated skin, and prevents dryness and intense itching.

-Sunflower Seed Oil

This home remedy is also great for managing eczema symptoms. It consists of fatty acids and antioxidants that help the skin maintain hydration, alleviate inflammation, and stimulate the overall integrity of the skin [2]. Routine use will have a noticeable impact on one's skin health as it prevents flare-ups by soothing skin symptoms like redness, itching, and dryness.

Oils can be messy to deal with. I recommend applying to your skin after bathing or before bed and sleeping in old pajamas to keep the oils on your skin and not on your sheets.

-Aloe Vera

Aloe vera is a plant known for its soothing and healing properties, making it a popular natural remedy for various skin conditions, including eczema. It is widely used for improving one's skin integrity which is why it is highly recommended for eczema patients. Aloe Vera consists of a gel, which is rich in certain substances that can hydrate broken, scaly, and dry skin, alleviate the adverse effects of inflammation, and fight off bacteria. A research-based study shows that aloe Vera can help relieve itching and dryness associated with eczema [2]. Yet, it often comes in a gel form that can be drying to the skin. Therefore, after the application of Aloe Vera, make sure to use a moisturizer or one of the oils above to prevent further irritation of your skin.

Over-the-Counter Remedies for Eczema

-Hydrocortisone Cream

Hydrocortisone cream is a topical corticosteroid widely used to reduce redness and itching associated with eczema. Hydrocortisone cream has been shown to effectively alleviate eczema symptoms by suppressing the immune response in the skin and reducing inflammation (5). It is often recommended as a first-line treatment option for managing eczema flare-ups. In the United States, over-the-counter (OTC) hydrocortisone creams are typically available in strengths ranging from 0.5% to 1%. Often the ointment form stings less than the cream form and after applying always follow with a moisturizer.

-Antihistamines

Antihistamines are oral medications (ex Zyrtec, Benadryl, Allegra, Claritin, Xyzal) that block the effect of the signaling chemical histamine that is made by our body. When histamine is activated, it leads to a cascade of events on a cellular level that can lead to inflammation. Antihistamines can effectively relieve itching caused by eczema, improving the overall comfort of individuals with this condition. You need to take it on a daily basis for at least 30 days for significant improvement in symptoms.

-Creams for Eczema

Moisturizing lotions and creams containing ceramides are essential for individuals with eczema as they help repair the skin barrier, retain moisture, and prevent dryness. They help to retain moisture giving a hydrating effect on the affected area, strengthening the skin barrier, stimulating skin health, and improving its integrity. Studies suggest that such moisturizers when used regularly help manage the symptoms of eczema as they reduce the potential risk of exacerbation by relieving inflammation and dryness. The Body Cream I formulated is loaded with ceramides for this exact reason. It is a great daily maintenance cream for eczema sufferers. The moisturizer you use should be allergen free and also free of irritants that can actually cause more harm than good. You’d be surprised how many moisturizers are actually bad for eczema. Avoid anything with fragrances, alcohol, parabens, sulfates, formaldehyde-releasing preservatives, lanolin, and essential oils. Also you want to pick creams over thinner lotions because thicker products are better at preventing water loss and repairing the skin barrier.

-Healing Balms

These are ointments that are aimed at helping heal a damaged skin barrier during a severe flare. There are many products on the market, including CeraVe, Eucerin, Aquaphor, Vaseline, Aveeno, and Restore Healing Balm. The goal of these is to lock in moisture, draw in hydration, calm the need to itch, and protect the new skin cells as they mature and try to heal the area. Each of these have things to consider when you are deciding what product to use.

-Prescription Remedies for Eczema

Prescription medications offer targeted treatment options for individuals with moderate to severe eczema. These are generally intended to calm the immune system that is driving the inflammatory process and less about restoring the skin barrier directly.

-Topical Corticosteroids

They are topical creams and ointments that are generally used to manage eczema. Their working principle is such that they inhibit the natural immune response in the skin resulting from eczema, preventing redness, swelling, and itching. These would be stronger than OTC Hydrocortisone cream, which maxes out at 1%. They come in various strengths and formulations as you can see here.

-Calcineurin Inhibitors

These are generally prescribed for treating moderate to severe forms of eczema. Their mechanism involves altering the immune system to relieve the symptoms of eczema. While these medications can effectively ease redness and itching, there have been concerns about potential risks such as skin cancer and lymphoma with long-term usage, so the FDA issued a special warning for them [12]. Examples of this include Tacrolimus (Protopic) and Pimecrolimus (Elidel).

-Oral Corticosteroids (for Severe Cases)

Oral Corticosteroids are prescribed to treat severe forms of eczema, specifically when all other topical treatments have failed. They are the strongest medications as they contain powerful anti-inflammatory agents to relieve inflammation. However, these oral medications pose potential side effects that can vary in severity. As a consequence, they are given to patients for a limited duration of time and that too is carefully supervised by the healthcare professionals to ensure such potential risks are avoided. Examples include Prednisone, Prednisolone, Methylprednisolone and Dexamethasone.

-Biologics

Biologic drugs are a newer class of medications that are essentially like antibodies. They target specific components of the immune system that drive inflammation and render them inert. These drugs, administered orally or through injections or infusions, help calm the immune response, alleviate inflammation, and improve eczema symptoms. FDA has approved two such drugs dupilumab and tralokinumab for the treatment of atopic dermatitis. These have shown success with lesser risk of side effects and complications compared to older treatment methods and medications [15].

Environmental Factors that can Impact Eczema

-Avoiding Triggers

Several triggers such as detergents, soaps, house dust, and certain clothing materials such as synthetic fibers, and other environmental factors can increase the risk of getting affected by eczema.

Dry air: Low humidity levels can lead to dry skin, which may worsen eczema symptoms.
Cold weather: Exposure to cold temperatures can cause the skin to become dry and irritated, triggering eczema flare-ups.
Hot weather: Excessive sweating in hot weather can aggravate eczema, leading to itchiness and irritation.
Harsh soaps and detergents: Chemicals present in soaps, detergents, and household cleaners can strip away the skin's natural oils, leading to dryness and exacerbating eczema. Watch out for the biggest offenders, like sodium lauryl sulfate (SLS), fragrances, parabens, formaldehyde-releasing preservatives, and propylene glycol.
Allergens: Common allergens such as dust mites, pet dander, pollen, and mold can trigger allergic reactions in eczema-prone individuals, leading to flare-ups.
Irritants: Irritants such as cigarette smoke, air pollution, and certain fabrics (e.g. wool or synthetic materials) can irritate the skin and worsen eczema symptoms.
Stress: Emotional stress and anxiety can weaken the immune system and trigger inflammation, potentially worsening eczema flare-ups.
Excessive bathing or swimming: Prolonged exposure to water, especially hot water, can strip the skin of its natural oils, leading to dryness and exacerbating eczema symptoms. Try to minimize bathing to less than once a day, use lukewarm water and always follow with a moisturizing cream.
Scratching: Scratching the affected skin can further damage the skin barrier and lead to increased inflammation and itchiness.
Certain foods: While less common, some individuals may experience eczema flare-ups due to food allergies or sensitivities. Common trigger foods include dairy, eggs, nuts, and wheat.

-Humidifiers for Eczema

As previously discussed, eczema can also be triggered by environmental factors, generally dry air. Dry air irritates the skin. Therefore, a humidifier can be used that helps reduce the dryness by increasing the level of moisture in the air. The humidifiers play an important role in the management of eczema, preventing flare-ups by ensuring that humidity levels are maintained properly. Make sure to keep it clean, as they can grow molds over time.

-Stress Management Techniques

Stress has also been regarded as one of the triggers that can result in flare-ups of eczema symptoms. It is because during stress, there's a spike in the generation of a hormone known as cortisol which exacerbates this skin condition. It is, therefore, important to exercise stress management and implement effective techniques to lower stress levels. They generally include an adequate amount of healthy sleep, exercise, meditation, mindfulness, and relaxing one's muscles. Stress Management techniques are crucial for elevating overall quality of life.

These recommendations are not sponsored. They are the result of Dr. Heather D. Rogers, MD evidence-based research and extensive clinical experience.

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