Remember that bout of poison ivy you got as a kid? Or maybe it was the chicken pox. The itchiness was relentless, but everyone around you kept advising: Just. Don’t. Scratch. Yet, that prickly, tingling sensation kept getting more and more agitating, to the point where ripping your eyeballs out would have seemed a welcome distraction.
For some eczema sufferers, that hellish circumstance can be part of everyday life. Except unlike the chicken pox or poison ivy, many sufferers are uncomfortably stuck: Science hasn’t pinpointed exactly why one to three percent of the adult population has eczema, nor does it have a cure for the skin disease. Perhaps most frustrating of all, the relief that any eczema solution provides for a patient can suddenly cease to work at any given time — taking the sufferer back to a state of needling, not-sure-what-to-do-about-it flare-ups.
As if all that skin irritation shrouded in uncertainty weren't enough, the American Academy of Dermatology (AAD) reports that atopic dermatitis (the type of eczema that generally lasts into adulthood) is more common today than it was 30 years ago.
Here’s what we do know: Atopic dermatitis, like all types of eczema, is characterized by patchy, flaky, dry, itchy, and inflamed skin. Research by the The Atopic Dermatitis Research Network (ADRN) indicates that people with atopic dermatitis produce proteins that can suppress a skin barrier protein called filaggrin. In other words, eczema’s occurence is likely due to a defect in the skin barrier that doesn’t allow it to retain moisture, according to Diane Dunn, a spokesperson for the National Eczema Association.
Who gets invited to this unpredictable itchy-and-scratchy show? Most sufferers (90%, according to the AAD) experience their first eczema-related flare-up before their fifth birthday, though some people don’t contract it for the first time until they’re adults. And, so far, the research is pointing to atopic dermatitis as yet another thing that we can blame our ancestors for: AAD statistics show that children whose parents have an atopic condition (be it a type of eczema or other allergic condition, like asthma or hay fever) are more likely to develop their own.
Since low humidity and cold temperatures can dry the skin, bringing on so-called “winter itch,” and further agitate eczema, now is the time for sufferers to take preventative measures to help keep flare-ups under control.
While eczema patients should certainly see a doctor for individual care, and possibly, prescribed medicines, at-home care can also be effective, says Dr. Peter Lio, cofounder of the Chicago Integrative Eczema Center and Clinical Assistant Professor in the Department of Dermatology and Pediatrics at Northwestern University’s Feinberg School of Medicine. To start, he says, moisturize at least three times per day.
“Because we think that the fundamental problem in eczema is a damaged skin barrier, the most important skin-care practice is to moisturize frequently with a good cream or ointment,” he says. “This helps lock the water in, keeps the allergens and irritants out, and allows the skin to heal. Above all else, this is key.”
Because environmental factors like dander, dust, and pollens can irritate the compromised skin barrier further, daily bathing is a must. While you may think that frequent bathing could dry out the skin, cleaning up the right way actually helps skin stay hydrated and soothed. Dunn recommends using tepid (not hot) water, patting (not rubbing dry) when out of the shower, and most importantly, applying an occlusive cream within three minutes of stepping out of the shower.
“Think ‘soak and seal,’” Dunn says. “The time to moisturize is while you’re still damp. If you have a topical medication for your eczema, put that on first, then moisturize. That will help lock in moisture and protect the skin barrier.”
Furthermore, it’s important to use non-irritating skin-care products. The National Eczema Association provides a seal of acceptance for approved, non-drying, non-irritating products and a list of what ingredients to avoid in personal care products as well.
Triggers aren’t limited to environmental factors alone. Remember that bit about eczema being classified as an atopic disease, which is in the same family as hay fever and other allergies? Just as with other environmental-associated triggers, for some, food allergies can prompt eczema flare-ups too (dairy, eggs, nuts and seeds, wheat, and soy products are common culprits for eczema patients with food allergies). Stress has also been shown to bring out itchy, red patches on the skin. And, for women, eczema symptoms may worsen when menstruating.
One vital thing an eczema patient can practice is patience. “There’s no cure or one treatment that works for everyone,” Dunn says. “With eczema, sometimes a treatment will work for six months, then suddenly stop working. People are constantly trying new treatments and new things.”
Sometimes, tinkering with diet or adding supplements with the help of a doctor can help improve conditions. (Dunn says the association has seen many people have luck taking Vitamin D, for example.) New Jersey-based dermatologist Dr. Emily Altman, who specializes in treating eczema, also cites research that indicates supplements like probiotics and lactobacillus may also help. However, she says, “People should definitely check with their doctors as oral supplementation may not be enough. Some people, depending on health conditions, may have contraindications." And, since everything from hokey miracle cures to bona-fide alternative therapies abound, Dunn reminds us to discuss any treatments with our healthcare provider. "[Do it] even if they appear harmless," she says, "since these treatments have not been well-studied and may have associated risks.”