Eczema The Itchy, Scratchy Skin Disorder
May 27, 2014
By Barret Procyshyn, Pharmacist Dauphin Clinic Pharmacy
Everyone strives for good skin. Just last week Trevor talked about the importance of protecting the skin from the suns damaging rays. In previous pharmacy features we have talked about allergies, acne and other skin conditions. Canadians spend hundreds of millions of dollars on skin care products trying to make their skin look and feel great.
With the desire to have great skin; many people and parents often get frustrated with an itchy, scratchy skin disorder called eczema. Eczema, referred to atopic dermatitis by health care professions is a chronic skin disorder. Patients typically have flares of dermatitis that present as ill-defined patches of red skin, scale and skin lesions. Chronic means this skin disorder is not temporary and even though it may have times of mild or no severity, it will come back. Eczema appears as itchy skin lesions, affecting either the face, body or a combination of the two. Eczema is a disease which involves the immune system, environmental factors, lifestyle and even genetic links. This often complicates diagnosis and treatment.
Eczema is quite common, affecting up to six million Canadians or anywhere from 10 percent to 20 percent of the population. Of eczema sufferers, about two thirds will develop symptoms in the first year of their lives. About 90% will experience symptoms by the time they are 6 years old. The positive statistics show half of eczema cases will resolve by the age of two. The other 50% of those who develop eczema as a young child with have to deal with the disease into their adult years.
Family history of asthma and hay fever both seem to contribute to a child developing eczema. Contrary to what some may believe, living in a developed country and being in a higher socioeconomic class actually increases your risk for eczema. This is because of increased exposure to higher pollution levels and potentially colder climates. Eczema rates have increased over the past decades and scientists are still attempting to discover the exact reason or reasons why.
As mentioned environmental factors contribute to eczema by disrupting the skins natural barrier mechanisms. Examples include chemical detergents, weather and even hot water. Some people may notice intolerances to household cleaners, soaps, cosmetic products or even wool fabrics. Various pollutants found in the air and microorganisms like dust mites may also precipitate eczema. Genetically some peoples bodies may not produce enough lipid cells or may not have a gene responsible for hydrating skin, which leads to skin breakdown and eventually eczema. The skin needs to be healthy so it can maintain resistance to microbes, allergens and other irritants. Healthy skin also has the ability to stay hydrated and will not become as easily irritated.
Simple lifestyle changes can significantly improve eczema. Bathing every two or three days using warm water and mild cleaners, while limiting the length of time in the tub will improve the skin. Using an oil or lotion while the skin is still wet with prevent water loss from the skin. Only fragrance free moisturizers should be use during the day to restore dry skin and increase lipid barriers. Products marked unscented may be harmful as they can actually contain chemicals masking scents, which will further break down the skin.
Scratching of itching skin needs to be minimized or eliminated. Sometimes this is not easy for young children. Keeping childrens fingernails cut will prevent skin damage and scratching triggers need to be limited. These triggers may include pets, fabrics, detergents or stress. Both adults and children may benefit from wearing cotton gloves at night to reduce scratching during sleep. A diet supplemented with Omega fatty acids may help to rebuild protective lipid layers on the skin.
Many topical eczema treatments contain key ingredients to help the skin improve its natural defense function. Oat extracts have anti-itch and anti-histamine effects. Shea butter has emollient and moisturizing characteristics along with some potential anti-inflammatory effect. Silicone ingredients help prevent against dehydration and irritant damage.
Topical corticosteroids work quickly, usually effectively and are available in a variety of potencies and formulations. Mild steroids are available over the counter, while some are only available with a doctors prescription. Topical hydrocortisone is available over the counter and is a good steroid starting point. Clobetasol is a more potent steroid, kept behind the counter but is available without a prescription. Steroid treatment, can be complex so you should always obtain a pharmacists assistance to select the safest and most effective product. A newer treatment option for eczema are topical immune modulators. These prescription products provide a very specific anti-inflammatory mechanism. These products will work more slowly than corticosteroids but safety data on their use is good. If you need help treating your eczema or your childs eczema start with your clinic pharmacist.