• eczema

Skincare for Eczema Sufferers

I often think back to my time in the Dermatology unit at the Sophia Children’s Hospital in Rotterdam. It was heart breaking to see the children covered from top to toe in ointment and bandages. They were in a lot of discomfort from the itching and had to wear special gloves to stop them from scratching their skin and damaging it even further. How awful! Eczema is a rotten illness and sadly more and more people are suffering from it: 10-20% of children and around 6% of adults suffer. Fortunately, not always as serious as the children that I saw but it is still awful. I am going to talk about eczema today and what you can do to soothe your skin.

What is eczema?
If you have eczema then the barrier function of your skin is ‘sick’. Because of this moisture can evaporate quickly making it easier for irritating substances to penetrate into your skin and cause symptoms of inflammation. Your skin starts to itch, becomes red, dry and flaky. Research has shown that patients with eczema are missing a number of important substances in the skin, which protect it from the outside atmosphere. You can compare it to a tent with worn out patches: these patches are where the tent leaks in heavy rain. The substances missing from the skin are filaggrin and claudin-1. I won’t go any further with that, otherwise it will become boring and technical. The important thing to understand is that eczema means that the skin’s barrier has broken down. You then realise how important good skincare is for people suffering from this annoying skin condition.

Medical treatment for eczema
People suffering from eczema generally seek help from their Doctor or a Dermatologist. Your Doctor will assess your eczema and on that basis will draw up a treatment plan. A corticosteroid cream is usually prescribed for mild eczema. Corticosteroids supress the inflammation and counteract the itching. This medicine does have its drawbacks if used long term. It is important that the use of corticosteroid cream is kept to a minimum. I am convinced that, together with a good skincare routine, its use can be reduced.

Maintenance..
People with eczema need extra help with their skin barrier. Whether your eczema is active or not it is a good idea to apply a barrier repairing cream onto your skin twice a day, morning and night.
We can (temporarily) heal those, as we see them, unsightly cracks and cuts with a good cream. Ingredients can form a layer over the skin which protects against moisture loss and the layer helps protect against bacteria and other irritating substances. Alongside this an ingredient, with properties which can draw in water and help the skin retain it, is also added to the creams. That is exactly what is required for eczema.

It is, however, important that you apply it twice a day. It is, of course, only a temporary measure: the cream will disappear with sweating, showering and also from friction with clothing, and then the protection has gone.

Rich creams and salves such as cetomacrogol are usually prescribed by your Doctor and these can also be obtained from the chemist without a prescription. They are perhaps unpleasant to use because of their greasiness and stickiness, but they are good basic salves without unnecessary additives (such as perfume and colourings which are found in those in the beauty shops). It will make a difference if you ask for cetomacrogol cream instead of cetomacrogol salve.

Do you still want to try something other than what your Doctor has advised? I have listed a number of suitable products in an earlier blog. Below are another two. The cream with Eucerin contains liquorice root extract, a lovely soothing ingredient of which I am a big fan.

AtoControl Body Care Lotion Eucerin
Lipikar Baume AP + by La Roche Posay

A few more tips…
Keep showers short and not too hot.
Lying in the bath for too long and hot showers are not a good idea if you have eczema. It is best to wash your skin as little as possible. As water can dry your skin out further allowing bacteria to cause (even) more problems.

Use a mild cleanser – and keep its use to a minimum.
Wash the skin briefly with a mild Cleanser, but not soap, and use lukewarm water. Immediately (within 3 minutes) after showering or bathing, apply cream, preferably while your skin is still damp.

Perfume free washing detergent and fabric softener
Research has shown that residues of washing substances in clothing can cause more irritation and dryness. Although washing detergents don’t usually cause an allergic reaction, I would still advise a perfume free washing detergent and fabric softener in order to keep irritation to a minimum. So use as little as possible and preferably a perfume free washing detergent, don’t put too much in the washing machine and use an extended rinse programme. According to researchers, washing your clothes with an unperfumed fabric softener is good for your skin.

Increase the humidity in your house
Dry skin increases the probability of eczema problems. Your skin dries out much more quickly in the winter due to the low humidity indoors. So make sure that the air in your house is humid enough. This can be done by placing containers of water on top of a radiator or you can use a humidifier for this.

Avoid temperature changes
Heat and sweating can aggravate your eczema. If you are unable to avoid this, then if you are sweaty cool off with a lukewarm shower.

Improve your gut bacteria
People suffering with eczema have different bacteria in their gut to those who don’t have eczema. Research has revealed that taking prebiotics and probiotics can improve the balance in the gut (read more about this at skinwiser). There are also strong indications that administering probiotics during pregnancy and up to 2 weeks after the birth reduces the risk of eczema.

Tips on clothing
Although little research has been carried out in this area, material such as cotton and silk appear to be more suitable for eczema sufferers than wool and synthetic material. Always wash new clothes before wearing. It is not certain, but it could be that substances (such as formaldehyde) are present in material, which can cause extra irritation.

A recent study has found that wearing special clothing can improve eczema. In the experiment, some people who had eczema were asked to wear a shirt, which had been coated with citric acid, for a number of hours a day over a period of 2 weeks. The idea behind this was to see if this layer of acid could improve the pH level in the skin of the participants. Surprisingly enough, this seemed to work: the skin barrier appeared to improve! An interesting idea, which needs to be investigated further.

Regards Jetske
(Dr. Jetske Ultee-Research Physician Cosmetic Dermatology)

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