Getting the Skinny on Red, Dry, Itchy Skin

SkinCareGuide

Eczema is…

Eczema is one of a group of skin conditions that cause intense dry, red and itchy skin. The two most common types are atopic dermatitis and contact dermatitis. Atopic dermatitis is flare-ups that occur because of a family history with the condition. Contact dermatitis is flare-ups that are motivated by exposure to allergens or irritants. Eczema is referred to as "chronic" because there is no cure and symptoms can reappear or "flare-up" at anytime. Eczema most often affects the area behind the knees, around the elbows and sometimes on hands, as well as the face. Specific / localized patches of dry, itchy and red skin are consistent with eczema.

The Face of Eczema

Over 7 million Canadians have eczema, but only 50 per cent of these have been diagnosed by their health care providers. Eczema usually starts in childhood. Twelve to 25 per cent of all Canadian children get eczema, and while many outgrow the condition, 80 per cent will have dry, irritable skin their whole lives.

Itching for Relief

Of the three most common symptoms of eczema -red, dry, itchy skin-the primary complaint is itchiness, which often leads to excessive scratching. With eczema, the itchiness regularly causes rashes, which is different than other skin conditions where the rash occurs first and then results in an itch. The skin's inflammatory response causes the itch-scratch cycle, as depicted below. Some may even experience a burning sensation at the site as well. Inflamed skin starts the cycle again because it's so itchy. As the itching persists, the patches often seem to spread and grow larger. The itch that goes along with eczema can be very difficult to tolerate and to manage. Having a good scratch is difficult to resist because it can provide short-term relief, but in the long-term it only aggravates the condition. Children are especially likely to scratch their itch. Night time, for example, is when kids commonly engage in it almost unconsciously to the point where some may even experience bleeding at the rash sites.

Keep Triggers Top of Mind

The causes of eczema are unknown. Genetics may play a role as the disease arises from the interplay of multiple genes with external environmental factors. Because there is no cure, effective eczema management requires a combination of prevention and treatment. For example, Canadians can minimize their eczema flare-ups by avoiding certain internal and external triggers. These triggers can include:

Environmental allergens like dust, mold, pet dander, and pollen.
Food allergens such as eggs, nuts, dairy, citrus or acidic foods.
Irritants like latex, rubber or plastics, or clothes made with synthetic fibres (nylon, polyester, wool).
Fragrant detergents, soaps, shampoos, conditioners, perfume, shaving creams, some make-up, bubble baths, etc.
Sweat or bacteria left on the skin for an extended period of time.
Extremes in temperature, either hot or cold (including outdoor and indoor temperatures - e.g. water temperature).
Elevated stress levels.

Starting from Scratch…

Here are some common tips on avoiding the triggers of eczema:

Switch to mild laundry detergents for clothes and bed sheets.
Dress in 100% cotton clothing for breathe-ability and comfort.
Remove food allergens from the diet: e.g. switch to soya milk.
Bathe in cool or tepid water with gentle soap.
Use moisturisers immediately after you bathe to keep the moisture locked in. Be cautious of perfumes in these moisturizers, as they may worsen the condition.
Avoid scratching affected areas. Some people wear cotton gloves at night to prevent scratching in their sleep.
Keep your fingernails short.
Don't let sweat stay on your skin.

Beyond the Itch

The itchiness and dryness of eczema can be quite painful and uncomfortable for patients of all ages. It can lead to many sleepless nights and can reduce productivity at school and work. Not only can eczema be physically painful, but the disease can take a serious emotional toll as well. Patients often feel embarrassed or ashamed of the dry, red, and scaly skin lesions they get during flare-ups. Research has shown that the emotional impact on child sufferers can affect their quality of life greatly: frustration, fussiness, isolation, negative self-esteem, and poor self-image are all common feelings. Parents of affected children have also been studied and results show they not only experience sleep disturbances, but also show social effects and emotional feelings of guilt, blame, worry and frustration as a consequence of their child's skin disease.

The 4 Rs of Eczema Management

In addition to preventing eczema flare-ups by minimizing any known triggers, treatment is also an important part of eczema management. Unfortunately, one remedy alone may not effectively control all symptoms. A multi-level treatment routine is necessary to minimize the severity and duration of eczema flare-ups. The four Rs of eczema management are a simple way to remember this layered approach.

Recognize

Recognize dry, red, itchy skin prone to eczema/dermatitis.

Remove

Remove known triggers such as dirt and bacteria with gentle, soap-free, non-irritating cleansers.

Restore

Restore and protect the skin barrier with moisturizing creams to help keep skin well-hydrated and keep irritants out.

Regulate

Regulate eczema flare-ups by treating them with a medicated cream that reduces inflammation and moisturizes the skin.

About SkinCareGuide:
The SkinCareGuide Network of dermatology-related websites was founded by a prestigious group of international dermatologists. It provides comprehensive information for patients and physicians about the skin, its care and various skin conditions and treatments. All content is reviewed by an independent Board of Medical Advisors to ensure that the information is accurate, unbiased and up-to-date. This information is not intended to replace a consultation with your own physician.

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