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A Patient's Guide to Eczema
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Eczema Trigger Factors To Avoid

Several factors are known to trigger or aggravate eczema, and should be avoided. Some of these factors are weather conditions as well as air-borne allergens, certain foods, skin irritants, and stress. These are detailed below.

Weather Conditions And Air-borne Allergens:

Climatic conditions such as pollution or smog will often cause eczema to flare. Eczema is more common in industrialized countries and in urban areas. Hot, humid weather as well as cold weather will also have adverse effects on eczema. Very low humidity can aggravate dry skin. Humidifiers are useful if there is central heating in your home. Cool bedrooms are helpful. Ideally both school and the workplace should be cool and as dust free as possible. Skin contact with chemicals and dirt should be minimized.

House dust, house dust mites, moulds, pollen, and animal dander from pets are all known to aggravate eczema. Vacuuming of carpets, curtains, and bedding should be done at least weekly. Washing the bedding weekly at high temperature and higher indoor humidity inhibits mites and benefits atopic skin. Fluffy toys need to be washed and shaken outdoors regularly to minimize the accumulation of dust mites. A reduction in house dust mites has been shown to reduce the severity of eczema. (Lancet 1996 347(8993) :15-8)

  • Cool temperature in bedroom
  • Dust free as much as possible
  • No carpets
  • Wash bedding weekly

Food Triggers:

Foods may play a role in a small group of infants and children. Most of these reactions resolve in older children.

Elimination diets may be useful if all other treatments have failed. It is frequently difficult during childhood to have severe restrictions of diet. In some cases foods do appear to be a distinct aggravating factor in eczema. True food allergies produce hives, not eczema.

Some of the findings about food and eczema are:

  • Allergy tests can be difficult to interpret (Allergy Clin Immunol 1999;104:s114-22)
  • Occasionally a long lasting benefit is seen in response to dietary changes (Clin Allergy 1988;18:215-28)
  • A restriction of milk in those young children with cow’s milk allergy showed a delay in growth (J Pediatri 1998;132:1004-9)
  • In pregnancy it would appear that it would be best for the atopic mother to minimize the consumption of milk, tomatoes, or any foods that she herself reacts to
  • Breastfeeding would appear to be of benefit for atopic children
  • Food additives such as sulfites, MSG may aggravate eczema

Commonest reactions to the following foods:

  • Milk
  • Eggs
  • Peanuts
  • Soybeans
  • Wheat
  • Seafood
  • Fruit with seeds

Skin Irritants:

  • Clothes using synthetic fibres such as nylon ,polyester or wool tend to irritate the skin, Latex, rubber and plastics should be avoided without protective cotton liners. Cotton and linen clothing and bedding are best. Residual detergents in clothes and bedding are irritating, so use less detergents and double rinse. Soap flakes (eg.Ivory snow) may be less irritating than laundry detergents. Fabric softeners are discouraged and should be perfume free if used
  • Gloves should be used to protect from water and detergents. PVC gloves are recommended for wet work and the use of cotton gloves for potentially dirty work around the house and garden will minimize the need to wash hands.
  • Contact with soaps, detergents, shampoos, conditioners, perfume, shaving creams as well as make up should be kept to a minimum. Soaps are alkali and are drying.
  • Make-up should not be applied to weeping lesions. Perfume – free cosmetics are advised and trial applications of cosmetics to small areas of normal skin before applying on to the face.
  • Bathing is allowed but luke warm water should be used. Washing with non soap cleansers are encouraged. Hot water, hard water, salt water and chlorinated water should be avoided.
  • Bubble baths should not be used. Pat dry and do not rub. Moisturizing after bathing is a must in order to retain water in the skin.
  • Avoidance of conditions that cause perspiration certainly is helpful in the control of eczema. Exercise should be performed in cool well ventilated areas. Multiple short sessions are easier on the skin.

  • Soft cotton clothes
  • No wool or polyester clothes
  • Double rinse clothes
  • No fabric softeners
  • PVC gloves for wet work
  • Cotton gloves for housework
  • No soap
  • No perfume

Stress:

Anxiety and emotional tension should be kept to a minimum. Techniques to reduce stress and the insight to avoid anxiety producing situations are benefical. It is important to realize that stress does not cause eczema but can certainly result in a flare up.


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