Marketing Scoops: 5 Ways To Manage Eczema During a Heat Wave, According To Dermatologists

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In the past week, the United States has experienced a scorching heat wave, with some cities in the Midwest, Northeast, mid-Atlantic, and West hitting record-breaking temperatures above 100 degrees Fahrenheit.12

High temperatures don’t just make life generally more uncomfortable, but the combination of sweat, humidity, and heat also creates unfavorable conditions for people with sensitive skin, especially those with eczema. What’s the best way to manage eczema during a heat wave? Here’s what dermatologists recommend for preventing flare-ups….Continue reading…

By Kayla Hui, MPH

Source: 5 Ways to Manage Eczema During a Heat Wave, According to Dermatologists

Critics:

There are several types of dermatitis including atopic dermatitis, contact dermatitis, stasis dermatitis and seborrhoeic dermatitis. Dermatitis symptoms vary with all different forms of the condition. Although every type of dermatitis has different symptoms, there are certain signs that are common for all of them, including redness of the skin, swelling, itching and skin lesions with sometimes oozing and scarring.

Also, the area of the skin on which the symptoms appear tends to be different with every type of dermatitis, whether on the neck, wrist, forearm, thigh or ankle. Although the location may vary, the primary symptom of this condition is itchy skin. More rarely, it may appear on the genital area, such as the vulva or scrotum. Symptoms of this type of dermatitis may be very intense and may come and go. Irritant contact dermatitis is usually more painful than itchy.

Although the symptoms of atopic dermatitis vary from person to person, the most common symptoms are dry, itchy, red skin, on light skin. However, this redness does not appear on darker skin and dermatitis can appear darker brown or purple in color. Typical affected skin areas include the folds of the arms, the back of the knees, wrists, face and hands. Perioral dermatitis refers to a red bumpy rash around the mouth.

Dermatitis herpetiformis symptoms include itching, stinging and a burning sensation. Papules and vesicles are commonly present. The small red bumps experienced in this type of dermatitis are usually about 1 cm in size, red in color and may be found symmetrically grouped or distributed on the upper or lower back, buttocks, elbows, knees, neck, shoulders and scalp.

The symptoms of seborrhoeic dermatitis, on the other hand, tend to appear gradually, from dry or greasy scaling of the scalp (dandruff) to scaling of facial areas, sometimes with itching, but without hair loss. In newborns, the condition causes a thick and yellowish scalp rash, often accompanied by a diaper rash. In severe cases, symptoms may appear along the hairline, behind the ears, on the eyebrows, on the bridge of the nose, around the nose, on the chest, and on the upper back.

People with eczema should not receive the smallpox vaccination due to risk of developing eczema vaccinatum, a potentially severe and sometimes fatal complication. Other major health risks for people with dermatitis are viral and bacterial infections because atopic dermatitis patients have deficiencies in their proteins and lipids that have barrier functions along with defects in dendritic cells and as a result are unable to keep foreign invaders out, leading to recurring infections.

If left untreated, these infections may be life-threatening, so skin barrier improvement (such as daily moisturizing to minimize transepidermal water loss) and anti-inflammatory therapy are recommended as preventative measures. The cause of dermatitis is unknown but is presumed to be a combination of genetic and environmental factors. The hygiene hypothesis postulates that the cause of asthma, eczema, and other allergic diseases is an unusually clean environment in childhood which leads to an insufficient human microbiota.

It is supported by epidemiologic studies for asthma. The hypothesis states that exposure to bacteria and other immune system modulators is important during development, and missing out on this exposure increases the risk for asthma and allergy. One systematic review of literature on eczema found that urban areas have an increased prevalence of eczema compared to rural areas. While it has been suggested that eczema may sometimes be an allergic reaction to the excrement from house dust mites, with up to 5% of people showing antibodies to the mites, the overall role this plays awaits further corroboration.

There have been various studies on the prevention of dermatitis through diet, none of which have proven any positive effect. Exclusive breastfeeding of infants during at least the first few months may decrease the risk. There is no good evidence that a mother’s diet during pregnancy or breastfeeding affects the risk, nor is there evidence that delayed introduction of certain foods is useful. There is tentative evidence that probiotics in infancy may reduce rates but it is insufficient to recommend its use.

There is moderate certainty evidence that the use of skin care interventions such as emollients within the first year of life of an infant’s life is not effective in preventing eczema.In fact, it may increase the risk of skin infection and of unwanted effects such as allergic reaction to certain moisturizers and a stinging sensation. There has not been adequate evaluation of changing the diet to reduce eczema.

There is some evidence that infants with an established egg allergy may have a reduction in symptoms if eggs are eliminated from their diets. Benefits have not been shown for other elimination diets, though the studies are small and poorly executed. Establishing that there is a food allergy before dietary change could avoid unnecessary lifestyle changes. Bathing once or more a day is recommended, usually for five to ten minutes in warm water.

Soaps should be avoided, as they tend to strip the skin of natural oils and lead to excessive dryness. The American Academy of Dermatology suggests using a controlled amount of bleach diluted in a bath to help with atopic dermatitis. People can wear clothing designed to manage the itching, scratching and peeling. House dust mite reduction and avoidance measures have been studied in low quality trials and have not shown evidence of improving eczema.

Low-quality evidence indicates that moisturizing agents (emollients) may reduce eczema severity and lead to fewer flares. In children, oil–based formulations appear to be better, and water–based formulations are not recommended. It is unclear if moisturizers that contain ceramides are more or less effective than others. Products that contain dyes, perfumes, or peanuts should not be used. Occlusive dressings at night may be useful.

Some moisturizers or barrier creams may reduce irritation in occupational irritant hand dermatitis, a skin disease that can affect people in jobs that regularly come into contact with water, detergents, chemicals or other irritants. Some emollients may reduce the number of flares in people with dermatitis.

If symptoms are well controlled with moisturizers, steroids may only be required when flares occur. Corticosteroids are effective in controlling and suppressing symptoms in most cases. Once daily use is generally enough. For mild-moderate eczema a weak steroid may be used (e.g., hydrocortisone), while in more severe cases a higher-potency steroid (e.g., clobetasol propionate) may be used. In severe cases, oral or injectable corticosteroids may be used.

While these usually bring about rapid improvements, they have greater side effects. Long term use of topical steroids may result in skin atrophy, stria, and telangiectasia. Their use on delicate skin (face or groin) is therefore typically with caution. They are, however, generally well tolerated. Red burning skin, where the skin turns red upon stopping steroid use, has been reported among adults who use topical steroids at least daily for more than a year.

There is little evidence supporting the use of antihistamine medications for the relief of dermatitis. Sedative antihistamines, such as diphenhydramine, may be useful in those who are unable to sleep due to eczema. Second generation antihistamines have minimal evidence of benefit. Of the second generation antihistamines studied, fexofenadine is the only one to show evidence of improvement in itching with minimal side effects.

Generalized Dermatitis in Clinical Practice.

Handout on Health: Atopic Dermatitis (A type of eczema)”.