Think of eczema as a skinallergy, one where your skin's barrier is weak or damaged from environmental or genetic factors. Symptoms include intense itching, often at night, plus inflammation, dry skin, and rash.
About 1 in 10 children have eczema. Fortunately most kids outgrow it, though there is a risk of it coming back when they are teens or adults.
To diagnose eczema, your doctor will first talk to you about your symptoms and medical history.
He or she will also ask about your family's history of rashes and other allergy-related medical conditions, such as asthma and hay fever.
While there is no single test to diagnose eczema, a good medical history and an exam of your skin are usually all that is needed.
Learn about eczema (atopic dermatitis), says California dermatologist Wendy E. Roberts, MD. Understanding what’s causing your symptoms can help you get the right kind of relief. "The skin barrier is about the skin meeting the environment, and everyone's environment is different. That's why knowledge is so important."
Soothe with a lukewarm wash. Hot water may feel good, but it strips the skin barrier of oils. That dries skin out, which leads to more irritation and itch. So avoid steamy showers and baths and opt for a short (5-10 minute) lukewarm wash. "If the steam is building up on the mirror, then the water is too hot and too drying," says Wisconsin dermatologist Kevin Belasco, DO. He suggests not showering or bathing every day, to reduce the risk of drying out skin. When you bathe, pat skin dry, don't rub.
Avoid harsh soaps. Steer clear of foaming, deodorant, scented, or antibacterial soaps, cleansers, or bubble baths. All can have additives that irritate or strip away oils that help form your skin's much-needed barrier. You definitely don't want to be squeaky clean, Roberts says, because "that means you've stripped the oils from your skin, which can make [atopic dermatitis] flare."
Moisturize well. Look for oil-based moisturizers, says Amy S. Paller, MD, department of dermatology chair at Feinberg School of Medicine, Northwestern University. Those mostly made of water may not lock in moisture the best.
Ointments usually have the most oils, followed by creams.
Lotions have the most water.
Moisturize right after bathing. Belasco suggests using prescription barrier creams like Atopiclair, EpiCeram, or Hylatopic Plus. These not only help skin stay hydrated, they may also reduce itching.
Manage the itch. Try topical or other anti-itch medication, suggests Florida dermatologist Leslie Baumann, MD, author of The Skin Type Solution. Ask your doctor which medication is best for your skin.
Blisters filled with clear fluid, sometimes surrounded by red halos
Swelling or inflammation
Ask your doctor about diluted bleach baths. They may help prevent infections and relieve symptoms, say the experts. Paller tells people to fill the tub halfway with water, then add a quarter cup of bleach, two times a week. Some dermatologists suggest rinsing the bleach water off afterward, but others don’t. Don’t try bleach baths without talking to your doctor first.
Dress for success. Wool and certain synthetic fibers can irritate skin more, so go for cotton clothes. Avoid tight clothes.