Eczema, also known as atopic dermatitis, is a chronic, incurable, skin problem that typically occurs in childhood. I say incurable only because the exact cause is unknown and a single treatment to relieve the disease such that it need comes back does not exist.
Atopic dermatitis is only one manifestation of “atopy”. The other, very common manifestation of atopy is asthma. There are a number of other associated conditions but in my experience, patients either have skin problems, breathing problems or both.
Oddly, although atopic dermatitis appears to be, at this point, incurable, it does seem to be preventable. Avoid being “overly clean” in your house or with your children. Although things to “get a little dirty”. Don’t use hand sanitizers, get a dog, let them roll around in the dirt. To really oversimplify it, atopic dermatitis is an overactive immune system reacting to things in the environment. When we are very young, our immune system is trained to “get used to” things in our environment such as dirt, the dog, etc. If these things (called antigens) aren’t present then our immune system never gets trained to say these are OK. Later on, our immune system recognizes these things as foreign and reacts to them in a way that is excessive, giving rise to rashes etc.
So, if you have children and they don’t yet have atopic dermatitis, do them a favor and allow them to get dirty.
What do you do if you have child with atopic dermatitis?
First and foremost, water is the enemy. That’s right. Although your child has a rash and is itchy and looks like they have weird stuff on their skin, resist the temptation to bathe or wash them. The more you bathe a child with atopic dermatitis, the worse they will get.
1) Bath no more than every other day and preferably less often than that.
2) Use warm not hot water
3) Keep baths or showers short
4) Don’t rub dry, just pat the skin until there won’t be puddle on the bathroom floor
5) Use moisturizers LIBERALLY – this means a lot. Patients ask me every day what skin care product to use and my answer is always the same. Use the one you like. if you don’t like it, you won’t sue it and using it each and every day is more important.
Since you will be using a lot of moisturizer, pick one that is inexpensive and readily available. By definition, over-the-counter moisturizers cannot contain any active drug products to they are really all about the same. Try a few until you find one that is not too greasy, smell right for you and is not too expensive.