WHAT  IS  ECZEMA?    Eczema  or  dermatitis  is  a  chronic,  noncontagious  inflammatory  condition  of  the  skin.    There  is  an  abnormality  in  the  skin  barrier  function  causing  dry,  itchy,  red  inflamed  areas  with  bumps  that  may  ooze  or  crust.    It  is  not  curable  but  can  be  controlled  with  lifestyle  &  medication  measures.  There  are  many  types  of  eczema  (atopic,  contact  {allergic,  irritant},  nummular,  dyshidrotic,  varicose,  seborrheic).    ATOPIC  ECZEMA  is  the  focus  of  this  article.    

ECZEMA  Dr  Elizabeth  Sawyers  MD,  CCFP,  FCFP  801-­‐1081  Carling  Ave,    Ottawa,  ON.  K1Y4G2  www.drsawyers.ca.  613-­‐725-­‐2334  

o Affects  17%  of  Canadians      

o Commonly  associated  with  hay  fever  &  asthma    

o Presentation  depends  on  age:  Babies:  Typically  affects  cheeks,  trunk,  diaper  area.      Children/Adults:  Typically  affects  crease  areas  (flexures)  of    the  knees,  elbows,  wrists,  ankles  &  neck,  hands  &  eyelids    

o 50%  of  children  outgrow  eczema  however  it  may  persist  into  adulthood    

o Increased  risk  for  skin  infections  characterized  by  fever,  sudden  progression  of  rash,  pus  filled  (yellow)  bumps  or  areas  of  tender  redness  requiring  antibiotics

Reduce/Avoid  Triggers  

Eliminate  Fragranced  Products  

 Wash  clothes  in  

mild  detergent  

Avoid  fabric  so`ners/bleach  

Use  nonsoap  washes  

instead  of  soap  

Dress  in  cobon,  avoid  

wool  

Keep  home  humidity  at  40-­‐45%  

Bathe  daily  in  tepid  

water,  avoid  hot  

Pat  skin  dry,  apply  

moisturizers  a`er  bathing  

ATOPIC  ECZEMA  FACTS:  

MANAGING  ECZEMA:  

“Vivamus porta est sed est.”

EMOLLIENTS/MOISTURIZERS     are   ESSENTIAL   in     helping   to   restore   the  defective   skin   barrier.   These   should   be   used  ALL   the   time   even   if   skin   is  clear   as   they   prevent   drying   &   protect   the   skin   from   irritants.     Apply  

liberally   in  the  direction  of  hair  growth  at  least  2x/day  if  not  more.    Absorption  is  highest  to  damp  skin.    Pat  skin  dry  after  bathing  &  apply  within  5  min  of  exiting  bath/shower.    Amounts  needed/week:    kids/adults:  up  to  250/500  gm.    

Ø Cetaphil  Restoraderm  Eczema  Cream,  Cerave  Cream,  Glaxal  Base,  Cliniderm  Cream  

NONSOAP  WASHES  should  be  used  instead  of  soap  which  is  drying  to  the  skin.    

Ø Cetaphil  Restoraderm  Nonsoap  Wash    

Antihistamines:   prescribed   for   those  with   insomnia   due   to   itching.  (Benadryl,  Atarax)  

Steroid   Creams:   the   mainstay   of  prescription   treatment  &  when   used  properly   under   supervision   are   safe.    These   come   in   a   variety   of   strengths  which   will   be   adjusted   according   to  the   degree   of   inflammation   present  with  your  eczema    At  times,  stronger  creams   may   be   required   for   short  durations   to   settle   inflammation.    Your   doctor   will   advise   you   on   the  strength   of   cream  needed,   how   long  to  use  &   in  what  areas.    Using   these  incorrectly   without   supervision   can  result   in  skin  thinning,  stretch  marks,  tiny   blood   vessels   appearing   on   the  skin   &   a   decreased   response   so  follow   prescribing   instructions.     Your  doctor   will   help   you   learn   the  different   strengths   of   creams,   when,    where  &  how  long  to  use.    

Nonsteroid   Creams   (Protopic,   Elidel)  may   be   used   acutely   or   as  maintenance  therapy.      

Squeeze  out  a  line  of  cream  from  the  tube  onto  your  index  finger  from  the  tip  of  the  finger  to  

the  first  crease.  This  is  called  a  fingertip  unit  (FTU).    Follow  the  chart  below  for  age  &  number  of  FTUs  needed  for  each  body  part.    Apply  to  the  affected  

area  only.

GENERAL  SKIN  CARE:  

MEDICATIONS: TOPICAL STEROIDS: How Much

Do I Apply?