The Greek term eczema means “to boil out,” and as the 35 million Americans suffering from this chronic condition can attest, skin often feels like its “boiling” during a flare up. Although there is no known cure for eczema, there are ways to keep it under control and alleviate its symptoms. Here we break down the causes of this dry, itchy disorder and the best methods for soothing and treating the skin.
What is eczema:
Eczema is a chronic skin condition caused by inflammation of varying degrees—from mild forms, when patches of skin are slightly dry, itchy and reddened, to severe forms that can lead to cracked, oozing areas. These patches can appear nearly anywhere, though the scalp, face, and skin flexes (like the inside of the elbow) are the most common culprits. Eczema is often genetic and usually begins in early childhood. It typically has a sporadic pattern of flare-ups and remission of symptoms and, though there is no cure, treatment can usually control or ease symptoms.
What causes it?
Eczema results from malfunction in the skin barrier. This is due to a reduction in fillagrin, the protein responsible for trapping water in the skin and keeping foreign substances out. Recent studies have shown that, when filaggrin is compromised, it’s not able to form a proper protective barrier for the skin, allowing essential water to escape and allowing aggravating allergens to enter. This results in dry patches that flake and itch, launching an endless cycle of scratching that only worsens symptoms. Many people experience eczema flare-ups in the winter months, when the dryness, cold and wind wreak havoc on the skin. Dust, sweating, stress, fragrance and dies have been known to worsen symptoms, and many sufferers have amplified itching in the evening, when the skin naturally experiences increases in water loss.
How to treat it:
When treating eczema, dermatologists focus on two issues: adding moisture and decreasing itching. Emollients (moisturizers) and steroid creams or ointments are the most common treatments. Emollients repair the external barrier by increasing the skin’s ability to hold water and help protect the upper layer of the skin. “You need to put moisture back in the skin with hypoallergenic, fragrance-free moisturizers,” says Dr. Jeanine Downey, a prominent New York City dermatologist, whose own eczema led her to the profession. “Look for ingredients like oatmeal, glycerin, dimethicon and mineral oil, which are very soothing.” She also recommends applying formulas immediately after a bath or shower to better lock in moisture. “It’s good to apply an unscented baby oil, towel dry and then layer on the lotion while skin is still damp,” says Dr. Downie. When it comes to itching, topical steroids are the main treatment for eczema lesions. Not only does scratching damage the protective upper layers of the skin barrier, but it actually causes it to over activate, further exacerbating the itch. “I tell my patients to cut their nails every other day,” says Dr. Downie. “There should only be the pink nail bed showing, no white at all. If they don’t have the weapons, they can’t go to war.”