Reader seeks remedy for eczema

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Q: I vaguely remember an article you wrote in my local newspaper several years ago about an unusual remedy for eczema. Would you be able to repeat this?

A: I’m unsure which unusual remedy to which you refer but eczema (atopic dermatitis) is a skin condition that causes redness and itching. It is long-lasting with periods of exacerbation that may be followed by periods when it goes into remission. As with many conditions, signs and symptoms will vary from person to person but generally include red/brownish gray patches often seen on the hands and feet, ankles, wrists, eyelids, and on the inner side of the arm at the elbow; skin that is dry, cracked and scaly; and relentless itching that appears more pronounced at night. Up to 85% of cases may present before the age of about 5 and may continue into adulthood.

While the exact cause for atopic dermatitis to occur is unknown, such conditions as Staphylococcus aureus (a bacteria on the skin) may create a film that blocks sweat glands, while a gene abnormality, an immune system dysfunction and even environmental changes may be contributory. Those factors that elevated a person’s risk factor for development may include being employed in the health care field, having a family history, being African American, having ADHD (attention deficit hyperactivity disorder), and more. Conditions that worsen eczema include stress, bacteria, viruses, variations in heat and humidity, cleaners and detergents, woolen blankets, pollen, dust, and the often uncontrollable urge to scratch that can lead to infection and still further damage to the skin.

Diagnosis is commonly made through a visual examination and by having a physician do a medical history. If any question remains, he or she may order patch or other testing to rule out possible skin diseases other than eczema.

Treatment may begin with a topical corticosteroid solution to reduce the level of itching. Drugs known as calcineurin inhibitors help control the itch and flare-ups and help maintain normal skin. Should an infection be determined, oral antibiotics might be just the ticket. Diphenhydramine (Benadryl and others) are available over-the-counter and may be helpful at bedtime. Diphenhydramine can cause drowsiness, thus the bedtime use. For severe cases, wet dressings treated with topical corticosteroids may be appropriate. This therapy may be better managed in a hospital setting but with appropriate training, it may also be accomplished at home. Then there is phototherapy (light treatment) wherein the skin is exposed to natural or artificial sunlight. And one thing we often don’t consider is stress management through such things as biofeedback, behavioral modification, acupuncture, and yoga.

On the home front, using a humidifier, avoiding scented soaps, taking a warm bath with colloidal oatmeal followed by patting dry rather than rubbing the skin, avoiding scratching, and lubricating with a lotion that contains vitamin C twice daily should help. While unproven and only used with the permission of your primary care physician, St. John’s wort, evening primrose oil, rice bran broth applied to the skin, vitamins D and E, zinc and selenium might offer some relief.

If you don’t find improvement, ask your physician for a referral to a local dermatologist who might be able to shed some other ideas on the subject.

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