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What’s the best way to prevent eczema?

A very important aspect to the treatment of eczema is preserving an intact skin barrier and moisturizing is the key to this.

If your child continually experiences itchy, dry, red skin and small bumps on parts of the face or parts of the body – it could be atopic dermatitis, sometimes also known as eczema, a chronic skin condition that affects both children and adults.

The word "atopic" describes the genetic predisposition to develop allergies, and therefore, atopic dermatitis implies that this disease is an allergic condition, and is treated by allergists/immunologists as well as dermatologists. But as it turns out, atopic dermatitis is much more complex than simply an allergic skin condition, and despite numerous scientific research studies, the chemical processes that occur within the body responsible for the development and progression of the disease are still not entirely clear.

What we are generally able to successfully accomplish in all (but the most severe cases) is to control the disease. The treatment includes avoidance and medications, but triggers are often difficult to identify (the role of foods is particularly controversial), and therefore difficult to avoid. Treatment with medications is often complicated by potential side effects. The treatment usually involves a topical steroid and sometimes an antihistamine is added for itching, although this is the one symptom of eczema that we do not have an effective treatment for. In using medications, we always adhere to the doctrine of weighing benefits and risks, and if the benefits significantly outweigh the risks, then the treatment should be considered. But besides avoidance and medications, there is a very important aspect to the treatment of atopic dermatitis, and that is to preserve an intact skin barrier. But how do you do that?

Two recent studies in the Journal of Allergy and Clinical Immunology evaluated the efficacy of a moisturizing regimen in infants who were at high risk for developing atopic dermatitis based on family history. The results of both studies validate what allergists and dermatologists already emphasize, that moisturizing is a critical part of the treatment of atopic dermatitis, and helps to preserve an intact skin barrier.

The use of emollients in the form of oils, creams or lotions is important . These are generally very safe and can be used as often as needed. Take care to read labels when purchasing and to avoid buying products that may contain irritants or additives like fragrances. We also encourage bathing once a day, a frequency that strikes a balance between keeping the skin clean (atopic dermatitis patients are particularly susceptible to skin infections) and avoiding excessive drying. Frequent washing of hands and transitioning between wet and dry throughout the day tends to remove many of the protective elements that keep the skin hydrated, so this practice is to be avoided, if possible.  This may be why people with eczema who work in healthcare, and engage in frequent hand washing, face particular challenges in keeping their disease under control.

The use of wet wraps is another way to keep the moisture in and the skin hydrated, but it must be done properly. Consult your allergist or dermatologist for the proper way to perform these non-pharmaceutical measures to treat atopic dermatitis. The use of herbal products is generally not recommended at the present time because there are insufficient studies to confirm their efficacy and safety.

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