Eczema (even the word sounds itchy) is most commonly used to describe skin problems that result from reactions to substances in our environment. Among the more common irritants are cleaning products, alcohol based or scented beauty products, soaps, and petroleum products. About 1 in 10 persons in the U.S. are affected. Only about 10 percent of the cases of eczema result from ingesting a food or medicine.

What are the symptoms?

With a mild case of eczema, you might experience redness, dryness, and itching of the skin. Left untreated, the skin can become leathery, scaly or discolored. Winter can be especially frustrating as it dries the skin further, often causing it to crack, ooze, and bleed in more severe cases. This type of eczema is commonly referred to as atopic (allergic) eczema.

What can I do?

The best treatment as always is prevention. Reducing your exposure to those things that may cause you to break out. Soap and water can cause irritation, so limit hand washing when it is safe to do so. Health care workers with eczema on their hands may find it especially difficult to prevent dryness and cracking.

While vinyl or plastic gloves may offer some protection for those whose work requires them to have their hands in water, the build up of sweat in side the gloves may counteract the benefits of wearing them. Remove or change the gloves often to prevent the build up of moisture.

You may need to buy cotton liners, sold in pharmacies or beauty supply stores to absorb the excess moisture inside of the gloves. Mechanics and laborers may have chemical exposures that make them susceptible to eczema.

Protecting your hands from the cold air and low humidity in the winter is an important part of this preventive strategy. Both heat and sweating will irritate the skin, so avoid rough scratchy or tight clothing, such as wool and some synthetic fabrics.

Cotton clothing allows the skin to breathe, reduces the surface temperature of the skin, and absorbs sweat. Avoid scratching. This will irritate the skin further and can cause minute breaks in the skin where bacteria can enter and cause infection. Impetigo commonly occurs this way.

Excess bathing can dry the skin and cause redness and itching. Use only a small amount of a mild unscented soap. Avoid using hot water. Now if your not already confused, Im going to suggest that having kept your hands dry all day to prevent worsening of the eczema, you now consider a 15 to 20 minute soak in the tub!

This is to allow the skin's outer layer to absorb water and become less dry. The trick here is to barely pat the skin dry and immediately apply a moisturizer to your skin. Use a product that is unscented (no perfume) and hypoallergenic (least likely to cause irritation).

Plain petrolatum jelly is unscented, inexpensive, and provides a barrier to prevent moisture loss from the skin. The idea is to keep the skin soft and stretchy. Check the label. Some products contain alcohol that can further irritate the skin.

When should I see my doctor?

So, youve taken all the precautions and your skin still feels like its on fire. It may be time to see your doctor for medication to help control the eczema. Your primary care physician can treat mild cases. More sever cases, or those that fail to respond to treatment may require a dermatologist (doctor who specializes in skin diseases).

If you cannot identify the cause, skin testing may be suggested. It identifies the cause only in about 20 percent of the cases. And even then, elimination of the identified offender may not prevent recurrences. Allergy shots are generally not helpful and may worsen the skins irritation.

Steroids (cortisone) are commonly used to treat eczema. They come in creams and ointments for use directly on the skin. It may take several weeks of use before the skin improves. Severe cases may require the use of injections or pill forms of the drug, but this is best avoided.

Less common forms of treatment may include coal tar products and ultraviolet light. Both require supervision by a physician experienced in their use to prevent worsening of the skin condition. Antihistamines can be used to control itching until the skin responds to treatment.

Medical Records Checklist: Eczema

If you have eczema, include the following information in your PersonalMD.com medical record:

Name, address, and telephone number of your primary doctor and/or dermatologist. Previous medical and surgical history. Date of your last visit to your dermatologist. Results of any tests, such as allergy or skin tests, and your physical examination, including a possible eczema triggers and locations of the rash. Treatment plan and/or recommendations. If you are prescribed steroids, include them in your current medications listing. Date of your next appointment, or when you need to schedule another examination.

If all this information is leaving you stressed, well thats yet another cause of worsening eczema. So relax. Eczema is uncomfortable, even maddening, but it is treatable. Once your skin is back in top-notch shape, take care of it. Avoid known irritants. Once eczema has occurred, these areas of the skin seem sensitive to development of the condition again.

Protect and Moisturize is your new winter mantra!

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