Red, swollen, itchy skin can strike people no matter their age. Sometimes, the more a person scratches, the worse it becomes. This may be eczema, a kind of dermatitis, or skin inflammation.

The most common kind of eczema is atopic dermatitis, seen in both children and adults. ‘Atopic’ refers to being overly sensitive to allergens in the environment, such as pollen, mold, dust, animal waste, and certain foods.

Atopic dermatitis is most common in babies and children, known to affect around 15 to 20 percent of children, but only one to two percent of adults. Most children develop this condition before the age of five, and in most cases, it goes away by adolescence. However, some people continue to suffer with eczema throughout their lives. Knowing how to treat eczema is the first step towards healthier skin.

With eczema, there is less production of fats and oil in the skin, resulting in less water retention. When moisture evaporates off the skin, skin cells shrink and cause cracks and itching. Irritants then enter the cracks, resulting in more itchiness.

The exact cause of eczema is still unknown, but a complex interaction of genetic and environmental factors may be a culprit. Families with allergic tendencies may be at a higher risk, as are people with an atopic tendency (which is an increased risk of developing asthma, hay fever, eczema, or some combination of these conditions). Eczema is not contagious, and though there is no cure, it can be managed by avoiding the causes that trigger it.

When the eczema is under control, maintain and protect the skin by using emollient therapy. An emollient is a substance used to soften and smooth the skin. Washing with oil is recommended, but avoid using anything soapy, since commercial soaps dry the skin. Body oils or emollients, such as white petrolatum, vegetable oil, or hydrophilic petrolatum, should be applied first, and then use moisturizers to keep skin soft and supple.

When eczema flares up and skin becomes red, dry, itchy, and flakey, more emollients and thicker moisturizers should be applied. Corticosteroid creams can be used to reduce inflammation.

In a moderate to severe eczema flare, a greasy cream should be applied several times a day, along with prescribed topical corticosteroids. In severe cases that may require hospitalization, wet wraps or bandages may be applied over emollients or steroidal creams to ease the itchiness and relieve inflammation.

Flare-ups of eczema can be prevented by avoiding triggers that dry the skin, such as:

• Scratching
• Swimming in chlorinated pools
• Playing in sand
• Sitting on carpets
• Perfumes, soaps, and cleaners
• Low humidity or dry climate
• Wool or man-made fibers
• Cigarette smoke
• Allergy-causing foods, such as eggs, peanuts, milk, fish, soy and wheat products
• Pollen
• Mold
• Dust mites
• Animal dander

Other factors which can make eczema worse are:

• Stress, anger, frustration
• Long and hot baths
• Not moisturizing skin properly
• Sweating
• Bacterial infections

Eczema can be very annoying and uncomfortable, especially for children, and can sometimes have an emotional impact as they become older. Parents should help them establish a skincare routine, such as bathing only with lukewarm water and applying moisturizers regularly. Techniques can be taught to help a child manage stress, such as breathing exercises, taking a break, or focusing on an enjoyable activity.

Both adults and children may benefit from taking an oatmeal bath. Always gently pat the skin dry with a soft towel after bathing. Take any prescribed medicine correctly, especially after bathing, as topical applications are absorbed faster after a shower or bath. A humidifier may also help when air inside the house is hot and dry. This helps keep the skin moist. During summertime, wear lightweight, breathable clothing so there is minimum contact of sweat with the skin. Alternative therapies such as applying oils like chamomile, evening of primrose, or borage seed may help bring relief, along with dietary supplements.

In more drastic instances, a change in career might be required, as occupations like farming, hairdressing, and industrial and domestic cleaning exposes people to chemicals and other irritants.

Outlook

It is smart to continue taking care of the skin even after outgrowing eczema, since it may still be vulnerable to irritants. Though it is impossible to predict whether a person's eczema will improve or not, taking the necessary precautions, and avoiding its triggers, can help people with eczema be more comfortable in their own skin.