Eczema Secrets From Board-certified Dermatologist & Author of “Skin
Rules: Trade Secrets From a Top New York Dermatologist,” Debra Jaliman

I’ve always had sensitive skin that was prone to redness and rashes. It seemed that my skin was always itching.  Very early on I was diagnosed with eczema and had to use fragrance free soap and moisturizer. I couldn’t wear mohair sweaters like my friends, only soft cotton on my skin. I’m sure it’s part on the reason I decided to become a dermatologist. Now as a dermatologist I see a lot of eczema in my practice. Eczema is a chronic skin condition that is usually hereditary and has inflammation and itching of the skin as it’s major components. People with eczema have defective surface oils and are missing ceramides in their skin which prevent moisture loss on the skin.  It is a very common condition as 10 to 20% of children in the United States have eczema. For 70% of them it starts when they are less than five years old. Certain things can trigger eczema for example clothing detergents, fabric softener, harsh soaps, perfumes and wool clothing. Also frequent bathing in hot water which dries out the skin will make eczema much worse. Low humidity is another problem as is overheated apartments. Swimming in chlorine or even salt water can also dry out the skin. Treating the skin too rough with a towel can irritate it. Not moisturizing after a shower or bath will exacerbate. When I have kids in my practice with eczema I spend a lot of time speaking with the parents about lifestyle changes. I recommend a humidifier in the bedroom to add more moisture in the air. It’s important to clean the humidifier weekly. It is important for the kids to wear cotton clothing so they don’t have irritating fibers near their skin (mohair, wool) to start the itch cycle. The kids need to take short baths or showers with lukewarm water, not steaming hot water which takes the oils out of the skin. It’s best to use a mild unfragranced soap that is superfatted instead of an antibacterial or detergent soap. Gently pat the skin dry with a towel do not vigorously towel off their skin as it can irritate it. Use a bland moisturizer that is fragrance free right after bathing or showering. I often recommend prescription strength moisturizers to re-create the natural barrier to the skin which are specially made for eczema. Sometimes it is necessary to use antihistamines to stop itching. There are new antihistamines that are non-sedating. Some patients who have severely scratched their skin and have developed skin infections it is necessary to use topical or prescription strength antibiotics. Sometimes it is necessary to use topical steroid preparations for a limited time because the itching is so severe.  There are also topical immunomodulators which can be used to help the body’s immune system treat the eczema. While its frustrating to have eczema there are many safe and effective treatments. Debra Jaliman is a board-certified dermatologist, author of “Skin
Rules: Trade Secrets From a Top New York Dermatologist,”and a MD
 Assistant professor of dermatology
 at Mount Sinai school of medicine
 in New York.