Today is winter in Chicago, and because of the Covid-19 pandemic, we are more indoors than ever before. This causes trouble for the skin.
The outside is cold and brittle, while the inside of the radiator and furnace is blown dry and hot. We seek hot baths and showers, which will further dry our skin. Furthermore, pandemic concerns have always existed, which also puts pressure on our system.
For people with chronic eczema (also called atopic dermatitis), the skin is particularly itchy in winter.
Dr. Amanda Wendel, a dermatologist in the Northwestern Central DuPage Hospital of Northwestern Medicine, said: “We live in times of high emotions, which can exacerbate the inflammation of our skin.” “Our skin is now more painful than ever.”
Eczema is called “rash itching” because itching starts first, followed by a persistent rash of anger.
Rachna Shah, MD, an allergist for allergy, sinusitis and asthma professionals in Oak Park, said that once uncomfortable itching begins, rough or thickened plaques, scaly lesions, or The hive rises. Common flares include elbows, hands, ankles and the back of knees. Shah said, but the rash may appear anywhere.
In eczema, signals from the body’s immune system can cause inflammation, itching, and damage to the skin barrier. Dr. Peter Lio, a dermatologist at Northwestern University, explained that itching nerves are similar to pain nerves and send signals to the brain through the spinal cord. When we tick, the movement of our fingers will send a low-level pain signal, which will cover the itching sensation and cause instant distraction, thereby increasing the sense of relief.
The skin is a barrier that prevents pathogens from entering the body and also prevents the skin from losing moisture.
“We learned that in patients with eczema, the skin barrier does not work properly, leading to what I call skin leakage,” Lio said. “When the skin barrier fails, water can easily escape, resulting in dry, flaky skin, and often unable to retain moisture. Allergens, irritants, and pathogens can enter the skin abnormally, causing the immune system to be activated, which further triggers allergies and inflammation. .”
Irritants and allergens include dry atmospheres, temperature changes, stress, cleaning products, soaps, hair dyes, synthetic clothing, wool clothing, dust mites-the list is constantly increasing.
According to a report in Allergology International, it seems that this is not enough, but 25% to 50% of eczema patients have mutations in the gene encoding ciliated protein, which is a skin structural protein. Can provide natural moisturizing effect. This allows the allergen to penetrate the skin, causing the epidermis to thin.
“The difficulty with eczema is that it is multi-factorial. Lio said that he recommends downloading the free app EczemaWise to track skin conditions and identify triggers, insights and trends.
Considering all these complex aspects, figuring out the root cause of eczema can be puzzling. Consider the following five steps to find your skin solution:
Because the skin barrier of patients with eczema is often damaged, they are more susceptible to secondary infections caused by skin bacteria and pathogens. This makes skin hygiene the key, including keeping the skin clean and moisturized.
Shah said: “Perform a warm shower or bath for 5 to 10 minutes a day.” “This will keep the skin clean and add some moisture.”
Shah said that it is difficult not to heat the water, but it is important to choose warm water. Run the water onto your wrist. If it feels higher than your body temperature, but not hot, that’s what you want.
When it comes to cleaning agents, use fragrance-free, gentle options. Shah recommends products such as CeraVe and Cetaphil. CeraVe contains ceramide (a lipid that helps maintain moisture in the skin’s barrier).
Shah said: “After the shower, pat dry.” Shah said: “Even if you wipe your skin with a towel, you can immediately relieve the itching, but this will only cause more tears.”
After that, use a high-quality moisturizer to moisturize. No fragrance, dense cream is more effective than lotion. In addition, check sensitive skin lines with minimal ingredients and anti-inflammatory compounds.
Shah said: “For skin health, the humidity of the house should be between 30% and 35%.” Shah recommends placing a humidifier in the room where you sleep or work. She said: “You can choose to leave it for two hours to avoid excessive moisture, otherwise it will trigger other allergic reactions.”
Clean the humidifier with white vinegar, bleach and a small brush every week, as microorganisms will grow in the reservoir and enter the air.
To test the humidity level in the house the old-fashioned way, fill a glass with water and put two or three ice cubes in it. Then, wait about four minutes. If too much condensation forms on the outside of the glass, your humidity level may be too high. On the other hand, if there is no condensation, your humidity level may be too low.
If you want to reduce the itching of eczema, consider anything that will touch your skin, including clothing and washing powder. They should be fragrance-free, which is one of the most common substances that cause outbreaks. Eczema Association.
For a long time, cotton and silk have been the fabrics of choice for patients with eczema, but a study published in the American Journal of Clinical Dermatology in 2020 showed that synthetic antibacterial and moisture-wicking fabrics may help reduce the symptoms of eczema.
A study published in “Clinical, Cosmetic and Research Dermatology” found that eczema patients wore long sleeves and long pants, long sleeves and pants made of antibacterial zinc fiber for three consecutive nights, and their sleep improved.
Treating eczema is not always that simple, because it involves more than just the rash. Fortunately, there are many ways to relieve the immune response and minimize inflammation.
Shah said that taking 24 hours a day of antihistamines, such as Claretin, Zyrtec or Xyzal, can help control itching. “This will help control the symptoms associated with allergies, which may mean reducing itching.”
Topical ointments can help ease the immune response. Usually, doctors prescribe corticosteroids, but certain non-steroid therapies may also help. “Although topical steroids can be very helpful, we must be careful not to overuse them because they thin the skin barrier and users may be overly dependent on them,” Lio said. “Non-steroid treatments can help reduce the use of steroids to keep the skin safe.” Such treatments include crisaborole sold under the trade name Eucrisa.
In addition, dermatologists may turn to wet wrap therapy, which involves wrapping the affected area with moist fabric. In addition, phototherapy also uses ultraviolet rays that have anti-inflammatory and antibacterial effects on the skin. According to the American Dermatological Association, this treatment can be “safe and effective” to treat eczema.
For patients with moderate to severe eczema who have not been relieved after using topical or alternative therapies, there is the latest biologic drug dupilumab (Dupixent). The drug-an injection that is self-administered once every two weeks-contains an antibody that inhibits inflammation.
Lio said that many patients and families believe that food is the root cause of eczema, or at least an important trigger. “But for most of our eczema patients, food seems to play a relatively small role in actually driving skin diseases.”
“The whole thing is very complicated, because there is no doubt that food allergies are related to atopic dermatitis, and about one-third of patients with moderate or severe allergic dermatitis have actual food allergies,” Lio said. The most common are allergies to milk, eggs, nuts, fish, soy and wheat.
People with allergies can use skin prick tests or blood tests to diagnose allergies. However, even if you are not allergic to food, it may affect eczema.
“Unfortunately, there is more to this story,” Lio said. “Certain foods seem to be inflammatory in a non-allergenic, less specific way, such as dairy products. For some people, eating large amounts of dairy products seems to make the situation worse.” For atopic dermatitis or As far as acne is concerned. “This is not a real allergy, but it does seem to cause inflammation.”
Although there are detection methods for food allergy, there is no definitive detection method for food sensitivity. The best way to determine whether you are food sensitive is to try an elimination diet, eliminate specific food categories for two weeks to see if the symptoms disappear, and then gradually reintroduce them to see if the symptoms reappear.
“For adults, if they are convinced that something will make the situation worse, I can indeed try a little diet, which is good,” Lio said. “I also hope to guide patients more comprehensively with a healthier diet: plant-based, try to reduce processed foods, eliminate sugary foods, and focus on home-made fresh and whole foods.”
Although it is tricky to stop eczema, starting with the above five steps may help the long-lasting itching eventually subside.
Morgan Lord is a writer, teacher, improviser and mother. She is currently a professor at the University of Chicago in Illinois.
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