Eczema is a frustrating—and sometimes even painful—skin condition that affects an estimated 31.6 million people in the United States alone. There are many different kinds of eczema, and one of the most common is a skin disease called atopic dermatitis (AD). If you're looking to learn about these conditions and develop a skin care routine for eczema, you're in the right place.

Dermatitis 101

Dermatitis is a catch-all term that refers to any type of inflammation in the skin. Getting a bug bite, having psoriasis, and even some acne-like facial rashes are a few examples that fall into this category. Also under the dermatitis umbrella is eczema, which describes conditions in which the skin is sometimes red, but always itchy, rough, and inflamed. Specifically, AD is a chronic inflammatory condition that manifests as itchy patches that can weep.

Atopic Dermatitis: "The Itch That Rashes"

Dermatologists and researchers have yet to fully determine the causes of AD. Science thus far has shown that in those with this condition, the skin's inherent immune system becomes overactive. The overactivity causes inflammation, which damages our protective barrier, leaving the skin more vulnerable to irritants. AD, often referred to as "the itch that rashes," is common in children but can occur at any age. According to the National Eczema Society, approximately 9.6 million American children, under the age of 18 have AD. Black and Latinx children have higher incidences. There is no gender difference in terms of rates of childhood AD, yet it is more likely to persist into adulthood amongst females. The primary risk factors for AD include a family history of eczema and a personal history of asthma or seasonal allergies. Irritants such as dry skin, heat, sweat, rough fabrics, and harsh soaps can be triggers for flare-ups, as can allergies to certain foods or pets.

Skin Care Tips

When it comes to caring for AD, there are a two basic rules: Keep moisture in, and keep irritants out.

In order to accomplish these, it's essential to establish a routine with a few key components:

Tub Time

Bathe once a day, for less than 10 minutes. Use warm water—not hot or cold. The latter two can be barrier-stripping irritants that trigger flares. Use a gentle, fragrance-free, non-soap cleanser, and only use the cleanser on body parts that can create an odor (e.g., underarms, genitalia, and feet). Do not use abrasive bathing tools like loofahs or brushes—your hand or a gentle cotton washcloth will do the trick. Pat dry—don't rub—with a towel, and apply moisturizer immediately after exiting the bath or shower, when the skin is still somewhat damp.

Moisturizing

As mentioned earlier, moisturizing is a pivotal step in an AD care routine. Use thicker creams and ointments. Avoid anything with fragrance, as these ingredients are unnecessary and could further irritate your skin. Do your best to moisturize at least two times a day. This is also good advice for building a skin care routine for eczema.

Products with ceramides, refined mineral oil (petroleum jelly), and hyaluronic acid are preferred. EltaMD Body Rich Moisture Crème, for instance, is a great choice.

Cleaning Clothes

If you're looking to treat dry eczema, make sure to wash new clothes before wearing them—and remember to take a look at your detergents. Use detergents that are free and clear of all fragrances, dyes, and extra chemicals. This is usually indicated plainly on the packaging of the product. As tempting as they are, avoid fabric softeners, especially those that come in the form of sheets as they are often heavily fragranced.

Helping Kids Cope

For kids in particular, remember to keep their nails short so that scratching does not create trauma or infection. Also, keep ambient air at a comfortable temperature to avoid sweat as a trigger. For everyone, but especially children, cotton clothes without tags are the least irritating.

When to See A Dermatologist

If you suspect you might have AD, schedule an appointment with a board-certified Dermatologist. During the visit, the Dermatologist will explain the condition, talk through a treatment plan, and determine the optimal skin care regimen for you. Treatments for AD may include topical medications, such as anti-inflammatory creams/ointments, oral steroids for flares, and even injectable biologics for cases that are chronic. In situations where a larger surface area needs to be treated, Dermatologists may use controlled bursts of therapeutic ultraviolet light. Amidst any therapeutic intervention, however, a daily, professionally curated skin care routine remains an extremely important component of an AD journey.

Author

  • Dr. Mona Gohara is a Connecticut-based Dermatologist and associate professor of Dermatology at Yale School of Medicine. She has a particular interest in skin cancer prevention and treatment for skin of color. Dr. Gohara spends a lot of time outdoors with her husband, son, and two dogs, Coco and Cleo. They all wear sunscreen.