In terms of interventions, the patient should employ a well-rounded approach that includes:
- Identifying and avoiding triggers
- Addressing the itch, reducing inflammation, maintaining moisture levels and managing barrier dysfunction – click to access article
- Managing sleep and reducing psycho/emotional/social stress – click to access article
This article (1) covers the topic of identifying and all triggers except for food triggers.
What You Use to “Keep Clean:
The first class of triggers to avoid are contact triggers. And the first category of contact triggers to minimize contact with are those that you use to clean your skin!
Avoid soap because they tend to have high pH. The stratum corneum, the outermost layer of your skin, has a lower pH of between 4.5 and 6. This is why moisturzers like Sebamed and Eucerin have low pH as their selling point. On that note, you can consider using acidic water from a Kangen filter if you or someone you know owns one. Filtered acidic water contains low pH minerals, similar to those present in hot springs, sulphur being the most well-known of them.
Note that after taking a shower, there is a strong urge to do something to skin that is clean. The first intervention here is to quickly moisturize and then to put on the body-hugging wrap or clothing. The second is to remain in an environment that does not aggravate the skin, usually one with air-conditioning and, even better if you can afford one, a humidifier thrown in! Right after the shower, many people may present with redder skin, or may sweat a little. The challenge then is to transition from the shower to a cooler environment. Some people may be able to handle cold showers, but it is not for every constitution.
Garments are the next class of contact irritants you want to be in control of. As much as you can, wear light cotton clothing that allows the skin to breathe. Avoid using synthetic clothing that may leave the skin humid and prone to perspiration. Avoid wool or other prickly textiles that may irritate sensory nerves fibres in the skin, aggravating itch.
That said, there are many clothing products for use in the treatment and management of various forms of dermatitis, eczema, EB, acne and other forms of allergic skin conditions that affect different areas of the body across all age groups. One such material possesses negative ions into the body upon contact with human skin through vibration because the material it is made from Teviron, which carries a negative charge. Teviron has also been shown to “regulate the calcium level in your blood serum (healthy level is 4 mg Calcium per 100cc of blood serum). This helps regulate the blood pH level, rejuvenates the cells, enhances the immune system and balance the autonomic nerves.” (See: http://negativeionscience.com/). It claims to be beneficial towards allergies, high blood pressure, diabetes and even insomnia.
Another would be Skinnies. It offers a clinically proven eczema treatment is seam free and irritant free. Used as part of the normal treatment program, Skinnies helps reduce the terrible ‘itch-scratch cycle’ in Eczema and Atopic Dermatitis. In EB patients, Skinnies helps to protect the skin, minimize infection and speed wound healing time. (See: https://www.skinniesus.com/)
The Air Around:
After controlling what you put on your skin and what you wear on top of it, the next possible trigger is the environment. Sometimes, it is just too difficult to control the moods of tropical weather, as the right mix of humidity and heat could just be perfect breeding ground for a flare.
Keep cool. Avoid drastic changes in humidity or temperature. On that note, consider using an air purifier or humidifier if you can afford to. The humidifier is a device that emits water into the air to increase moisture in the surroundings. The use of humidifiers are recommended to relieve congestion from the common cold, flu and sinus infections. Humidifiers may also help alleviate the symptoms of dry eyes, eczema, itchy skin, dry nasal passages, cracked lips and nosebleeds due to dry air, allergies or asthma. The skin needs humidity levels of at least 30 to 40 percent in order to stay healthy. This humidifier doesn’t warm up the air or cause drastic changes in ambient temperature. If you want the best for an eczema situation, a cool mist is best.
Another option is to select an air purifier to aid in your eczema treatment, choose a purifier with a HEPA filter for the best filtration. Purifiers designed to filter not only dust and pollen but also mould and other bacteria tend to be the most effective. Finally, an air purifier with a humidifier is helpful at keeping your skin moist as it filters allergens out of the air.
The Non-Air Around:
In almost all cases, an air purifier will not single-handedly eliminate the effects of eczema. If you suffer from atopic dermatitis, take additional measures to ensure that your house is allergen-free. Cover your bedding in hypoallergenic bed and pillow covers and wash all bedding and clothes in a mild detergent without fabric softener.
Check that living environment does not have mites. House dust mites live on human dead skin cells found in household dust and their waste products are one of the most common causes of year-round allergy and asthma. Vacuuming and dusting the house on a frequent basis is not enough to remove dust mites and their waste. Up to 95% of mites may remain after vacuuming because they live deep inside the stuffing of upholstered furniture, mattresses, pillows, carpets, stuffed animals, and toys.
Use a zippered, dust- proof cover for mattresses and pillows. These covers are made of a material with pores too small to let dust mites and their waste products get through. They are referred to as allergen- impermeable. Plastic or vinyl covers are the least expensive, but some people find them uncomfortable. Allergen impermeable covers made of fabric can be purchased from allergy supply companies as well as from many stores selling bedding products. Wash sheets, blankets, bedspreads, duvet covers, and comforters every week. Water temperatures of at least 130° F are needed to kill dust mites. Wherever possible, try to rid the bedroom of all types of materials that mites love. Choose washable bedding and toys. Try to limit the number of stuffed toys and upholstered furniture. Avoid use of wall-to-wall carpeting if possible. Keep pets out of this room as well. Roll up shades are easier to clean than fabric curtains, but if you do have curtains, be sure to wash them often. Special vacuum cleaner bags (microfiltration bags) are available which help reduce the amount of dust, which gets stirred up during vacuuming. Special filters for vacuum cleaners can also help keep mites and mite waste from circulating back into the air. You can buy these bags and filters in large department stores and from an allergy supply company or in some specialty vacuum stores.
Avoid swimming for the time being. Chlorine is an irritant. But is also may help with its antibacterial effect. Dryness of the skin after swimming is likely to occur if the pH of the pool water is raised (pH above neutral can cause dry skin, as can calcium build-up).
Soaking in a bath can be beneficial because you moisturize the skin while removing dirt and bacteria. However, note that soaking for more than 20mins can dry up skin instead and use lukewarm water. Apply emollient immediately after drying. There are many nourishing formula to help relief the itch from dryness. Oats is frequently used to fight dryness by leaving a protective layer on the skin, cleanses and moisturizes, and helps maintain the skin’s natural barrier function. The naturally occurring antioxidants in oats have also been found to exhibit inflammatory properties.
Food triggers are one big area to cover in another article. Atopic eczema can sometimes be caused by food allergens, especially before the age of one. Some studies of children and young people with atopic eczema found that one-third to nearly two-thirds also had a food allergy.