8 Eczema Habits to Breakby Lisa Davis Health Writer
What’s red, rashy, and misunderstood? Eczema, which causes dry, itchy, inflamed skin. It affects nearly 32 million people in the United States–about 10% of the population–and even for people with a mild-to-moderate case, the condition can cause great distress. But dermatologists say that sufferers frequently make the wrong moves when it comes to prevention and treatment. “I’d say 75% of the people who come to me are using things I’d rather they didn’t use,” says dermatologist Ronald Davis, M.D., in San Antonio, TX. Here are some of the most common mistakes people make—and how to fix them.
Mistake: Treating All Eczema the Same
“Eczema” is the ultimate wastebasket term–it refers to any condition that makes the skin red, itchy, and inflamed. So simply knowing you have eczema doesn’t give you all the information you need about how to treat it; managing it requires figuring out what type of eczema you have.
Atopic dermatitis, the most common kind of eczema, usually begins in childhood. It’s the culprit when children have persistent red, roughened patches on their cheeks (so they look even more like little dolls!), but it can also cause itchy patches on the inside bend of the knees and elbows, and on the hands, feet, ankles, eyelids, and other spots. It’s caused by a gene variant that makes skin less able to retain moisture, leaving it more easily aggravated by things in the environment. In adults, contact dermatitis is common—as the name suggests, that occurs when you come into contact with something that bothers your skin, either because you’re allergic to it or because it’s just plain irritating. A poison ivy rash is eczema of the allergic variety. “Dishpan hands” are reddened and scaly from exposure to irritating household cleansers.
Mistake: Washing Too Often
If you have eczema, one key to managing it is to keep your skin hydrated, says Joel Gelfand, M.D., professor of dermatology and of epidemiology at the University of Pennsylvania School of Medicine. Unfortunately, he says, people often go about this the wrong way—washing too frequently or spending too long in a hot shower or bath. Lukewarm water in small doses is best, he says. That means short showers or baths, no more than once a day. Use a gentle cleanser–not a soap, which will strip your skin of natural oils (that squeaky-clean feeling is not one you want). Then slather on moisturizer as soon as you get out. When you do, pick a cream, not a lotion – the greasier it feels, the more oil it contains, and the better it will be at maintaining hydration. Ointments are best of all, says Mona Gohara, M.D., associate clinical professor of dermatology at Yale University. “They’re less cosmetically elegant, but those are the ones that help the most,” she says.
Mistake: Believing that “Natural” Means Better
The label on your skin product may promise that what’s inside is all-natural or organic, but that doesn’t mean your skin will like it, says Dr. Gohara. “Poison ivy is organic, and it’s not very good for your skin,” she says. Natural products often contain irritating ingredients, like peppermint oil (which can trigger an allergic response for some people) or aloe (which can cause inflammation). “People often assume expensive products that smell nice and have natural ingredients will be best for their skin,” says Dr. Gelfand, but that’s just a triumph of marketing. “Simple, affordable, fragrance-free products are almost always the better choice for people with eczema.”
Mistake: Getting Blindsided by an Allergy
Allergic reactions can be tricky to identify. For one thing, you can suddenly develop a sensitivity to something you’ve happily used for years; for another, the rash may crop up on a part of your body that wasn’t even exposed to the allergen. And it sometimes takes a couple of weeks for the reaction to bloom, making the detective work even more challenging. So a A persistent rash may require a trip to the dermatologist for a patch test.
Common triggers for contact dermatitis—besides obvious culprits like poison ivy—are nickel (about 18% of people in the U.S. are allergic), nail polish and other adhesives, fragrances, and preservatives.
Mistake: Overdoing Anti-aging Products
Most of the eczema Dr. Gohara sees in women is caused by beauty products. Retinol is a common culprit, since it tends to dry out skin, a problem for people with eczema. Even women who have never had eczema before can run into trouble if they use retinol too frequently or try a formulation that’s too strong. Other beauty-product ingredients can cause reactions, too. “When someone comes in with eczema, I have them go on a beauty holiday for a few weeks,” says Dr. Gohara. That means using nothing on the skin but a mild, non-soap cleanser, and creams and ointments help the skin grab onto extra moisture. Go slow when you start adding products back into your regimen: Remember, it can take a couple of weeks for a reaction to show.
Mistake: Trying DIY Remedies
It makes sense: You notice an angry rash on your face or hands, so you slather on an antibiotic ointment. After all, maybe you’ve got a minor infection–and besides, those ointments always seem to speed healing.
But if you have eczema, that can backfire. Neomycin and bacitracin are two of the top 12 allergens responsible for eczema of the hand, dermatologists say. Some people even develop a simultaneous allergy to all three ingredients in triple antibiotic ointment (neomycin-polymyxin-bacitracin). If an infection is to blame for your skin redness, swelling and blistering, you should notice improvement after a few days of using an antibiotic ointment. If not, it’s probably time for a visit with the doctor.
Other widely used home remedies can also worsen eczema. Common offenders include witch hazel and apple-cider vinegar.
Mistake: Thinking You’re Allergic When You’re Not
People with eczema sometimes go on an elimination diet to try to soothe their skin; gluten-free diets are particularly popular. And in fact, there’s some justification for this kind of thinking, since children who develop atopic dermatitis early in life often also develop food allergies (about 35% of them have an allergy to one food or another). For them, avoiding their trigger food is critically important, since a food allergy can cause a fatal reaction. But eczema in adults generally isn’t associated with a food allergy or sensitivity. If you have a known gluten sensitivity, it makes sense to try avoid ing it (and the same goes double if you have celiac disease, an immune disorder that makes gluten dangerous to consume). Otherwise, says Dr. Gohara, gluten probably isn’t playing a role in your skin woes.
Mistake: Minding the Rash–and Neglecting the Stress
Even mild-to-moderate eczema can be stressful, researchers say, especially if the rash is on your face or genitals. Unfortunately, it’s a vicious cycle: Eczema causes stress, and heightened stress can trigger an eczema flare. It also lowers the itch threshold so that eczema sufferers become more sensitive to skin irritation. Mindfulness meditation techniques can help, says Dr. Gelfand. Setting aside a few minutes a day to meditate can make eczema more manageable and may even reduce your flares.