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Author: DrAmanda Oakley, Dermatologist, Hamilton, New Zealand,1997.

Dermatitis refers to a group of inflammatory conditions. It affects the outer layer of the skin, the epidermis.

Dermatitis affects about one in every five people at some time in their lives. It results from a variety of different causes and has various patterns.

The terms dermatitis and eczema are often used interchangeably. In some cases the term eczematous dermatitis is used. Dermatitis can be acute or chronic or both.

An in-between state is known as subacute eczema.

Psychological stresses can provoke or aggravate dermatitis, presumably by suppressing normal immune mechanisms.

Treatment of dermatitis

An important aspect of treatment is to identify and tackle any contributing factors (see above).

Dermatitis is often a long-term problem. When you notice your skin getting dry, moisturise your skin again and carefully avoid the use of soap. If the itchy rash returns, use both the moisturiser and the steroid cream or ointment. If it fails to improve within two weeks, see your doctor for further advice.

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Dermatitis | DermNet New Zealand

For some people with eczema, the regular use of emollients is all that is needed to keep the condition under control. However, for many people there will be a time when a steroid preparation is required as part of their treatment in order to bring an eczema flare under control. Topical steroids are the most common treatment for eczema flares. This is when eczema becomes red, sore and very itchy. Topical steroids are used in short treatment bursts and should be used in conjunction with emollients. Emollients for washing, cleansing and moisturising are essential to a good skin care routine for treating and preventing dry and itchy skin.Emollients need to be used all the time. For more information on emollients click here. What are topical steroids?

Topical means something that is applied to the skin. Steroids are a group of natural hormones, produced in the body by a variety of different glands. They are also produced synthetically as medicines. The topical steroids used for treating eczema are totally different from steroids used in contraceptive pills or for bodybuilding.

Topical steroids are a valuable tool in the management of eczema. They reduce redness and soreness (inflammation) and can be very effective in controlling flare-ups, as they make the skin less itchy and sore, giving it a chance to heal.

Topical steroids are mostly prescribed to treat eczema flares. In this case, you will generally be instructed to apply topical steroid for short bursts of treatment, and then stop or step down use when the eczema flare settles. If you are prescribed a milder steroid you will generally be told to stop after a burst of treatment; but if you are prescribed a stronger steroid, you may be instructed to step down back to lower potency preparations as your eczema flare settles.

Sometimes people with more severe eczema whose eczema flares very frequently are prescribed topical steroids to apply on 2 consecutive days a week on the areas where their eczema usually flares. This is known as weekend therapy and can help to prevent the almost continuous flare cycle, meaning that in the long run less topical steroid would be needed to control the eczema than if each flare were treated as it occurs.

You will generally be advised to apply your topical steroid 12 times a day to areas of active eczema i.e. where it is flaring. (NICE Guidelines for children under 12 years recommend once a day.)

It is important to use the correct amount of topical steroid for your eczema, as instructed by your healthcare professional. Topical steroids should be applied with clean hands so that the skin just glistens. It can sometimes be difficult to judge how much steroid to use and there are guidelines on the amount required to cover body areas that are affected by eczema. These are based on the Finger Tip Unit (FTU), and explained in detail in our fact sheet which you can download as a pdf from the related documents to the right of this page.

There are no standard rules regarding whether to apply a steroid preparation after or before using an emollient. However, whichever order of care you choose it is important to leave as long a period as practical, of around 30 minutes, between the two treatments.

You may be given more than one topical steroid to treat your eczema; for example a milder steroid may be prescribed for the face or genital area and a stronger steroid for other parts of the body. Make sure that you are clear which preparation to use on which part of the body. If in doubt talk to your pharmacist /nurse or contact your doctor.

In the UK topical steroids come as ointments, creams, lotions, scalp applications and impregnated tape/plasters and in four different strengths:

Mild

Moderately potent

Potent

Very Potent.

In deciding which type you need, your doctor should take account of your age, the severity of the eczema, where it occurs and any other treatments you are using. Milder preparations are usually used for the face, genital areas or on babies.

The period of time a steroid may be used depends upon the severity of the eczema and the potency of the topical steroid. Your healthcare professional will advise you on this.

Some topical steroids have added ingredients and are sometimes prescribed where eczema is infected.

If you download our topical steroids factsheet look under related documents to the right of this page you will find tables listing the topical steroids currently available in the UK showing their potencies also which ones have added ingredients. Bear in mind that outside the UK treatments with the same or a very similar name may have different active ingredients and be of a different potency.

Topical steroids, used appropriately and under supervision, are a safe and effective treatment for eczema. The likelihood of side effects occurring is directly related to the potency of the preparation, where it is being used, and the condition of the skin on which it is used and the age of the person concerned. All these factors should be taken into consideration when a prescription is given to treat eczema.

Hydrocortisone 0.05%, 0.1%, 0.5% or 1% is extremely unlikely to cause adverse effects and can be used as prescribed on the face and in young children. Be careful not to confuse this with hydrocortisone butyrate, which is a potent topical steroid.

If used inappropriately or over long periods of time, topical steroids can thin the skin; blood vessels may become more prominent, and the skin can lose its elasticity, developing stretch marks. Other possible side effects include increased hair growth of very fine hair and perioral dermatitis (i.e. a spotty rash around the mouth).

Topical steroids have been in widespread use for over 50 years and although side effects can occur, as explained in our fact sheet available to download from the right of this page, this is usually because treatment has been used incorrectly. Under the supervision of a doctor, and used properly and sensibly in combination with good skincare as part of an overall management routine, topical steroids are a valuable treatment for eczema.

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Topical Steroids : National Eczema Society

Eczema (atopic dermatitis), and the closely associated psoriasis, are two very common skin problems.

Both eczema and psoriasis are potentially allergic conditions that can be triggered by environmental factors and dozens of other external irritants like:

While psoriasis is most often linked with external allergic triggers, eczema is often caused by food allergies.

However, although theyre different diseases and have varying triggers, their treatments have many commonalities. .

Eczema is the itch that rashes, meaning, theres really no rash until you start scratching the itchy area. Hence, the first thing you need to do is to stop scratching!

Addressing the itch -- As anyone with eczema will attest, this is easier said than done. But fortunately, there IS a really simple, inexpensive way to relieve the itch: Simply put a saltwater compress over the itchy area.

Youll want to use a high quality natural salt, such as Himalayan salt. Simply make a solution with warm water, soak a compress, and apply the compress over the affected area. Youll be amazed to find that the itching will virtually disappear!

Another method that can be helpful for reducing or stopping the itch is EFT.

Proper skin hydration When working with any type of skin condition, you need to make sure your skin is optimally hydrated. Skin creams are rarely the answer here, but rather youll want to hydrate your skin from the inside out by consuming high quality, animal-based omega-3 fats in your diet.

Your best sources for omega-3s are animal-based fats like krill oil or fish oil. I also find it helpful to include a bit of gamma linoleic acid, typically in the form of primrose oil, as this works remarkably well for eczema. Products like krill for women are good for both sexes for this condition as they have both fatty acids.

Plant-based omega-3s like flax and hemp seed, although decent omega-3 sources in general, will not provide the clinical benefit you need to reduce inflammation and swelling in your skin.

Secondly, youll want to reduce your exposure to harsh soaps and drying out your skin with excessive bathing. Use a very mild soap when you cleanse your skin, especially in the winter to avoid stripping your skin of moisture.

Taking care of your gut = Taking care of your skin Many dont realize this, but the health and quality of your skin is strongly linked to the health of your gut. I recommend taking a high quality probiotic to ensure optimal digestive health. Fermented foods can be used as well, but are neither as common nor as easy to use.

Diet and skin quality Food allergies play an enormous role in eczema. In my experience, the most common offending agent is wheat, or more specifically, gluten. Avoiding wheat and other gluten-containing grains is therefore a wise first step.

If you were to visit my clinic outside of Chicago as a new patient, one of the first steps we would advise would be to go on a gluten-free diet for a number of weeks and carefully observe any health improvements. This is an enormously common problem and many of our patients are surprised to find how much improvement they actually achieve from this step.

Avoiding grains will also reduce the amount of sugar in your system, which will normalize your insulin levels and reduce any and all inflammatory conditions you may have, including inflammation in your skin.

Other common allergens include milk and eggs. I recommend you do an elimination trial with these foods as well. You should see some improvement in about a week, sometimes less, after eliminating them from your diet if either of them is causing you trouble.

Basking in the sun Vitamin D in the form of sun exposure is your best friend when dealing with either of these skin conditions, but its especially helpful for psoriasis.

I produced a one-hour lecture that explains the health benefits of this long under-appreciated vitamin, so if you havent seen it already, I strongly recommend you take the time to watch this free video now.

Ideally, youll want to get your vitamin D from appropriate sunshine exposure because UVB radiation on your skin will not only metabolize vitamin D, but will also help restore ideal skin function. High amounts of UVB exposure directly on affected skin but not so much to cause sunburn! will greatly improve the quality of your skin.

However, if you cant get sufficient amounts of sun during the winter months, a high quality safe tanning bed can suffice. A safe tanning bed will provide the optimized forms of UVA and UVB wavelengths, without dangerous magnetic skin balance.

You dont have to use expensive, dangerous medicines to treat eczema or psoriasis!

Steroid creams especially, are clearly something youll want to avoid, because although they work initially, you will tend to rapidly develop tolerance to them. These creams contain synthetic steroids, which are absorbed into your skin, and can wreak serious havoc with your adrenal system.

So please, avoid steroid creams and other potentially dangerous medications for these skin conditions and use these natural methods instead. Youll find they work almost all the time, especially if you diligently apply them.

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Fend off Psoriasis and Eczema with Simple, Inexpensive ...

There are many recognized triggers of eczema.

However, the role that diet plays is a murky area of research.

This article reviews the current evidence surrounding eczema treatment.

What is Eczema?

Eczema, also referred to as atopic dermatitis (AD), is a chronic and recurrent inflammatory skin condition that causes itchy, red, and swollen patches of skin.

Unlike psoriasis, eczema most often appears on the inside of the elbows and knees.

There are numerous types, butinfantile eczemais the most common developing in 1 in 5 infants (1).

However, know that eczema can affect anyone at any age. In fact, 334 million people worldwide were said to have eczema in 2013, and 10-30% of people in the U.S (2).

Unfortunately, rates have increased by 2 to 3-fold in Western countries over the past few decades (3).

Summary: Eczema is a common inflammatory skin condition, and rates are on the rise. The most common type is infantile eczema (occurs in children less than 5 years old).

What are the Causes of Eczema?

Several factors contribute to the likelihood of developing eczema.

Eczema risk factors include:

Summary: Many factors increase the risk of eczema including genetics, gender and immune abnormalities. Eczema is not an allergy but has many overlapping symptoms.

Conventional Eczema Treatment

Despite no known cure for eczema, various treatments are available to manage and prevent flare ups.

Dermatologists treat severe eczema with topical (on the skin) or oral medications and phototherapy. Milder cases require skin care and lifestyle modifications (8).

Commonly prescribed medications include anti-histamines, antibiotics, and corticosteroids (oral or topical). Unfortunately, these treatments also have undesirable side effects and lack long-term relief.

Those with eczema are also typically instructed to avoid common triggers including:

Summary: Eczema has no cure, but there are useful strategies for treating and preventing future flare-ups. Alongside medication, common triggers to avoid include dry climates and high stress levels.

Dietary Triggers to Eczema

Current research is unclear about the connection between eczema and specific food triggers.

Food Allergies and Eczema

Those with eczema are more likely to have food allergies, particularly in children under the age of 3 or 4.

Common food allergies in children with eczema include cows milk, eggs, peanuts, soy, wheat, cod/catfish and cashew.

Studies suggest the connection between childhood food allergy and eczema is 33 to 63%. Adult onset eczema is less likely linked with food allergy at a rate of 10%. However, this does not mean that food allergies cause eczema (10, 11).

Additionally, age reduces the likelihood that food allergy contributes to eczema, as most children outgrow their food allergies (12).

The exception is adults with a birch pollen allergy. One study found their eczema was triggered by foods that cross-react with birch pollen like green apples, carrots, hazelnuts, celery, and pears (13).

Therefore, if you have a birch pollen allergy and eczema, consider removing these foods from the diet.

Food Sensitivities and Eczema

IgE-mediated food allergy testing may have poor reliability in those with eczema.

Adults with eczema typically dont suffer from classic food allergies (i.e. IgE-mediated allergy), but rather experience delayed reactions after eating certain foods. This type of reaction is a delayed food hypersensitivity, also referred to as a food sensitivity.

Presently, there is no gold-standard test for diagnosing food sensitivities. Therefore, if you suspect food sensitivities trigger your eczema, consider keeping a food/symptom diary and working with a healthcare provider to identify problematic foods (14).

Pseudoallergens and Eczema

The connection between pseudo-allergens like food additives, histamine, salicylates and benzoates triggering eczema is controversial (15).

While the reason is still unclear, its theorized that these chemicals can cause inflammation in mast cells, a type of white blood cell. Those with eczema have higher levels of mast cells in the areas of skin with the rash (15).

One double-blind-placebo-controlled study on 50 adults found that 63% benefited from a 6-week low-pseudo-allergen diet. This diet avoided all foods containing preservatives, dyes and or antioxidants (16).

Celiac Disease and Eczema

Those with celiac disease (CD) are 3 times more likely to suffer from eczema (17).

Even relatives of those with CD are twice as likely to have eczema. This connection is based on the possible role of autoimmunity causing eczema (18).

Summary: Childhood eczema is more likely associated with food allergies compared to adult eczema. If you have birch pollen allergy or celiac disease, removing cross reactive foods and gluten helps.

Eczema Elimination Diet

Elimination diets are commonly recommended to help identify dietary triggers for a specific symptom.

A low FODMAP diet for food intolerance is the obvious example.

In this case it can be used as a home remedy of sorts for eczema treatment.

Following an elimination diet for 4 to 6 weeks may be beneficial for eczema sufferers. Remove all possible trigger foods and notice any changes in the skin (19).

There is no standardized elimination diet for this condition, but consider developing a plan based on your suspected trigger foods.

Below is a list of eczema trigger foods to help you get started.

Monitor eczema symptoms after strict avoidance of these suspected foods. While changes in symptoms may be coincidental, presence of food hypersensitivities could also explain the change.

Thereafter, carefully rechallenge the avoided foods back into the diet, ideally under the supervision of a dietitian or other health professional. When challenging foods, allow a few days between trials for the development of delayed symptoms (12).

This rechallenge plan for those on a low FODMAP diet may help you better visualize the concept.

Keep in mind that eczema has multiple causes and triggers. An elimination diet is not appropriate for everyone, so talk to your doctor or dietitian before starting one.

Summary: Some eczema sufferers may benefit from trialing a 4 to 6-week elimination diet based on their health history. Be sure to undergo this plan with the supervision of a healthcare professional.

Other Home Remedies for Eczema

Sometimes a change in diet does not provide much help.

Many search for other natural approaches instead:

Summary: There are many other natural therapies to help relieve eczema, however the evidence on most is limited. Consider these only after consulting with your doctor.

Treating Eczema Is Complex

Eczema is a complex inflammatory skin condition.

Its most common in children, but can develop at any age.

Conventional treatment options are available, yet dont offer long-term relief or a cure.

Unfortunately, there are no solid dietary recommendations either. Removing any known food allergies or sensitivities is a good place to start, which is best done through a structured elimination diet.

There are certain probiotic strains that are also worth exploring if you are struggling with symptoms.

Until we know more, its important you pay close attention to your body and notice if there are any specific dietary triggers for you.

This post originally appeared on Diet vs Disease as Does Diet Affect Eczema Treatment?

Disclaimer: The views expressed above are solely those of the author and may not reflect those of Care2, Inc., its employees or advertisers.

Originally posted here:
Does Diet Affect Eczema Treatment? - Care2.com