Communications: Patient Education

Patient Education: Taking the Itch Out of Winter: Dealing with Atopic Dermatitis

Tuesday, February 18, 2014  
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Feeling that winter itch?  Cold temperatures, indoor heating and long hot showers can zap the moisture from a person’s skin making it dry and cracked.  For those prone to reoccurring skin problems like eczema, a general term used for body rash, these “wintery” conditions will often cause flare-ups leading to intense itching and discomfort.

Atopic dermatitis is the most common type of eczema.  Symptoms include mild to severe itching, scaly and flaky skin, as well as rough, red skin.  Most people have their first symptoms before they turn five years old as it is typically seen in babies and children.  Parents should bring their newborn or child to their family physician at the first sight of symptoms because dietary changes recommended by a doctor can help in controlling symptoms and exacerbations.  Many children will outgrow atopic dermatitis, yet others will continue to deal with it as an adult.  It often happens in people who have a personal or family history of allergies such as hay fever and asthma. 

“The exact cause of atopic dermatitis is not known,” said Roli Dwivedi, M.D., a Minneapolis family physician and member of the Minnesota Academy of Family Physicians (MAFP).  “However, there is believed to be a genetic component to it.  Those who get atopic dermatitis likely have a family member who has also had it.”

The condition can develop any where on the body, but it most often develops on exposed areas such as the arms, legs, scalp, elbow creases, knees, face, wrist, hands or knuckles.  In older children and adults, the skin can become dark and thick which is a sign of recurring incidences of atopic dermatitis.  In those with darker skin, the area affected will often become lighter with thick patches.

Diagnosis is sometimes difficult as symptoms vary from person to person, but a family physician can tell if  someone has atopic dermatitis by examining their skin and asking questions about their health history. 

“The condition can’t be cured, but there are ways to help relieve the symptoms of atopic dermatitis,” said Dr. Dwivedi.  “If you do get a rash, you should avoid scratching it.  As tough as it may be, scratching or rubbing irritated areas will only make the condition worse.” 

A person with atopic dermatitis should use an unscented, thick moisturizing cream or ointment that keeps their skin from drying out.  Petroleum jelly or other emollient creams work well to lock in moisture and reduce excessive dryness.  For moderate to severe cases, steroid cream and ointments can be applied to the skin to relieve itching and redness.  These creams are available by prescription and should only be used intermittently.  Excessive use of topical steroid can leave a person’s skin fragile with a risk of breakage and bacterial skin infection.  Other possible treatments include antihistamine pills (medicines used for people with allergies) and light therapy, but due to risks associated with some of these alternatives, these should only be considered after talking with your doctor and ruling out safer options.

The best way to deal with atopic dermatitis and other types of rash is to prevent flare-ups by avoiding things that trigger them in the first place.

  • Stay clear of irritants  - Limit your contact with harsh soaps, household cleaners, detergents and other chemicals.  Wool or some synthetic fabrics may also irritate the skin.
  • Take care of your skin while washing, bathing or showering – Only use mild, unscented soap and use cool or warm water, not hot. 
  •  Avoid getting too hot or too sweaty  - Heat and sweat make a person’s skin more irritated and itchy.
  • Reduce stress – Practice stress reduction techniques because eczema can flare-up when a person is feeling stressed.

“Finally, you should use a gentle moisturizer every day, “ said Dr. Dwivedi. “The number one rule of thumb in the winter is to ALWAYS keep your skin moisturized.”

The Minnesota Academy of Family Physicians is a professional association of approximately 3,000 family physicians, family medicine residents and medical students organized to assist family physicians in providing quality medical care in Minnesota. The MAFP is the largest medical specialty organization in Minnesota and is a state chapter of the American Academy of Family Physicians, one of the largest national medical organizations in the United States with more than 103,000 members.

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