From Amanda Hofmann, VP Clinical at United Allergy Services:

Earlier this month, the famous groundhog, “Punxsutawney Phil”, saw his shadow and promised 6 more weeks of winter. This past week, Phil showed he was serious about that promise as winter storms swept across most of the US. This recent wintry weather has given us the perfect opportunity to talk about proper skin care, especially if eczema or atopic dermatitis is present.

What is Eczema and Atopic Dermatitis?

Commonly, patients and even healthcare providers use the terms ‘eczema’ and ‘atopic dermatitis’ interchangeably. All atopic dermatitis is a form of eczema, however not all eczema is atopic dermatitis. Atopic dermatitis is the most common form of eczema and typically begins in childhood. This skin condition is typically characterized by dry, itchy skin and rashes that range from red/purple to brown/gray. Skin becomes dry, itchy, and inflamed due to immune system hyper-reactivity and the lack of a protective protein called filaggrin. A key factor in atopic dermatitis is a lack of this protein. Filaggrin allows our skin to produce and maintain a strong skin barrier. Without a strong skin barrier, moisture can quickly escape the skin and bacteria carried by fingernails can easily penetrate the skin after scratching.

Atopic dermatitis is commonly triggered by allergen exposure, stress, infection, or weather changes. Also, combining cold, dry air outside and dry indoor heat causes moisture to escape from the skins surface, leading to dry skin. Layering clothing, blankets, or taking lengthy hot baths or showers can lead to skin dehydration. All of these factors are more present in winter, making this time of year prime for suffering an atopic dermatitis outbreak.

Skin Care Tips: Eczema and Atopic Dermatitis Relief

Here are some helpful hints on how to help the skin survive and get some much-needed relief:

  • Dress in soft, breathable clothing. Avoid itchy fabrics like wool that can further irritate the skin.
  • Despite the persistent itch, try not to scratch or rub the skin. Scratching causes additional skin damage and irritation, as well as causes more heat on the surface of the skin. Skin damage, irritation and heat leads to more intense itching. By refusing to scratch, the itching cycle can be broken and the skin will be protected from virus and bacteria carried by fingernails.
  • For relentless itching sensations, apply cool, damp cloths to affected areas to cool the skin down. Also useful are cold compresses, ice packs, or even that bag of frozen peas in the back of the freezer. Just make sure to always place a towel or barrier between very cold or frozen items and bare skin.
  • Although hot showers and baths go hand in hand with winter weather, aim for lukewarm water bathing lasting for no more than 10 minutes.
  • When bathing, skip the harsh washcloths and loofahs. Instead use your hands to lather up with a good cleanser. (A cleanser is different than soap or body washes. Soaps and body washes typically contain sodium lauryl sulfate which is a skin irritant, and are not as moisturizing or hydrating as a cleanser)
  • Make sure cleansers, moisturizers, detergents, and skin hygiene products are fragrance free and dye free. (Look for the National Eczema Association Seal of Acceptance on products to guarantee they are free of fragrance, dyes and other common allergens.)
  • After bathing, pat the skin dry rather than harshly rubbing.
  • Replace moisture in the skin by applying a moisturizer immediately after taking a bath or shower. Aim for moisturizing to occur within the first 3 minutes.
  • Moisturizers are classified as an ointment, cream, or lotion based on the amount of oil and water they contain. Higher oil content in a moisturizer is usually better for providing relief and even treating atopic dermatitis. Ointments have the highest oil content and are the best line of defense for atopic dermatitis.
  • Try using a humidifier.  Change the water in the humidifier and clean the machine every three days. Using distilled or demineralized water is recommended.

The National Eczema Association is a great resource for learning more about eczema, atopic dermatitis, causes, symptoms, and treatment options. There is a wealth of information on their website: https://nationaleczema.org/

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Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, PA, and spent  8 years in clinical practice before joining United Allergy Services. She is the Vice President of Clinical at UAS and the past president of the Association of PAs in Allergy, Asthma, and immunology. 

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