Monday, February 24, 2014


(Posting this mostly for my convenience)

Eczema is a chronic recurring skin disorder that results in dry, easily irritated, itchy skin. There is no cure for eczema, but good daily skin care is essential to controlling the disease. When your skin is dry, it is not because it lacks grease or oil, but because it fails to retain water. For this reason, a good daily skin care regimen focuses on the basics of bathing and moisturizing.
Wind, low humidity, cold temperature, excessive washing without use of moisturizers, and use of harsh, drying soaps can all cause dry skin and aggravate eczema.

Taking Care of Dry Skin

The most important treatment for dry skin is to put water back in it. The best way to get water into your skin is to briefly soak in a bath or shower and to moisturize immediately afterwards. Use of an effective moisturizer several times every day improves skin hydration and barrier function. Moisturizer should be applied to the hands every time they are washed or in contact with water.
Some dermatologists recommend that you perform your bathing and moisturizing regime at night just before going to bed. You are unlikely to further dry out or irritate your skin while sleeping, so the water can be more thoroughly absorbed into your skin.
If you have hand eczema dermatologists recommend that you soak your hands in water, apply prescription medications and moisturizer (preferably an ointment), and put on pure cotton gloves before going to sleep.

Basics of Bathing


Use warm, not hot, water for at least 10 to 15 minutes. Avoid scrubbing your skin with a washcloth.


During a severe flare, you may choose to limit the use of cleansers to avoid possible irritation.


(within three minutes of taking a bath or shower), apply any special skin medications prescribed for you and then liberally apply a moisturizer. This will seal in the water and make the skin less dry and itchy.

Ways Water Helps Your Skin

  • Water hydrates the stratum corneum (the top layer of skin).
  • Water softens skin so the topical medications and moisturizers can be absorbed.
  • Water removes allergens and irritants.
  • Water cleanses, debrides, and removes crusted tissue.
  • Water is relaxing and reduces stress.

Is Water an Irritant or a Treatment?

Water IRRITATES skin IF…

  • Skin is frequently wet without the immediate application of an effective moisturizer.
  • Moisture evaporates, causing the skin barrier to become dry and irritated.

Water HYDRATES skin IF…

  • After skin is wet, an effective moisturizer is applied within 3 minutes.
  • Hydration is retained, keeping the skin barrier intact and flexible.

Cleansing Tips

  • Gently cleanse your skin each day.
  • Use mild, non-soap cleansers.
  • Use fragrance-free, dye-free, low-pH (less than 5.5) cleansing products.
  • Moisturize immediately after cleansing while your skin is still wet.
  • Avoid scrubbing with a washcloth or towel; pat instead.

What Cleansing Products Should I Use?

Our skin surface is much more acidic than soap: the average pH of soap is 9 – 10.5 while the normal pH of skin is 4 – 5.5. Some non-soap cleansers are specially formulated with a lower pH to be less irritating. NEA Seal of Acceptance Product Directory provides excellent suggestions for appropriate cleansers for eczema.

What Does Cleansing Remove?

  • Sebum (an oily substance produced by certain glands in the skin)
  • Apocrine and eccrine secretions (skin gland secretions, discarded cells)
  • Environmental dirt
  • Bacteria, fungus, yeast and other germs
  • Desquamated keratinocytes (dead skin cells that are the normal product of skin maturation)
  • Cosmetics, skin care products, medications

Bath or Shower?

Either a bath or shower (about 10 – 15 minutes long) will keep the skin from drying out.
DO NOT rub your skin.
DO NOT completely dry your skin after your shower or bath. Instead, pat yourself lightly with a towel if needed.

Types of Baths

A soak in a tub of lukewarm water for 10 – 15 minutes will help the skin absorb water. You may wish to try one of the following for specific treatment:


Bleach baths make the tub into a swimming pool! Soak for about 10 minutes and rinse off. Use 2 – 3 times a week. Bleach baths decrease the bacteria on the skin and decrease bacterial skin infections. Use ½ cup household bleach for a full bathtub, ¼ cup for a half bath.


Add one cup to one pint of vinegar to the bath. Can be used as a wet dressing too as it kills bacteria.


Oils in the bath are a favorite of some providers and patients. Bath oils can leave the tub slippery—be careful. They can also leave a hard-to-clean film. See if they work for you.


When there is a significant flare the bath water may sting or be uncomfortable. Add one cup of table salt to the bath water to decrease this side effect.


Baking soda added to a bath or made into a paste can be used to relieve the itching.


Oatmeal added to a bath or made into a paste can be used to relieve the itching.