Ashley Lora, The Eczema Warrior

WHAT IS ECZEMA?

Eczema is the name for a group of skin conditions that cause the skin to become red, itchy, and inflamed. Over 30 million Americans have some form of eczema. The most common form of eczema is called Atopic Dermatitis.

Eczema affects all skin colors. The prevalence of eczema is increasing and more common among the Black, Asian, and Pacific Islander population.

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person scratching arm with eczema

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person with eczema on arm

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person with eczema on eye and face

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Though eczema can appear anywhere on the body, in adults it is usually seen on the neck, upper arms and back, elbow and knee creases, and back of the hands, feet, fingers and toes. The skin around the eyes, including eyelids, may also be affected. While many people first develop eczema as children, it can develop at any point in your life and have a significant impact on overall quality of life.

The most common symptom of eczema is itch.  Research shows more than 85% of people with eczema experience itch every day. For many people, the itch can range from mild to moderate. Up to 30% of people rate sleep disturbance as their most or second most burdensome symptom.

Eczema and its symptoms are different for everyone. 

Here’s what to look for:

  • Itchiness
  • Dry, sensitive skin
  • Inflamed, discolored skin
  • Rough, leathery, or scaly patches of skin
  • Oozing or crusting

You may have all or just a few of these symptoms. There may be times your symptoms go away, and other times when you have flare-ups.  The best way to find out if you have eczema is to consult with a healthcare professional.

How is Eczema Different in Skin of Color

Eczema can look quite different on darker skin tones.

WHY DO PEOPLE GET ECZEMA?

The answer to why some people get eczema is a complex mix of factors including genetics, skin barrier function and environment. You may be at higher risk for developing eczema if a parent, sibling, or other close relative has it. Environment is also thought to play a significant role. Eczema rates tend to be higher in urban settings where there are higher levels of environmental pollutants.

If you think you may have eczema – take our quiz to help recognize common eczema symptoms and schedule an appointment with your healthcare provider.

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FORTIFY YOUR SKIN’S MICROBIOME

Your skin is a diverse community of good and bad bacteria on the skin’s surface that make up its microbiome. Healthy looking skin has a balanced microbiome and preserved skin barrier. People with eczema have a weakened or “leaky” skin barrier that allows water to escape and allergens, irritants, and infectious agents to enter. People with eczema also tend to have an over-reactive immune system.  Certain triggers, whether internal or external, can cause a hyperreactive response that leads to itching and scratching, causing what is known as the “itch-scratch cycle”.

Much like our gut relies on active probiotics and other gut bacteria to restore health, the biome of the skin is at its best with a balanced microbiome. Prebiotics are food for good bacteria in the microbiome. In skincare, prebiotics like colloidal oatmeal encourage the presence of good bacteria, which can help create a healthy environment for the skin microbiome. When your skin microbiome is balanced, your skin looks and feels healthy.

IMPACT ON QUALITY OF LIFE

Dealing with eczema can take its toll. In fact, research shows atopic dermatitis is associated with a lower quality of life than a number of other common chronic illnesses, including heart disease, diabetes and high blood pressure. The harmful effects can impact a range of areas, including emotional and mental health, physical activity, social functioning, sleep disturbance, work productivity, leisure activities, and family relationships.

Just know you’re not alone. Half of adults with moderate to severe AD say that atopic dermatitis significantly limits their lifestyle and nearly 35% with mild atopic dermatitis also experience some lifestyle limitations.

Having eczema may make you feel anxious, embarrassed, or lacking in confidence. It could also make you feel angry, frustrated or depressed.  More than one-third of people with AD say they “often” or “always” feel angry or embarrassed by their appearance due to the disease and one-third to one-half of adults with AD avoid social interactions because of their appearance. If you’re experiencing anxiety or depression, consult a healthcare provider or mental health specialist.    

While there is no single solution for coping with eczema, there are lots of management strategies that can help – some literal, like taking medicine daily or sticking to a skincare routine. Others are more subtle and personal, like practicing self-care, taking time for you, and finding distractions.  The key is knowing yourself and finding what works best for you.

Emotional Impact of Eczema

MANAGING ECZEMA

While there is no cure, eczema can be managed by identifying and avoiding the things that cause flareups and establishing a daily skin care routine.  

Eczema: Tips to Remedy Triggers & Evaluate Products

AVOID ECZEMA TRIGGERS

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IRRITANTS

Over time, you will learn the things that contribute to your eczema flareups. Common irritants can include:

Soaps detergents & dryer sheets 

Bubble-bath & certain shampoos

Disinfectants like chlorine

Fragrances & dyes

Wool or other coarse fabrics

Your doctor may recommend:

  • Washing new clothes before wearing them.
  • Using dye free and fragrance-free products.
  • Using sunscreens made for sensitive skin.
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ALLERGENS

Some people have a reaction to indoor and outdoor allergens that can cause an allergic reaction. The result is itchy, inflamed skin. Here are some common allergens:

House dust mites

Pets

Pollen (seasonal)

Molds

To reduce house dust mites:

  • Vacuum and wet-dust the bedroom floor and furniture frequently.
  • Keep soft toys to a minimum and wash often.
  • Groom pets regularly to reduce pet dander.
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ENVIRONMENT

Extremes of temperature and humidity may trigger a flare-up of eczema symptoms. Environmental triggers include:

Hot or cold temperature

High or low humidity

Tobacco smoke

Traffic pollution

Water hardness

Try to maintain an even temperature and humidity in your home. Hot temperatures can cause sweating which can trigger eczema.

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FOOD

Though food allergies do not cause eczema, they can trigger a worsening of existing eczema symptoms. The most common culprits include:

Dairy products

Eggs

Nuts and seeds

Wheat

If you suspect a food is making your eczema symptoms worse, talk to your doctor. You may be asked to keep a diary to help identify one or more suspect foods.

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STRESS

Stress doesn’t cause eczema, but stress, anger and frustration can make symptoms worse. Stress can also trigger habit scratching, causing a cycle of more inflammation and itching, making the skin rash even worse.

WHAT HELPS ECZEMA

Showering Tips

  • Use lukewarm water, not hot.
  • Limit the length of your shower or bath to 10 to 15 minutes.
  • Use a mild, non-drying, fragrance free cleanser.
  • Gently pat skin dry – don’t rub.
  • Avoid body sponges and washcloths.

Moisturizing Tips

  • Apply moisturizers to damp skin (within 3 minutes of taking a bath or shower).
  • If prescribed by a doctor, apply any special medications first and then liberally apply moisturizer. For some medications you may be advised to wait 15-20 minutes after applying before applying moisturizer, so be sure to follow your doctor’s instructions.
  • Consider using a moisturizer with colloidal oatmeal, such as AVEENO® Eczema Therapy Moisturizing Cream or AVEENO® Eczema Therapy Itch Relief Balm clinically proven to help relieve the itching and irritation of eczema. Colloidal oatmeal is the only skin protectant ingredient FDA-approved for the treatment of eczema.

As always, talk to your doctor if you have any questions or concerns.

HOW IS ECZEMA TREATED?

The treatment of eczema is similar in people of all races and ethnicities. Goals of treatment include relieving itch and hydrating to help restore the skin moisture barrier. 

Gentle skin care and liberal use of moisturizers are considered first-line therapy for management of eczema. So even when you are not experiencing a flare, basic management including trigger avoidance and moisturization is essential.  

Cleansers and Moisturizers

Moisturizers help replace lost moisture, help restore the skin moisture barrier, and help relieve flare-ups. It is important to continue a regular moisturizing routine even when you are not experiencing a flare. Mild cleansing won’t strip the skin of essential moisture and can help prepare the skin for topical therapies.

 

Over-the-counter Medications

Topical anti-itch creams containing hydrocortisone may help to ease symptoms. Follow the directions on the label carefully. Do not use more often or longer than recommended on the label or by your healthcare provider.

 

Prescription Medications

There are a number of prescription topical eczema medications used to manage symptoms and reduce inflammation. The most common include topical corticosteroids in varying strengths. Considered the mainstay of eczema therapy, topical corticosteroids help to ease itching in both acute and chronic eczema. When using a steroid, follow your doctor’s directions carefully and only apply the steroid to eczema-affected areas of your skin. Using too much may cause hypopigmentation – a lightening of that area of the skin.

Non-steroidal prescription treatments for the treatment of mild-to-moderate atopic dermatitis in adults and children include Topical Calcineruin Inhibitors (TCIs) and PDE4 Inhibitors. Other prescription treatment options include oral corticosteroids, biologics and antibiotics.

 

Topical Steroid Withdrawal

The National Eczema Association (NEA) is committed to raising awareness about Topical Steroid Withdrawal (TSW), a serious potential side effect of topical steroid use that is not readily recognized by patients and providers.

The National Eczema Association recently released an educational announcement on the use of topical steroids for the treatment of eczema. Topical corticosteroid withdrawal (sometimes called “topical steroid addiction” or “Red Skin Syndrome”) appears to be a clinical adverse effect that can occur when topical corticosteroids are inappropriately used or overused, then stopped.  It can result from prolonged, frequent, and inappropriate use of moderate to high potency topical corticosteroids, especially on the face and genital area, but is not limited to these criteria.

Burning, stinging, and bright red skin are the typical features of topical steroid overuse and withdrawal.  The signs and symptoms occur within days to weeks after TCS discontinuation. If you believe you have these symptoms, contact your healthcare provider.

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ADDITIONAL TIPS FOR COPING WITH ECZEMA

Pamper your skin.  Eczema can be managed through maintaining good skin care habits while avoiding things that can trigger flare-ups.

Try not to scratch. Easier said than done, but repeated scratching on dark skin can lead to skin thickening and pigmentation changes.

Use sunscreen. Everyone should protect their skin from the sun every day, all year round.  If your eczema has caused discolorations, going out in the sun can worsen it.  Many people with eczema find mineral-based sunscreens containing titanium dioxide are gentle to the skin. 

THE AVEENO® COLLOIDAL OATMEAL DIFFERENCE

For generations, the moisturizing properties of colloidal oatmeal to help restore, nourish and soothe the skin’s moisture barrier have been known to help compromised skin conditions. Colloidal oatmeal is the only skin protectant ingredient FDA-approved for the treatment of eczema.

Moisturizers are considered first-line therapy for the treatment of eczema. But not all emollients are alike. Aveeno® Eczema Therapy products are formulated with colloidal oatmeal, rich in proteins, vitamins B and E, and nourishing lipids that help restore and strengthen the skin’s moisture barrier, helping to relieve dry skin while helping to support the skin’s microbiome, for healthier looking skin.

The clinical benefits of colloidal oatmeal have been demonstrated through extensive research across diverse patient populations. In clinical studies, Aveeno® Eczema Therapy Moisturizing Cream has been shown to improve signs of atopic dermatitis from Day 1 and Aveeno® Eczema Therapy Itch Relief Balm provides immediate and long-lasting relief of dry, itchy skin.

Additional studies have shown Aveeno® Eczema Therapy Moisturizing Cream is proven to provide symptomatic relief, reduce topical corticosteroid use, and enhance quality of life in people with mild to moderate atopic dermatitis. Aveeno® Eczema Therapy Moisturizing Cream is an affordable and easily accessible treatment alternative to prescription barrier creams improving the skin moisture barrier with comparable efficacy.

Solution Related Products

Experience dermatologist-recommended eczema solutions that help provide relief to eczema-prone skin.

ADDITIONAL RESOURCES

American Academy of Dermatology (AAD) The AAD website provides a search tool that you can use to find a board-certified dermatologist in your area. 

Skin of Color Society (SOCS) – The SOCS aims to raise awareness and champion excellence in the treatment of dermatologic conditions in skin of color. The SOCS website provides an extensive searchable list of providers on their website.

National Eczema Association. The National Eczema Association website also has a search tool  that you can use to find a doctor or other healthcare professional in your area who specializes in treating eczema.

Eczema in Skin of Color