Put the ex in Eczema - Skin Care - Brief Article

Men's Fitness, March, 2002 by R. Daniel Foster

It can be maddening. The vicious itch-scratch cycle that eczema creates can leave your skin red and raw, your composure unraveled and your love life in ruins. The condition, which can afflict most any body part, is genetically based. If your mom or dad had it, you've got a one-in-four chance of scratching too. Sufferers constitute about 10 percent of the population, with about 15 million Americans enduring symptoms at any given time.

It doesn't stop there.

"Eczema-prone skin can be extraordinarily sensitive," says Robert McAlister, Ph.D., executive director of the National Eczema Association. "People with eczema often have hay fever and allergies as well. They're just more responsive to irritants." Those triggers include woolen fabrics, detergents, certain soaps and fragrances, and emotional stress.

There are three main types of eczema, none of which are contagious. The most common form is atopic dermatitis, which usually appears in skin folds that dry, redden and then itch. Often involved are the insides of elbows, the backs of knees, nose creases and between the toes.

Seborrheic dermatitis is an advanced form of dandruff, possibly caused by fungi colonizing on the scalp; it generally strikes men more than women. Affected areas, which also include the chest, eyebrows, eyelids, ears, forehead and chin, can be oily and red and may or may not itch.

Hand eczema can redden and crack hands, covering them with itchy, scaly patches. The condition is more likely to occur if your skin often gets wet or is exposed to chemicals. Or you may have a contact allergy; latex gloves are common culprits.

THE FIX

* Moisturizing the skin is your first and primary defense: Rub in your favorite balm immediately after bathing. "Eczema-prone skin cells are poor retainers of water," says McAlister. "When you bathe or just wash, you rob your skin of the small amount of moisture it's been able to produce. You need to replenish it fast."

* No more than three minutes should pass after washing before you seal in moisture. Also, use warm and not hot water, which dries skin. Avoid excessive toweling and scrubbing.

* For extreme dryness, choose products with petroleum jelly--greasy, yes, but highly effective at providing an airtight moisture barrier. Thick creams (the ones that come in jars) are best for less intense cases. Mineral oil-based products as Uremol, Lac-Hydrin and AmLactin contain urea and lactic acid to help absorb moisture. Standard hand lotions are less effective; use them for dry, non-inflamed skin.

* Severe cases of eczema often require a prescription-strength corticosteroid ointment or cream that soothes itching by decreasing levels of inflammation. However, prolonged corticosteroid use can thin your skin and create irreversible stretch marks.

* Topical immunomodulators have been developed in the past year to banish that thinned-skin side effect. These drugs suppress the immune system to squash local inflammation and interrupt the itch-scratch cycle. Ask your doctor about tacrolimus (brand name Protopic) and, pending FDA approval, pimecrolimus.

* Luxiq, a new, foam-based corticosteroid, penetrates skin without leaving a greasy residue; it's great for the scalp and other hairy areas. "Luxiq is really a disappearing foam," says McAlister. "Ointments and creams tend to build up and get gunky, so this is a welcome breakthrough."

* To treat seborrheic dermatitis, look for shampoos that contain coal tar, zinc pyrithione, selenium sulfide or salicylic acid.

* For hand eczema, doctors recommend Cetaphil or Aquaphor liquid cleansers. antibacterial or Avoid antibacterial or waterless cleansers that contain alcohol.

* Wear cotton gloves if your hands get irritated; for wet work, cover the cotton with neoprene or vinyl gloves. Irritants can get trapped beneath rings, which should be taken off when showering, washing hands or doing chores.