Handle an Eczema Flare Up

Eczema is a catch-all phrase that refers to several skin conditions. The three most common forms of this skin condition are atopic dermatitis, contact dermatitis, and dyshidrotic eczema.[1] How you handle your flare-up depends on the type of eczema you have. Sufferers tend to go through cyclical periods with their eczema: times when their skin is clear, first signs and symptoms, and full-blown flare-ups.

Steps

Understanding the Types of Eczema

  1. Identify triggers for atopic dermatitis. Atopic dermatitis is essentially a chronic allergic reaction. It is most common in children and babies. However, an adult can have this type of eczema as well.[2] Flare-ups of this type of eczema can be caused by irritants, allergens, stress, fabrics, and dry skin, to name just a few.[3] If you have food allergies, you may be more likely to experience eczema flare-ups.[4]
    • Atopic dermatitis is often passed down from one generation to the next, and people who are prone to this type of eczema are also likely to develop hay fever or asthma.[3]
    • This type of eczema in infants often starts on the child's head area, either the cheeks or the scalp, though it can spread to other areas. It can exhibit as small, red bumps that itch or as a scaly rash. When it spreads, it often shows up in the bend of the elbow or knee, though it can be all over the body, especially in babies. It is not contagious.[5]
  2. Watch for triggers of contact dermatitis. Contact dermatitis is also an allergic reaction, but it's not chronic like atopic dermatitis. Contact dermatitis only occurs when your skin comes into contact with a particular irritant.[6] The most common irritants are certain types of metals, poison ivy, soaps, and even perfumes or make-up. This rash is not contagious, either.[6]
    • Contact dermatitis also shows up as small, red bumps that itch. They may also leak fluid, and turn into scaly, scabbed skin.[7]
  3. Learn your risk for dyshidrotic eczema. This type of eczema is less common than atopic dermatitis. It usually only shows up on your hands and feet.[8] Flare-ups for this type of eczema can be caused or exacerbated by stress, allergies, too much time in water, dry skin, and contact with certain metals, such as nickel.[9]
    • This type of eczema begins as a scattering of tiny blisters that itch. Once they burst, the skin takes on a scaly look.[8]
    • Women are twice as likely to develop dyshidrotic eczema than men.[9]
    • People with chronic dyshidrotic eczema are less likely to have flare-ups after middle age.[10]

Handling Atopic Dermatitis Flare-Ups

  1. Apply a corticosteroid cream. This type of cream can significantly reduce flare-ups, though it may take up to 3 weeks. Your doctor can prescribe a stronger cream than you can get over the counter.[11]
    • The best time to apply the cream is right after you shower. Rub the cream on the affected areas.[11]
    • Make sure you only use the corticosteroid cream as your doctor directs you, as they can have serious side effects if you use them too long on any particular area.
  2. Take a cool bath. A lukewarm bath can help relieve the symptoms of eczema, taking the sting out of warm skin. Bath your child with eczema once daily, but not for more than 10 minutes at a time.[12] Add a dash or two of bath oil to the water, and apply a moisturizer or corticosteroid cream afterwards.
    • Some people find colloidal oatmeal effective. You can find colloidal oatmeal at a drug store. Add it to a warm bath, and sit in the bath 10-15 minutes.[13]
    • When skin is infected, use bath time to soften scabs. Gently rub off the scabs after the bath, as creams should be applied directly to skin.[14]
    • Do not add bubble bath or other such additives to your bath. These will irritate your skin.
  3. Ask your dermatologist about a bleach bath. A bleach bath sounds harsh, but it can actually be helpful to kill the bacteria on your skin that cause eczema flare-ups. If your doctor approves it, add a 1/2 cup of household bleach to a lukewarm bath. You or your child can take a bleach bath once a day. Don't soak in the bleach bath for longer than 5-10 minutes.[15]
    • For an infant or toddler bleach bath, add 1 teaspoon of bleach per gallon of water.
    • Do not apply bleach directly to the skin. This could cause irritation.
  4. Isolate irritants. While it can be difficult to isolate what irritants or allergens cause a flare-up, it can be important for dealing with atopic dermatitis. For irritants, everything from bar soap to laundry soap and to perfume and cigarette smoke can cause flare-ups.[3]
    • To isolate what irritants affect the person with atopic dermatitis, try switching out items one at time. For instance, you can start by trying a more natural laundry detergent. If that's not it, you can try switching out the soap used in the bath or shower for another one.[11]
  5. Isolate allergens. If you have atopic dermatitis, you may also be more sensitive to certain allergies, including food and airborne allergens. They may cause normal reactions, as well as causing your eczema to flare up. Try to determine what causes allergic reactions for you by keeping a food journal, so you can track allergic reactions against what you eat.[3]
    • For food allergies, foods such as peanuts, wheat, soy, milk, and eggs can cause allergic reactions, including an eczema flare-up, in children and adults with atopic dermatitis.[3]
    • Some airborne allergens you may be more susceptible to include pet dander, pollen, and dust mites.[3]
    • Ask your doctor about allergy testing if you cannot determine what you or your child may be allergic to.
    • Some food allergies, especially peanuts, can cause life-threatening reactions. If you believe you or your child is having an allergic reaction to a food, seek medical care immediately.
  6. Avoid certain fabrics. Fabrics that scratch the skin, such as wool and even some man-made fibers, can also cause flare-ups. Choose fabrics that don't scratch, and make sure clothing fits properly so it doesn't rub. Natural fibers such as cotton, silk, and bamboo are good choices, but avoid wool.[3]
    • Also, remove tags from clothes or by ones without, as they can rub, as well.[16]
    • Always wash new clothes before wearing them, as they can still have irritating dyes and chemicals in them.[16]
  7. Use a moisturizing cream or lotion twice a day. Keep your skin moisturized, as it can help keep eczema flare-ups to a minimum. In addition, it can help soften your skin, easing the pain of eczema.[16]
    • Pick a cream that is thick and fragrance-free. Fragrances can irritate skin if you have eczema. In fact, something simple such as petroleum jelly can be effective.[16]
  8. Try wet wrap therapy. Wet therapy is the process of apply wet bandages at night to help soothe eczema. They reduce heat on the skin, block you from scratching, and help moisturize the skin.[17]
    • First apply a corticosteroid cream to the irritated areas of the skin. Use a moisturizer all over the body after the corticosteroid cream. Remember the corticosteroid cream should only be applied to the areas where your eczema is flaring up.[18]
    • Soak cloth towels, clean bandages, or paper towels in water with a small squirt of unscented bath oil. Wrap the wet towels around the skin. Apply them to the areas that are most severe. You may need to completely cover your arms and legs if the eczema is really bad. Try a wet shirt if your chest is irritated.[18]
    • Remove them in the morning. You can also apply them during the day. If you do so, take them off when they are dry.[18]
    • Hold cool, wet towels against the face, but don't wrap them around. Keep them on for 5 minutes.[18]
  9. Don't scratch. Scratching makes the rash worse. In fact, scratching the rash can cause the skin to thicken in areas and lead to infection.[19]
    • If you have trouble not scratching, cut your nails short or wrap band-aids around your fingertips.
  10. Take oral antihistamines. Oral antihistamines, such as diphenhydramine (Benadryl), can be helpful to reduce the itching associated with flare-ups. Because they can cause drowsiness, take them before bed.[20]
  11. Ask your doctor about other options. If your atopic dermatitis doesn't respond to at-home treatments, she may recommend other topical or oral treatments. She may also recommend a referral to a dermatologist (skin specialist), who can prescribe other medications.[20]
    • If your skin becomes infected, or you develop open sores from scratching, your doctor will likely prescribe antibiotics.
    • Your doctor may prescribe oral or injected corticosteroids. These suppress inflammation by mimicking the natural effects of your body's hormones in greater doses. They have the possibility of serious side effects and are not recommended for mild cases or long-term use.[20][21]
    • Another option is skin-repairing creams. A certain class of drugs called calcineurin inhibitors (e.g., tacrolimus, pimecrolimus) alter your immune system when applied to the skin and help reduce atopic dermatitis flare-ups. They can cause serious side effects, so they are usually reserved only for severe cases.[20]

Dealing With Contact Dermatitis

  1. Wash off the irritant. If you notice a rash developing in response to something you've put on your skin, wash your skin off with warm soap and water.[22]
    • You may notice red skin, small, itchy bumps, tiny blisters, and/or warm skin.[22]
    • Also wash anything else that came in contact with the irritant that you use regularly, such as your clothing.[22]
  2. Avoid scratching. Though scratching is tempting, you should avoid it as much as possible. Scratching can make the rash worse, and possibly introduce infection.[22]
  3. Employ antihistamines. Because contact dermatitis is an allergic reaction, you can take an over-the-counter oral antihistamine pill, such as loratadine or cetirizine. Take these pills once a day to help manage symptoms.[23]
  4. Isolate irritants and allergens. Just like atopic dermatitis, allergens and irritants can cause flare-ups, even if you inhale them or eat them.[23] Try changing out your soaps and detergents to figure out what bothers you, and keep a food journal so you can make connections between what you eat and flare-ups.
    • Remember that sometimes more than one factor may be causing your dermatitis. You may be affected by both your make-up and your sunscreen. In addition, sometimes the sun plays a factor, causing dermatitis in combination with another irritant.[22]
  5. Ask about patch testing. One way to help determine the source of your contact dermatitis is to do a patch test. Your doctor will apply patches of certain allergens and irritants to your skin, which you wear for 48 hours. When you go back to the doctor, she'll determine which ones you've reacted to, which can help you avoid allergens in the future.[23]
  6. Avoid allergens and irritants. Once you figure out what causes your contact dermatitis, you will need to avoid that irritant in the future. For instance, if a particular detergent or soap causes your eczema, you will need to switch to other brands, preferably ones that are natural and fragrance-free.[23]
  7. Use moisturizers frequently. Moisturized skin is less likely to develop a flare-up. Additionally, moisturizers can help relieve the pain of flare-ups by softening cracked skin.[23]
    • Apply a thick moisturizer several times a day to your body.
  8. Try wet dressings. Like atopic dermatitis, bad flare-ups of contact dermatitis can be treated with wet wrappings. Apply wet bandages or cloth towels over moisturizers at nighttime to help soothe the area.[23]
  9. Use a steroid cream. Just like with atopic dermatitis, a steroid cream can help relieve the symptoms of contact dermatitis. Apply this cream to the affected area after you bathe or at nighttime.[24]
  10. Ask about corticosteroid pills. If your reaction is particularly severe, ask your doctor about corticosteroid pills. These pills can help relieve inflammation on your body.[24]
    • You may also need a round of antibiotics if your rash becomes infected.[24]

Dealing With Dyshidrotic Eczema

  1. Use a moisturizing cream or ointment. This is especially helpful for dyshidrotic eczema, which tends to occur on the hands and feet. Choose a moisturizing cream formulated for hands or feet.
    • Petroleum jelly can also help keep your skin moisturized.
    • You may also be able to find a barrier cream, such as Tetrix, that can help reduce your exposure to skin irritants. This can be helpful if you handle irritating substances, such as water, cement, or nickel, during your work.
  2. Use a corticosteroid cream. Corticosteroid creams are effective for pretty much any kind of eczema. Your doctor can prescribe you one that will help treat your flare-up.[25]
    • Use the cream after bathing, or try putting it on before you go to sleep. In fact, you can apply it at night and then put on cotton gloves, which will keep the cream on your hands.[26]
  3. Don't scratch. Scratching makes the rash worse. In addition, bursting the blisters also makes the rash worse. If you can let them heal instead of bursting them, your skin will likely heal faster.[26]
  4. Avoid water. Unlike other types of eczema, water can irritate this rash. Try to keep your hands out of water as much as possible.[26]
    • Sweating can also contribute to flare-ups. If you sweat a lot, your doctor may prescribe a treatment for this to help your eczema.
    • Additionally, make sure to dry your hands thoroughly when you do get them wet.
  5. Avoid certain types of metals and other irritants. Metals such as nickel, chromium, and cobalt may also cause flare ups. You may be exposed to these metals if you work with concrete.[9] Other chemicals from work or environmental exposure may also cause a flare-up.
    • To keep your hands from this irritant, try wearing gloves.
  6. Use calamine lotion. Calamine lotion can help sooth your rash. It can also calm the itching.[26]
    • You can also apply this lotion after washing your hands or bathing.
  7. Try a witch hazel soak. You can find witch hazel at the drug store, usually near the rubbing alcohol. Witch hazel is an astringent. Soaking your hands in a bath of witch hazel can provide you with some relief and help the healing process.[27]
  8. Try techniques to help you relax. This type of eczema can flare up when you're stressed out. Try to keep your stress levels down by incorporating calming routines into your life, such as a daily meditation regiment.[9]
    • Identify what causes you stress. Whether it's your job or even the evening news, identifying what makes you stressed out is the first step in dealing with it. Avoid or change what you can, such as skipping the news, and try to change your attitude about the rest.[28]
    • Try meditation. One simple way to meditate is pick a mantra. A mantra can be any simple phrase that calms you, such as "Life is good," or even just "om." Close your eyes, and repeat the phrase, letting your mind fill up with it. Continue until you feel calmer.[29]
  9. Talk to your doctor about immune-suppressing creams or pills. Because this type of eczema is an immune response, immune-suppressing creams or pills can be effective. Some drugs in this class are tacrolimus and pimecrolimus.[25]
    • Your doctor will decide whether creams or oral treatment will be more effective for you.
  10. Ask about phototherapy. This type of light treatment can help decrease the severity of a flare-up, especially when used in combination with medications to help you absorb the ultraviolet light used.[25]
    • Usually, this treatment is only used when others do not work.[25]

Tips

  • See your doctor if you suspect you have any type of eczema. She can help you decide on the best course of treatment.

Warnings

  • If you see any signs of infection, such as increased redness, warmth, swelling, or pus, see your doctor immediately.

Related Articles

Sources and Citations

  1. ↑ https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/eczema
  2. ↑ http://www.mayoclinic.org/diseases-conditions/eczema/basics/definition/con-20032073
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 http://www.niams.nih.gov/Health_Info/Atopic_Dermatitis/default.asp
  4. ↑ https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/a---d/atopic-dermatitis/who-gets-causes
  5. ↑ http://kidshealth.org/parent/infections/skin/eczema_atopic_dermatitis.html
  6. ↑ 6.0 6.1 http://www.mayoclinic.org/diseases-conditions/contact-dermatitis/basics/definition/con-20032048
  7. ↑ http://www.mayoclinic.org/diseases-conditions/contact-dermatitis/basics/symptoms/con-20032048
  8. ↑ 8.0 8.1 http://www.mayoclinic.org/diseases-conditions/dyshidrosis/basics/definition/con-20026887
  9. ↑ 9.0 9.1 9.2 9.3 http://www.nlm.nih.gov/medlineplus/ency/article/000832.htm
  10. ↑ http://emedicine.medscape.com/article/1122527-overview
  11. ↑ 11.0 11.1 11.2 http://familydoctor.org/familydoctor/en/diseases-conditions/eczema-and-atopic-dermatitis.printerview.all.html
  12. ↑ http://nationaleczema.org/eczema/child-eczema/infants-toddlers/
  13. ↑ http://dermnetnz.org/treatments/oatmeal.html
  14. ↑ http://skincentre.com.au/wet-wraps-eczema-2/
  15. ↑ https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/a---d/atopic-dermatitis/eczema-bleach-bath-therapy
  16. ↑ 16.0 16.1 16.2 16.3 https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/a---d/atopic-dermatitis/tips
  17. ↑ http://www.medscape.com/viewarticle/515440
  18. ↑ 18.0 18.1 18.2 18.3 http://www.dermnetnz.org/procedures/wet-wraps.html
  19. ↑ http://kidshealth.org/parent/infections/skin/eczema_atopic_dermatitis.html#
  20. ↑ 20.0 20.1 20.2 20.3 http://www.mayoclinic.org/diseases-conditions/eczema/basics/treatment/con-20032073
  21. ↑ http://www.mayoclinic.org/steroids/art-20045692
  22. ↑ 22.0 22.1 22.2 22.3 22.4 http://acaai.org/allergies/types/skin-allergies/contact-dermatitis
  23. ↑ 23.0 23.1 23.2 23.3 23.4 23.5 https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/a---d/contact-dermatitis/diagnosis-treatment-and-outcome
  24. ↑ 24.0 24.1 24.2 http://www.mayoclinic.org/diseases-conditions/contact-dermatitis/basics/treatment/con-20032048
  25. ↑ 25.0 25.1 25.2 25.3 http://www.mayoclinic.org/diseases-conditions/dyshidrosis/basics/treatment/con-20026887
  26. ↑ 26.0 26.1 26.2 26.3 http://www.nhs.uk/Conditions/pompholyx/Pages/Introduction.aspx
  27. ↑ http://www.mayoclinic.org/diseases-conditions/dyshidrosis/basics/lifestyle-home-remedies/con-20026887
  28. ↑ http://www.mayoclinic.org/healthy-lifestyle/stress-management/basics/stress-relief/hlv-20049495
  29. ↑ http://www.mindbodygreen.com/0-16452/6-simple-meditation-techniques-for-real-people.html

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