This time of year, I always find myself seeing more patients with eczema. The common presenting complaint is a persistent rash that itches so much that it disturbs sleep. The dry, itchy patches of skin are commonly seen on the back, sides of the torso, arms and legs, but can happen almost anywhere. People with a history of allergies, asthma, or childhood eczema are even more likely to develop eczema in the fall or winter.
There are a number of contributing factors to the increased incidence of eczema in the winter:
Furnaces run more, drying out the air inside homes and buildings. We wear more clothing, increasing the friction on our skin. Hot water feels better, so we tend to spend more time in the shower or bath.
That last one sounds counter-intuitive, but the hotter the water and the longer we're in it, the more it tends to remove oils from our skin making us drier. Using true soap is especially drying. Soap attaches to oil which is then stripped off the skin when the soap is rinsed off. That "squeaky clean" feeling from using real soap often isn't a good thing.
Addressing eczema for milder cases can be as simple as applying moisturizers on a frequent basis, using non-soap cleansers, and modifying bathing habits. The most effective moisturizers are creams or lotions with no fragrance. Hypo-allergenic products are preferable. They should be applied liberally at least twice daily. Applying immediately after a bath or shower is an ideal time to apply moisturizers in an effort to "trap" moisture in the skin. Numerous non-soap cleansers are on the market in either bar or liquid form, and usually are labeled as a "cleanser" on the packaging. Keeping baths or showers warm, but not hot, and limiting them to about 5 minutes can be very helpful. Even skipping a shower periodically can help by letting the skin "re-oil" itself again. Avoiding irritating clothing such as some forms of wool, polyester, and rayon can also be beneficial.
More severe cases of eczema can be treated with prescription medications such as topical steroids, non-steroid topical medications, and, in severe cases, oral steroids or other immunosuppressant systemic medications. The vast majority of patients can be treated with topical medications to control eczema. Topical steroids come in various forms and strengths, and can be used safely as long as appropriate medicines are chosen for the severity of the eczema and the body site it involves. Many also benefit from using anti-histamines to control itch while their eczema is improving. See a physician if you can't control your eczema with the over-the-counter measures of moisturizers, non-soap cleansers, and shorter baths/showers.
Stay moisturized, pay attention to how you bathe, and take it easy on your skin. It's eczema season.