Dear Nurse Felicia,
I have been suffering from eczema since I was a child and lately I’ve been having very bad symptoms again. I really don’t like taking steroid medications so what can I do to help prevent the outbreaks from occurring?
Itchy and Scratchy
Dear Itchy and Scratchy,
Oral steroid medications should only be taken when eczema is very severe and all topical treatments (creams and ointments put on the skin) have failed.
You are right that these medications can be dangerous and may have unpleasant side effects, so they should always be taken under supervision of a doctor.
While eczema cannot be “cured” or outbreaks totally prevented there are many ways you can help treat your eczema on your own to minimize outbreaks and diminish their severity when they do occur.
To minimise outbreaks:
• Avoid tight clothes and itchy fabrics like wool or synthetics as well as harsh detergents and laundry starch.
• Avoid contact with latex rubber. (FYI, non-latex condoms are available for people with skin conditions or latex allergies so this is no excuse not to use protection!)
• Be aware that some costume or plated jewelry can contain nickel which can also cause skin reactions.
• Heat and sweat can also be irritants so be sure to bathe directly after exercise or other strenuous activity.
• Take warm baths or showers rather than hot to minimise drying-out your skin, gently pat skin dry rather than rubbing vigorously, and apply a good quality, fragrance-free moisturiser immediately after bathing.
To cope with outbreaks when they do occur:
• Wash daily with a gentle, hypo-allergenic soap and moisturise immediately after.
• Apply a non-prescription steroid cream (hydrocortisone) and anti-itch lotion (ones with camphor or menthol can be very soothing). Reapply as often as possible until the outbreak has resolved.
• Antihistamines (Diphenhydramine, Benadryl) can help relieve itching but also cause drowsiness so should be taken cautiously during the day and avoided when driving or operating machinery. They can be very useful at night though when itching would disturb your sleep.
• Don’t scratch!!! This will only make it worse. If you find that you tend to scratch during the night without realizing, try wearing light cotton gloves to sleep.
Best of luck,
Felicia Price is an American Registered Professional Nurse working in Kigali.
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