Finding the best skin treatments

A topic dermatitis is frequently called “the itch that rashes.” Intensely itchy patches occur on various parts of the body without any seemingly obvious cause. They may be limited to a few spots on arms and legs or may cover most of the body.

Scratching often leads to redness, weeping and even infection. Constant scratching can result in permanent skin changes, as well as loss of sleep and other problems.

Up to 20 percent of children and 3 percent of adults experience atopic dermatitis. While many cases resolve in early childhood, for some it may be a lifelong debilitating problem. Most cases begin in early infancy, but atopic dermatitis may appear at any stage of life.

Atopic dermatitis increases the risk of hand eczema. Many of the children will develop hand eczema as adults. Some of the contributing causes can be irritant chemicals (soap, solvents) or physical trauma such as digging in the garden or handling a lot of papers.

Without proper diagnosis and treatment hand eczema can become both chronic and debilitating. It can interfere with job performance and quality of life. Treatment may require long-term medications (topical steroids, emollients, non-steroidal immune modulators), and modifications in daily hygiene and work habits.

• To decrease the risk of hand eczema, the following may help:

• Wear gloves to protect against harsh cleanser, solvents.

• Use a dishwasher when possible.

• Cooler water and mild soaps are less irritating.

• Emollients (Vaseline, hand cream) should be applied frequently.

• Wear gloves outside in cold weather.

Environmental causes are often important. Wool fabrics, other rough fabrics, jewelry and even some lotions can worsen irritation. Many people with atopic dermatitis also have asthma, and controlling the lung disease may prove beneficial. Allergy shots have not been proven to help eczema in general.

Treatment should be done with the help of your pediatrician or dermatologist because other conditions such as contact dermatitis and allergic reactions may mimic the symptoms. Also, treatment often requires a multifactorial approach as well as lifestyle changes.

Treating the skin involves daily moisturizers (creams or Vaseline are often better than lotions) and topical prescription medicines such as steroid creams or immune modulating creams. These should be used in compliance with your dermatologist recommendations. In the case of infection an antibiotic (topical or oral) may be needed. Lifestyle changes including moisturizers, proper clothing (no wool), and eczema friendly bathing habits may be needed. In severe cases systemic corticosteroids or other systemic drugs may be needed.

Dr. Josephine Futrell is a partner with Dr. Sarah Glorioso at Ark-La-Tex Dermatology, with clinics in Shreveport and Bossier City, and is part of the Willis-Knighton Physician Network.