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Eczema

Eczema is frequently called atopic dermatitis because it was noted to occur in individuals with allergic symptoms, e.g., allergic rhinitis (hay fever) and asthma. The term atopic simply means allergic. Even though eczema was considered to be an allergic problem, allergy seems to be less likely as our understanding of the disease increases. Physicians know that eczema is a very complex disease and contains allergic as well as non-allergic elements in different individuals. As a result, the treatment of every individual may vary.

While the causes of eczema continue to be investigated, certain things are known about the disease. The skin is much more easily irritated than normal skin. Dryness of the skin is a primary component and results in significant itching. Eczema is known as “the itch that rashes”. Itching is made worse by irritants on the skin. Winter months are particularly bothersome because of the dry winter air. Flares in the summer months can occur after exercise because sweat is a significant irritant. Citrus or some vegetables, e.g., tomato, can act as a primary irritant when they touch the skin. Stress in some individuals can affect the skin. While emotional factors may play a role in flaring eczema, they are not considered a primary source of causing the onset of eczema, if it is not already present.

Eczema occurs in about 3% of the population. In about 80% of those individuals, the onset occurs in the first year of life. One-half are free of disease by age 2 years, about one-fourth by the end of adolescence, and the remaining one-fourth will continue to have eczema into adult life. Some individuals do not have the onset of symptoms until adolescence or adulthood.

Treatment is multifaceted and includes lifestyle modification as well as various types of medication. A portion of treatment will be listed in the accompanying tables. Adequate attention to clothing, diet manipulation, and attention to the emotional well-being of the affected patient are very important. It is preferable for a patient with eczema to wear clothing which will not irritate the skin; soft cotton material would be best. The room temperature should be kept moderate with controlled humidity (between 35-50%). Overheating and perspiration should be avoided.

Some investigators believe there is a genetic tendency for eczema with approximately 50% of eczema patients ultimately developing allergic rhinitis and/or asthma. This is compared to about 20% without the presence of eczema. While allergy skin testing and allergy injection treatment are usually helpful in cases of allergic rhinitis and/or asthma, it is generally agreed that this is often not the case with eczema. In some individuals, starting allergy shots for allergic rhinitis and/or asthma may actually result in significant flaring of the eczema.

Prevention

  • Trim fingernails short
  • Cotton gloves at night if needed to decrease scratching
  • Clothing should be double rinsed after washing to remove all residual detergent (irritants)
  • Avoid excessive room temperatures
  • Wear light, non-occlusive clothing (e.g., cotton instead of polyester)
  • Keep the bedroom moderate (cool) and avoid excessive bed clothing
  • Allergen contact or ingestion avoidance (e.g., foods, pets, dust mite) can reduce stimulation of the skin

Treatment

  • Bathing for moisturization, e.g., soaking in tepid water for 30-45 minutes at least once daily and if possible 2-3 times.
  • Within 2 minutes after getting out of the tub, a lubricating cream or ointment should be applied to help hold the moisture in the skin. Examples include Aquaphor, Curel, Moisturel, Eucerin, Keri, Lubriderm, Acid Mantle, Unibase, Vanicream, petrolatum, and chilled Noxzema,etc. Newer medications include Triceram/Certopic, Impruv, Mimyx, Nourica Repair, Cerave, Atopiclair, and Hylira. Some of the newer medications are by prescription only. None of the medications in the above list contain steroids.
  • In general, lotions should be avoided since they contain alcohol which may sting and provide limited moisture.
  • If marked irritation or weeping areas are present, wet wraps with a drying solution (e.g., Burrow’s solution, one tablet mixed in one quart of water is available by prescription) will avoid the stinging or burning sensation that can occur with bathing.
  • Addition of oil or similar substances to the bath water generally has little effect on increasing moisturization.
  • Pat dry with a soft towel; do not “rub” dry since this will remove natural, protective oils from the skin.
  • Showers do not add moisture to the skin and actually remove the protective oils from the skin resulting in increased dryness.
  • Topical steroids are the mainstay of therapy for more severe eczema. Ointments or creams are generally used.
  • Nonsteroidal medications that help the immune system in the skin may be necessary either in addition to or in place of topical steroids if the topical steroids are not adequate for relief. Examples of the nonsteroidal medications are Elidel and Protopic.
  • Antibiotics, topical and/or oral, may be needed if the lesions become infected. An alternative to antibiotics is the use of Clorox baths. One-quarter to one-half cup of Clorox in a full bath provides antibacterial activity that will treat all known bacterial infections. No resistant bacteria to Clorox are known.

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Do you have the winter sniffles?

5 ways you can manage indoor winter allergies

Do you suffer from itchy eyes, a runny nose or a scratchy throat during winter? Do you often find yourself coughing, sneezing and having trouble breathing? Chances are you may have indoor allergies.

Allergens are not just found outside in trees or grass. The indoors can host many triggers like mold in pipes, pet allergens, and dust mite and cockroach allergens.

Indoor allergies are a year-round problem, but you’ll notice them more during the winter because you spend more time at home. Also, because of the colder weather, you’re likely keeping doors and windows shut to keep the cold out. By doing that, you’re also sealing allergens indoors with you, and your heating system will recirculate the indoor air and any allergy triggers.

You don’t have to accept indoor allergies as an inevitable fact of the winter season. Using these five tips from the American College of Allergy, Asthma and Immunology (ACAAI), you can be proactive and manage your winter allergies.

1. Clean regularly
It may seem like a simple solution, but cleaning house is one of the easiest ways to deal with indoor winter allergies. Dust, mold, pet dander and dust mite and cockroach droppings can hide anywhere and cause sneezing, coughing and congestion.

To limit your exposure to these indoor allergens, keep a regular cleaning schedule. Dust and vacuum frequently, especially under and behind furniture, where allergens can easily build up. Wipe down counters and other surfaces that you use often. During the holidays, wipe off holiday decorations, especially if you’ve stored them in areas where dust and mold proliferate.

2. Reduce pet allergy triggers
It can be difficult to balance your love for your pets and indoor allergy management. Just like you, your pets are spending more time indoors, increasing your exposure to pet dander and saliva.

While you may enjoy snuggling with your pets before bed, keeping them out of the bedroom will help with any allergies you experience at night that can disrupt your sleep. During the day, keep the door to your bedroom closed, so your furry family members aren’t tempted to go in.

When petting your cat or dog, make sure to wash your hands afterward, so you don’t accidentally touch your face and provoke an allergic reaction. Finally, remember to groom your pets regularly to reduce indoor air allergens.

3. Protect your bedding from dust mites
According to the ACAAI, dust mites live and multiply in warm, humid places and are often found in pillows, mattresses, carpeting and upholstered furniture. Even if your home is visibly clean, dust mite allergen particles are too small to be seen.

Use mite-proof zippered cases for your mattress and pillows to limit your exposure to dust mites. Every week, wash and change your sheets, blankets and other bedding in hot water to eliminate any lingering dust mite droppings.

4. Find and prevent indoor mold
Did you know that there are roughly 1,000 species of mold in the U.S.? Many molds aren’t visible to the naked eye, and mold spores can cause allergic reactions when they become airborne. Because mold can grow in your basement, bathroom, under the sink and anywhere with running water, avoiding mold allergens can be difficult.

If you suspect you have indoor mold, it’s best to contact a professional who can find and clean up existing mold in your home. To prevent mold from growing inside your home, quickly stop and clean up any leaks. Also, make sure to reduce moisture and humidity in bathrooms and kitchens. If humidity control is a problem, consider a dehumidifier.

5. Find an allergist
Consulting an allergist is the best way to identify and treat your winter indoor allergies.

“Allergists are the best trained medical professionals to treat allergies and asthma,” said Kathleen May, MD, ACAAI president. “They can help you get tested, get treated and get better so you can enjoy the holiday season and beyond.”

After a consultation, your allergist may perform tests to diagnose your allergies and identify potential causes. An allergist can also prescribe antihistamines and other allergy treatments to give you relief from your allergic symptoms.

Using these five tips, you can better manage your indoor allergies this winter so you can enjoy the cozy colder months without suffering from allergies. 

About ACAAI
ACAAI is a professional medical organization of more than 6,000 allergists-immunologists and allied health professionals, headquartered in Arlington Heights, Ill. The College fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy, and research. ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer, and provide patients with the best treatment outcomes. For more information and to find relief, talk to your OAAC provider.

The post Do you have the winter sniffles? appeared first on Oklahoma Allergy and Asthma Clinic.

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