People suffering from eczema are susceptible to extreme weather conditions. Skin affected with Atopic Dermatitis loses its capability of adapting to different conditions with a poor tolerance for extreme weather. Humidity is one of the vital factors in the environment, to which skin reacts almost immediately and it plays a major role in how your body handles eczema. Humidity in its extreme, no matter if it is low or high is usually a problem for Eczema. Low humidity dries the skin, especially during winter months whereas high humidity in hot temperatures may result in prickly heat-type symptoms, making eczema-prone skin itchier and more irritated resulting in a flare-up.
In hot and humid weather, the natural defense mechanism of the skin comes into action.To tackle the heat and keep body temperature under control, skin perspires releasing sweat. The level of sweating differs from person to person and also depends upon the extremity of the temperature. As the sweat mostly consists of water it gets evaporated coolingthe body. However, sweat also consists of salts such as sodium chloride and traces of other elements such as zinc, nickel, copper, etc. which remain on the skin leading to irritation on the skin causing eczema to flareup. Moreover, the hot temperature itself can be very irritative for sensitive skin of eczema sufferers worsening the condition and triggering the itch cycle.
How to Handle Excessive humid conditions?
Avoid sweating conditions
Sweating is the leading cause of Eczema Flares in hot and humid conditions. Avoid activities andsituations that cause you to sweat a lot.If it is unavoidable than take shower soon after the activity causing you to sweat like a workout, playtime, etc.
Prevent accumulation of sweat
Body parts such as the back of knees and elbows are more prone to flareups because of the accumulating sweat in these areas which takes longer to dry. These areas should be wiped often using smooth wet clothes to avoid further irrigation or start of an itch cycle
Wear breathable clothes
Clothes play a vital role in the management of Eczema.Different types of clothes are suited to different weather. Forhot and humid climate, breathable cotton clothes are preferred. Alsoon hot weather avoid multi-layer clothing so as to prevent your body from heating up as it may cause you to sweat. Clothes made up of polyester, nylon or wool may irritate your skin and can cause an eczema flare.
Maintain comfortable indoor condition
Though you cannot do much about the external climatic condition, you can always control the conditions inside your home byusing humidifier/dehumidifier and air conditioner, etc. 50% of relative humidity is ideal to prevent dry skin and to provide comfort for people suffering from Eczema.
Take extra precaution if you suffer from an allergy. Hot temperatures usually tend to aggravate allergies.If you are allergic to pollen always keep a check on the pollen level in the air before you step out of the house and take necessary precautions.
Monitor the temperature
Keep a check on the temperature during daytime and avoid traveling or moving out of your house when the sun’s rays hurt you directly.
Keep yourself hydrated
Stay hydrated from inside to keep your skin moisture intact by consuming a lot of liquids including water, juices and other cold fluids as your body loses water in the form of sweat.
Atopic Dermatitis (AD) is an inflammatory skin disease that is characterized by red, itchy and in some cases scaly skin. AD or as commonly known as Eczema is a growing health concern especially in children due to its high prevalence and associated low quality of life. Researchers don’t know the exact reason or cause of eczemabut believe that genes, environmental triggers, or interactions between them contribute to the onset of AD. We cannot do much about the genetic combination of an individual, so the only option left is to identify and control risk factors and triggers from the environment & surroundings.
Effect of Air pollution on Eczema
Air is everywhere and so are the particles polluting it. Due to increasing urbanizationboth indoor and outdoor air pollution is rising, and these arewell-known environmental risk factors for Eczema. One of the important factors to be considered with regards to people suffering from Eczema is Outdoor Air Quality and especially when they are planning to be outdoors. You can control your indoor pollutants but cannot do much when it comes to outdoor.
A variety of pollutants in the air, such as tobacco smoke, volatile organic compounds, formaldehyde, toluene, nitrogen dioxide, and particulate matter, have been found to act as risk factors for the aggravation of Atopic Dermatitis causing eczema flares.
The sources of these pollutants also vary.They can be volcanoes, forest fires, industrial and mechanical wastes from automobiles, factories, and power plants. It has also been found that even toxic pollutants from automobiles in road traffic significantly increase the chance of eczema flares.These pollutants are so effective that even short-term exposure to air containing these pollutantsis enough to exacerbate the symptoms.
These chemicals apart other airborne allergens that affect eczema include pollen and dust mites. These allergens enter the body through the skin via hair follicles setting up an immune response. These foreign particles cause the body to create chemicals that cause redness and swelling to occur, creating a substantial amount of inflammation.
When the skin is exposed to these chemicals and pollutants it triggers skin inflammation and causes damage to the skin’s natural protective barrier. As result water evaporates from the skin, resulting in dry skin and ultimately worsens eczema causing flares.
Always check Realtime air Quality and pollution levels at your location or the place you are planning to travel before leaving and cover your face using scarves or mask.
Record, track, identifyand avoid your environmental triggers that induce the development or aggravation of Atopic Dermatitis to prevent the flares.
Children with pre-existing AD should be managed with strict avoidance of various aggravating factors as well as appropriate skincare and reduction of inflammation.
Environmental tobacco smoke (ETS) is a penitential risk factor for aggravating eczema symptoms. Eczema sufferers should quit smoking and stop hanging out with people who smoke.
Topical steroids and emollients should be used to alleviate the symptoms and control the flares.
Keep yourself moisturized, a good moisturizer hydrates the skin and creates a barrier between your skin and free radicals and other pollutants. To protect yourself, wear sunscreen on your face and neck.
Drink plenty of water to keep your skin hydrated and healthy enough to fight against these pollutants.
Rinse your body or take a bath whenever you are outdoors for a considerable amount of time or are exposed to pollution so as to get rid of pollutants from your skin.
Atopic Dermatitis is a chronic skin condition that cannot be cured and has to be managed. The severity of Eczema varies over time and worsens due to some reasons which are called triggers. There are different types of triggers and everybody is not affected in the same way by a trigger. When a person suffers from a breakout of Eczema i.e. the severity of Eczema worsens, she is said to be having a flareup.
There’s a strong association between allergies and Eczema especially with triggers un the air. Common indoor triggers in the air include dust mites, pet dander, etc. Recent studies havealso revealed a relationship between the development of eczema flares and Pollen content of the air. Pollen content and associated allergies are often seasonal and are most acute during the transition of spring to summer.
Environmental allergens like pollen not only produce immediate allergic reactions but also interrupt the permeability barrier of the skin. The lipids released from pollen exhibit chemical and functional similarities to leukotrienes and prostaglandins (pollen-associated lipid mediators).They induce an immune response which exacerbates eczema symptoms causing flares.
Pollen allergens enter the skin through hair follicles and generally can stay there up to 1 week. Hence, allergens penetrating the hair follicles may remainactive for an extended period of time causing skin irritations and flares.
Handling Eczema in High pollen content
As the adage goes, prevention is better than cure. To prevent flares caused by pollen.
It is very important to know pollen content at your location or the place where you are planning to travel/visit so that necessary precautions can be taken.
Tools such as EczemaLess which leverage AI can guide you with the pollen content of at your location and can give you a correlation between your flares and triggers.
Studies have found that pollen triggers flares and exacerbates the symptoms only on the skin which gets directly exposed to it. So covering your body/skin completely while going out will prevent the direct contact of pollen to skin thereby avoiding the trigger and subsequent flares to a large extent.
Avoid morning walks or being outdoor in the morning during spring as the pollen contents are high in the morning.Similarly, avoid freshly cut grass to prevent direct exposure to pollen in spring.
Take a shower immediately after being outdoors for a while so that you can rinse off the allergens before they exacerbate any allergic reactions giving rise to immune response.
If you the local pollen content is high keep your doors and windows shut to avoid this airborne allergen from entering your house. Keep your outdoor equipment and tools outside the house if not then at least outside your bedrooms so that you are not bringing pollen along with you in your resting place.
Use Anti-allergy filters in your air conditioner to limit the exposure to pollens indoors. Using Air condition also help to keep the temperature in check thereby reducing the chance of sweat and ultimately itching.
Do not forget to follow your daily care routine of applying moisturizers, wet wraps, showers, etc along with the extra care measures to manage your eczema effectively during the pollen season
Study Referred: Birch pollen influence the severity of atopic eczema Clin CosmetInvestig Dermatol. 2015; 8: 539–548.
Eczema also commonly know known as Atopic Dermatitis can become so infected that the person has to go to the hospital and stay over for treatment, this can be very upsetting, especially for youngsters which means missing days of school. Some infections, such as eczema herpeticum (a viral infection), are serious and need medical attention right away, you don’t have any option and in case, if left untreated it may cause sepsis which can be life-threatening.
Some kinds of skin infections can be treated with antibiotics (in the form of tablets, creams, injections or IV drips). Other kinds of skin infections are fungal (such as ringworm) and are treated with antifungal creams or tablets.
It is very obvious that one should immediately visit the physicians for advice to fight back the infection but as it always said that “prevention is better than cure”. Let’s check out what all things can be done to avoid infections and smooth eczema management.
Prevention measure to avoid Eczema Infection
It is important to keep your skin healthy as possible to avoid infection, especially during an Eczema flare. When flares occur, a person should follow the recommended treatment plan to help manage and reduce the flare.
If you are suffering from Eczema, avoid contact with anyone who has cold sores. Cold sores are highly infectious. Since the presence of Eczema reduces the immunity against viral infections, eczematous lesions can get infected easily.
Frequent hand washing – As we touch surfaces all the time, it is best to wash our hands frequently, especially if they get contaminated with germs.
Avoid touching your eczema lesions unnecessarily as you can introduce germs to the rash
Avoid scratching – Scratching can damage the skin and break the natural surface barrier for infections. Cut and maintain your nails so that it doesn’t hurt much in case you scratched unknowingly
Keep the rashes and skin moisturized well for extra protection.
Follow a healthy diet and avoid foods that you may be sensitive for e.g. nuts and dairy products
Keep your skin as clean as possible
Children who have eczema should be monitored closely and reminded not to scratch.
If flares of Eczema occur, seek treatment early and stick to the recommended treatment plan. The more severe your eczema, it is more prone to infection.
Keep your environment clean, free from dust and animal dander
Manage your stress – as stress is known to trigger eczema, managing your stress well can reduce flares and thus infections. Practice relaxation techniques, yoga and meditation.
What you can do as a home remedy?
Bath or shower every day to clean the skin.
Use warm water and a soft cloth to gently soak and lift off any crusts.
Use a soap-free wash e.g. non-ionic cream, aqueous cream, emulsifying ointment. Don’t use soap and bubble bath as these make the skin dry.
Antiseptic baths two times a week can help. See bleach bath instructions.
Steroid creams and ointments
Apply steroid to all red and itchy skin (active eczema) at-least once a day. Immediately after the bath is best.
Use enough to make the skin shiny. Steroid for the face/neck: Steroid for the body/arms/legs:
When the skin is no longer red and itchy stop using the steroid but keep it moisturized. If eczema comes back, start using the steroid again
Smooth on lots of moisturizers many times a day to keep the skin soft.
Apply all over not just where there is eczema.
Treatment for Eczema Infection
Once the infection breaches your prevention immediately look for treatment.
On approaching the medical care, the physician may take skin from the site which will be sent for pathology testing. The Microbiological testing of the smear helps to identify the type of infection. The mode of treatment will majorly depend on the result of the test whereas empirical treatment can be started without delay. According to the results of the culture and antibiotic sensitivity testing, treatment can be modified.
If the infection is mild an antibiotic cream or ointment will be prescribed. e.g: Neosporin, Polysporin, Fucidine.
Sometimes the antibiotic is combined with a steroid. e.g: Betnovate N, Fucicort, Corticosporin.
When the infection is widespread, an oral antibiotic will be added. e.g: a course of Flucloxacillin or Co-Amoxyclav to fight the infection better.
To infants and children with infected Eczema, oral antibiotics will be given in syrup form, whereas for adults, tablets and capsules are preferred.
If the patient is ill with fever and chills, your doctor will admit you and treat the infected Eczema with IV antibiotics.
Sometimes steroids can worsen infections. Topical immune-modulators like Protopic ointment and Elidel cream are preferred to steroids by some doctors when treating infected Eczema.
Viral infections are treated with oral antiviral medications e.g: Oral Acyclovir for 1 week. Sometimes an antiviral cream (Herperax) can be applied topically over the rash. Eczema which is infected with a virus can heal spontaneously with time even without treatment with anti-viral medications. However, if it doesn’t heal seek treatment.
If Eczema Herpeticum is severe, hospital admission is required and drugs will be given via a drip.
If there is a pain, pain relief can be done by Tylenol (Acetaminophen) or Advil (Ibuprofen). These are also available as over the counter products. Make sure that you adhere to the proper dose and dosage instructions.
Treatment of Fungal infections of Eczema – Use of a cream or ointment containing antifungal and steroid combinations. e.g: Candacort (Clotrimazole and Hydrocortisone) Ecocort (Econazole and Triamcinolone) Candid B (Betamethasone and Clotrimazole)
Once the inflammation is controlled you may be treated with a pure antifungal cream or an ointment. Sometimes your doctor may first control the fungal infection with a pure antifungal cream or ointment rather than a combination.
e.g: Clotrimazole (Lotrimin), Lamisil (Terbinafin), Tolnaftate
Once the fungal infection is controlled treatment will follow with usual topical products which control the Eczema rash.
Sometimes fungal infections can be widespread especially in immune-compromised patients such as those who suffer from immunity disorders, AIDS, Cancer etc. Then a course of oral or intravenous antifungal medication will be added depending on severity.
In addition to the specific treatment of infection, the usual treatment for Eczema should also be followed, such as;
Moisturizing the skin well – Moisturize your skin adequately with a good emollient twice a day, especially after a bath, while the skin is still damp. Emollients with minimal fragrance, which are alcohol and paraben free, are the best. Ingredients in a good moisturizer are glycerol, Dimethicone, aqueous cream, Lanolin oil, Shea butter, Argon oil, cocoa butter etc. Moisturizers are best when used in Ointment form rather than a cream form. Choose the best emollient which is suitable for your skin or get a prescription from your doctor which will be the best for you.
Management of itching with an antihistamine – These are also available as over the counter products. e.g: cetirizine (Alerid, Cetzine), Loritidine (Claritin, Claratyne), fexofenadine (Allegra) or Chlorpheniramine (Piriton) to reduce itching.
As antihistamine products prevent you from the urge of scratching it will help the control of further skin damage and infection.
Wet dressing or bandages to cover and treat eczema rash – This helps to maintain moisture and to prevent further damage to the skin by scratching. However, bandages are preferred once the infection is controlled. Avoid applying bandages when eczema is infected.
When to look back to your physician
If you find that the infection is not at all improving after 2–3 days of treatment
If your child is missing school due to severe skin infections or not sleeping well because of eczema
Once you complete the course and find the symptoms are recurring
Eczemaless an AI tool to check the severity of Eczema and keep track of your Eczema progress.