As a dermatologist, I treat many patients struggling to manage mild to severe eczema. There are several different types of eczema, but the most common is called atopic dermatitis. Atopic dermatitis is a type of eczema characterized by symptoms like constant itching, dryness, and “weepy” rashes that ooze and may become infected. Fortunately, there are many treatment options to help manage severe eczema, including steroid creams, special barrier creams, light therapy, biologics, and oral medications. In addition to these therapies, it’s crucial patients make lifestyle choices that benefit their skin and help keep their eczema symptoms controlled. I tell my patients we have to work together—treating eczema is not just about taking medications or applying prescribed creams. It’s crucial to also take care of your skin and your body as a whole.
If you have eczema, don’t take hot showers or hot baths. Of course, the word “hot” is relative; you might not think the water is hot, but if the whole bathroom steams up while you shower, you’ll need to turn the temperature down. Stick to lukewarm showers and baths, and your skin will thank you.
It’s also important for people with eczema to choose the right soap and use it correctly. Find a product that’s free of fragrance, dyes, and preservatives, and stay away from antibacterial soaps—these soaps dry your skin out significantly. Additionally, you don’t need to use soap on your entire body. Soap up areas like your armpits and groin, and avoid the rest. Soap dries out your skin, and with eczema, the goal is to keep moisture in as much as possible.
Moisturizer is the cornerstone of eczema therapy. If you just take the pills, injections, or topical steroids, you’re not going to be 100% better until you change your skincare habits.
Immediately after you get out of the shower or bath, gently pat yourself with a towel until you’re slightly dry and then apply moisturizer to your entire body. When patients ask me how much moisturizer to use, I tell them to apply enough so that if someone tried to grab them, they wouldn’t be able to hold on without slipping. Pick a moisturizing cream or lotion without fragrances, dyes, or preservatives, and consider using oils like coconut oil to really keep in the moisture. I also recommend that patients use humidifiers to fill the air around them with moisture, too.
The hardest eczema symptom to deal with is the itching. When you scratch, you can open up wounds, which will itch even more, and the cycle continues. When patients ask me for tips on how not to itch, I tell them this: when they find one hand reaching to scratch an itch, take the other hand and whack it away. Then, apply moisturizer to the itchy area.
Eczema is caused by inflammation in the skin, so it’s a good idea to reduce inflammation as much as possible. Following a healthy diet full of fresh fruits, vegetables, and fiber can help patients better control their eczema. Patients should try to avoid carbohydrates when possible, as well as cut out red meat and processed food. I’ll also recommend patients take vitamin D supplements because it’s been shown to improve eczema; often we don’t get enough vitamin D naturally. When my patients eat well, they also lose weight, which can make eczema symptoms better, too.
Often, the stress of living with eczema is difficult to manage. People don’t know eczema isn’t contagious and they might make my patients feel uncomfortable or ashamed. However, it’s very important to manage stress, as stress can make eczema a lot worse. As with many people, stress and eating habits can be closely linked, and when you’re anxious, you’re much more likely to grab an unhealthy snack or fast food meal. This leads to weight gain and increased inflammation, which we know worsens eczema. I tell my patients to find a stress reduction technique that works for them, like yoga, meditation, or massage. Take some time for yourself before bed to unwind and drink some calming tea. Managing stress levels helps you manage your eczema symptoms and boosts your health in general.
Although lifestyle changes can significantly help my patients with eczema, I try not to bombard them with too many changes all at once. Try making one change at a time and sustain it for a few weeks before trying another. Slowly, you’ll be on your way to living a healthier life and be able to control your eczema.