Central heating in the winter got your skin flaring up? You’re not alone—more than three million people suffer from inflammation and red itchy skin because of a number of factors including weather, stress, and genetics. If you have rash-like symptoms that appear on your arms, behind your knees, or on areas of skin exposed to varying environmental factors, you might have eczema (also known as dermatitis).
Board-certified dermatologist and CEO of Curology, Dr. David Lortscher broke down what exactly eczema is, how to fight it, and when to seek medical attention. Don’t let winter dryness get you down, we’re here to help.
What is eczema?
Eczema shows up as itchy, inflamed skin caused, in part, by an overactive immune system. Dermatologists think of eczema as “the itch that rashes” rather than “the rash that itches.” Eczema (or dermatitis) is the term for an inflammation of the superficial layers of the skin, where redness, itching, small bumps and blisters, weeping, oozing and crusting, and later scaling, and thickening of the skin may occur.
What are the different types of eczema?
There are different types of dermatitis, including atopic eczema, allergic contact dermatitis, irritant contact dermatitis, and asteatotic (due to very dry skin) eczema. When most people talk about eczema they usually are referring to atopic dermatitis or atopic eczema. Atopic dermatitis is common and tends to run in families along with asthma, hay fever, sinus trouble, and dry skin.
What causes eczema?
The exact cause is unknown. However, eczema (atopic dermatitis) is influenced by a number of factors including genetic predisposition, day-to-day stress, and environmental stressors. No cure has been found for atopic dermatitis, but treatments and self-care measures can relieve itching and prevent new outbreaks.
Does eczema get worse in different seasons?
Eczema can be exacerbated by hot, summer weather—sweating might to trigger itching and irritation. Eczema can also be exacerbated by cold and dry weather, dry skin tends to be more prone to itching and irritation as well.
Do over-the-counter options exist?
Yes, it helps to start with soothing moisturizers, particularly those that contain ceramides which are naturally occurring lipids (fats) in the skin, that help to maintain normal skin barrier function.
Mild topical steroids are also available over-the-counter and may be used when eczema flares. However, prolonged use of steroids, particularly prescription-strength, may aggravate acne, thin the skin, cause dilated blood vessels, and cause stretch marks. Dr. Lortscher doesn’t recommend the use of over-the-counter topical steroids for more than a week or two. You should consult a dermatologist if symptoms persist.
What recommendations do you have for over-the-counter creams?
In general, one of the best things you can do for eczema is to find a great moisturizer. Lotions can be a bit drying, as they have a higher water content, so Dr. Lortscher recommends picking a heavier cream with ceramides or petrolatum.
If your skin is particularly dry or if you’re exposed to very cold dry air, you should begin using a thin layer of a heavier moisturizer in the morning to help protect your skin. Moisturizing is the key to improving skin barrier function, resolving symptoms much faster, and reducing relapse with continual treatment.
Dr. Lortscher’s recommendations for the best moisturizers to fight eczema:
When should you seek medical attention?
If your skin isn’t responding to over-the-counter treatments, there are prescription topicals that your dermatologist can prescribe. Stronger prescription topical steroids are available for short-term use. Protopic (tacrolimus) 0.03% and 0.1% ointment and Elidel (pimecrolimus) 1% cream are calcineurin inhibitors, meaning topical medications that work to inhibit the immune system to reduce inflammation and irritation. Dr. Lortscher typically uses Protopic ointment and Elidel cream to wean patients off topical steroids.
- Eucrisa is a topical, non-steroid treatment. Eucrisa works differently than Protopic and Elidel, targeting an enzyme called phosphodiesterase that helps the body deal with inflammation.
- Dupixent is an injection for individuals who have eczema resistant to topical treatments or who do not have access to topical treatment. Dupixent works by blocking factors that allow white blood cells to communicate inflammation.
Lastly, a special note about scrubs:
Although scrubs may be a seemingly obvious fix for sloughing off dead skin, avoid using scrubs on skin with active eczema. A scrub by definition (i.e., exfoliation by means of mechanical abrasion) would likely be really irritating for skin affected by eczema. However, if the granules are soft (almost paste-like), and if the base of the product is heavier and more ointment-like, then water may be trapped in the skin (which is a good thing!), and the hydration may soothe the eczema.