The following scenario is all too familiar to many: you experience a sudden, intense itch. That itch turns into an angry, scaly red rash, and then that begins to spread. No, it's not poison ivy nor chickenpox. You have atopic dermatitis, better known as eczema.
According to the National Eczema Association, more than 31 million men and women (in the United States alone!) suffer from this frustrating genetic condition. Everyone from Adele to Kate Middleton has dealt with it and recently, it gained media attention thanks to HBO series The Night Of, in which John Turturro's character, John Stone, suffers from an intense case of eczema. While his flare-ups famously landed him in the hospital, the common ailment can typically be managed with some simple tips. We talked to Dr. Craig Austin, New York City dermatologist and founder of Cane + Austin, to get the lowdown on this itchy issue.
What is eczema and what causes it?
"Medically, it's called atopic dermatitis," said Dr. Austin. The condition is genetic and presents as dry, itchy skin that results in rashes. "It's usually an itch that rashes rather than a rash that itches," he explained. Dermatologists diagnose eczema by its appearance and occasionally by biopsies to exclude any other issues.
What triggers eczema?
"Once your skin is dry, it breaks down easily to form a rash," Dr. Austin said. Environmental factors like cold, dry air; overexposure to water; irritating soaps or perfumes; stress; and diet can all contribute to eczema.
Which body parts are prone to eczema?
Though eczema rashes can occur anywhere on the body, Dr. Austin told us that it's more common on flexural areas (elbows, backs of knees, etc.) and arms and legs. "It probably occurs on the extremities more due to the lack of circulation to these areas, thus resulting in drier skin," he noted.
How severe can eczema become?
Unfortunately, eczema can go beyond seriously intense itching; sufferers are more at risk for skin infections. "A person with eczema who develops a cold sore due to herpes simplex virus is more susceptible to having it spread all over the skin," warned Dr. Austin. Those with this condition are also vulnerable to erythroderma, an inflammatory disease that causes much of the body to become red. This will lead to loss of bodily fluids and electrolytes. "These are serious issues which all need to be regulated in a hospital under supervision of doctors," he explained.
What products are effective in treating eczema?
Gentle exfoliation and deep hydration are essential when dealing with these rashes; exfoliate to remove the dull, dry skin, then moisturize the tender skin underneath with a rich cream. Over-the-counter formulas containing lactic acid, like Fragrance-Free AmLactin Moisturizing Lotion 12 Percent ($18), do double duty. Dr. Austin's own Cane + Austin Body Retexture Lotion contains another alpha-hydroxy acid, glycolic acid, to slough off dead skin cells.
"It's a great home treatment for eczema if you're aiming to avoid a trip to the dermatologist and application of toxic steroids and antibiotics," he remarked. In more intense cases, he prescribes topical prescription moisturizers, steroid creams, and antibiotics for deeper treatment. Find more eczema-friendly products here, then DIY a relief cream here.
How else can someone with this condition manage it at home?
- Avoid drying out your skin. This sounds obvious, but everything from excessive swimming and overwashing hands to long, hot showers can strip skin of moisture.
- Add extra hydration back into your skin. Make sure you drink plenty of water and moisturize religiously. Dr. Austin also suggests using a humidifier in Winter to prevent skin from getting too parched.
- Follow an anti-inflammatory diet. Processed foods, sugars, simple carbohydrates, and alcohol increase cortisol and insulin production, which cause inflammation (your body's immune system response). "Eat foods containing omega-3 fatty acids such as salmon, walnuts, and sardines, which help decrease inflammation and dryness in skin," said Dr. Austin. Discover more anti-inflammatory foods here.
- Skip perfumed soaps, lotions, and other beauty products. Scented items can irritate sensitive skin. Dr. Austin likes Neutrogena's and Cetaphil's fragrance-free formulas as they are extremely gentle.
- Don't stress. Stress also triggers cortisol production and thus inflammation in your body, which will lead to itching and eczema flare-ups. Consider a tropical vacation during Winter to help you unwind. "It might clear your eczema due to decreased stress and increased [skin] hydration from the humid environment," remarked Dr. Austin.