The Eczema Picture

ECZEMA SKIN CARE

2010-06-24T09:31:00.000-07:00

Initial and ongoing treatment for eczema should include:
Keep your skin hydrated through proper bathing and using moisturizers. This includes bathing in warm water, bathing for only 3 to 5 minutes, avoiding gels and bath oils, and using only non-drying soaps;

Apply a moisturizer immediately after bathing; avoiding irritants that causes a rash or make a rash worse. These include soaps that dry the skin, perfumes, and scratchy clothing or bedding;

Avoiding possible allergens that cause a rash or make a rash worse. These may include dust and dust mites, animal dander, and certain foods, such as eggs, peanuts, milk, wheat, or soy products;

Controlling itching and scratching. Keep your fingernails trimmed and filed smooth to help prevent damaging the skin when scratching. You may want to use protective dressings to keep from rubbing the affected area. Put mittens or cotton socks on a baby's hands to help prevent him or her from scratching the area.

IDENTIFYING ECZEMA

2010-05-28T10:26:00.000-07:00

Eczema is a skin condition which affects approximately 26 million Americans. Eczema is characterized by a rash, dryness of skin, itching, and redness of skin. It occurs due to the overproduction of damaging inflammatory skin cells and continues to worsen as a result of certain factors in the environment. Foods, shampoos, soaps, laundry detergents, synthetic fabrics, stress, and temperature changes are capable of irritating already existing eczema. Although eczema is considered a chronic skin condition, there are various treatments and interventions available to help control eczema. Eczema is a hereditary condition and thus is not contagious to others.

Within any disease there can be a wide range of severity. This is the case for people with eczema. Some people may have only a small patch of affected skin while others may have larger patches all over the body. An individual may experience one mild incident while others experience chronic severe incidences. The affected skin is very sensitive and the individual must be aware of the trigger factors and try to avoid them. While eczema can vary in its level of severity, it can also differ according to the type that the individual has.

The Stages of Eczema

2010-04-28T11:49:00.000-07:00

Early stages of eczema can cause the skin to turn red, blister, and ooze. Later stages of eczema can cause the skin to turn a brownish color and be scaly. In almost every case, eczema itches. Eczema can be widespread or limited to a few areas. Atopic eczema, also called atopic dermatitis, is the most common form of eczema. Eczema runs its course through three distinct phases: acute, sub acute, and chronic.

The usual symptoms associated with the acute stage of eczema include pain, heat, tenderness, and possible itching. The affected areas are characterized by extreme redness and drainage at the lesion site. In acute eczema you would experience vesicles, blisters, and intense redness of the skin. The skin surface will sting, burn, or may itch intensely. The common examples for this stage of eczema would include acute contact eczema, acute nummular eczema, stasis eczema, and pompholyx eczema. The acute disease typically is characterized by inflammation, redness, swelling, and itching, as well as some blistering and oozing. Skin biopsies show inflammatory cells and swelling.

The sub acute phase of eczema includes symptoms associated with skin redness and crusting; however, there is no extreme swelling. You may observe redness, scaling of the skin, fissures, and a parched or scalded appearance to the skin. People in the sub acute phase tend to complain about the symptom of itching more than the pain. The itching in the sub acute phase is generally slight to moderate with possible stinging and burning. The common examples of the sub acute phase include contact allergy, irritation, atopic eczema, stasis eczema, nummular and asteatotic eczema. The sub acute disease typically is characterized by inflammation, redness, swelling, and itching, as well as some blistering and oozing. Skin biopsies show inflammatory cells and swelling.

Individuals with lesions developed over three months are referred to as having chronic eczema. Itching is a predominant symptom in this phase as well and scratching causes the lesion to worsen. In the chronic stages of eczema the skin would show a thickened, lichenified, excoriation and or fissuring appearance. At this time you would experience a moderate to intense itch. Chronic eczema most occurs in atopic eczema and lichen simplex chronic eczema, fingertip eczema, and hyperkeratosis eczema. Chronic dermatitis is identified by thickened, leathery skin with excess ridges, as well as dark and dull skin. Under the microscope, the outermost skin layer is seen to proliferate and become elongated.

The Picture of Eczema Research

2010-03-16T09:16:00.000-07:00

The team of Eczema Skin Care Researchers at Eczema-Ltd possess a total of 40 years of collective research led by a Johns Hopkins MD. They have confirmed that the main cause or etiology of eczema is an immune system disorder, but there are many other causes as well. Eczema generally results from an overly acidic body and skin which creates an over active immune system response.

The pH scale (potential of hydrogen), ranges from 0 to 14 with 7 being neutral. This acidic/alkaline scale is logarithmic meaning that each number is ten times stronger than the preceding number. For example, a pH of 2 is ten times more acidic than a pH of 3 and one hundred times more acidic than a pH of 4. So you will now be able to more easily understand why an eczema sufferer needs to minimize the acidic foods and drinks as it takes so many more alkaline foods and drinks to compensate. As you rethink your past eczema history, you will see that all the eczema triggers come from 'acidic items' regardless of whether they are foods, drinks, stress, being out of breath due to not enough oxygen or not being able to exhaust enough carbon dioxide. We all know that if we hold our breath for 60 seconds our face turns pink or red. We are aware, but hardly think that the actual cause is a combination of a build up of carbon dioxide, which is an acidic gas, and a shortage of oxygen, which is alkaline. Very similarly, when we exercise for a long period, we have a build up of lactic acid, which is an acidic body waste. Likewise, those with eczema need to be very concerned about the build up of acids in the blood stream due to the foods and beverages that we consume.

Probotics May Reduce Symptoms of Food-Related Eczema

2009-11-17T10:31:00.000-08:00

Natural News) Most health conscious people know of the positive effects on digestion from using probiotic supplements. Many take probiotic supplements after using antibiotics to replace the good intestinal flora bacteria indiscriminately killed during antibiotic use.

This practice is so well known that MD's have begun recommending probiotics during and after antibiotics.

But there is new evidence that probiotic benefits go beyond that. One area of investigative research is building the immune system's resistance to allergies that affect the skin. An obvious example of a skin's allergic reaction is eczema, which tends occur often with infants.

A recent Dutch study gathered over 150 pregnant women with allergic disease histories in their families. During the last six weeks of pregnancy, they were given either three strains of probiotics or an inactive placebo pill. Neither they nor the doctors knew which was which.

After those pregnant women gave birth, most of their children were monitored by the Dutch researchers. The children continued to receive probiotics or placebos for 12 months. After three months, the rate of eczema occurring among the probiotic subjects was less than half of those given only placebos.

There were no more probiotics or placebos administered to the children after 12 months. However, many were still observed up until age two. As they approached that age, the gap between eczema occurrences between the two groups, probiotic and placebo, narrowed somewhat.

But there was still a substantial difference. The study results were considered evidence that probiotics can have an effect on offspring from allergy-prone mothers, and the report was written up in the Journal of Allergy.

Another recent study published in the Journal of Nutrition involved probiotics administered to mice. This time the focus was on food allergies. The mice all had whey intolerances, and they were fed probiotics and prebiotics while drinking milk. With the help of probiotics, their intolerance to whey showed considerable improvement with almost no skin reactions.

Up to eight percent of children have various chronic food allergies. Extending this study to children may prove probiotics to be a useful natural remedy for eliminating food allergies.

Sources for this article include:
http://www.reuters.com/article/healthNews/idUSTRE5985G520091009
http://www.associatedcontent.com/article/1954094/can_probiotics_help_with_allergies.html?cat=5

Eczema Skin Care Research at Eczema-Ltd

2009-10-29T09:23:00.000-07:00

The Eczema Skin Care Research team at Eczema-Ltd possess a total of 40 years of collective research led by a Johns Hopkins MD. They have confirmed that the main cause or etiology of eczema is an immune system disorder, but there are many other causes as well. The main causes of eczema are listed below along with descriptions of the form of eczema they are most commonly associated with:

General allergic over-sensitivity, called atopy also known as atopic eczema. Atopic eczema is linked with asthma and hay fever, which are conditions of the immune system. These conditions are often passed down through the generations of a family.

Contact with substances that irritate the skin chemically, called irritant contact eczema. This is caused by direct contact between the skin and the substance, which might be a detergent, soap, diesel or engine oil, strong chemicals in household cleaners, acids, alkaline mixtures, detergents, etc. and various other chemicals that acutely inflame the skin. The condition can become chronic with repeated exposure. This form of eczema is often encountered in the workplace. Direct irritant contact eczema can occur at the first exposure. For example, most people will develop this form of eczema on first exposure to strong chemicals that are acid or alkaline in nature.

Contact with substances that sensitize the skin, leading to acute inflammation when re-exposure occurs is called allergic contact eczema. This type commonly involves nickel, poison ivy, cosmetics, and rubber products. Prior exposure to the irritant allergen is necessary for allergic contact eczema to occur.

Exposure to sunlight as well as certain medications that cause photosensitivity can result in light sensitive eczema.

Infants exposed to moisture from drool or those that have inflammation of the scalp (cradle cap) can develop infantile eczema.

Varicose veins can lead to a form of eczema affecting the lower legs, called stasis eczema. This is also known as varicose or gravitational eczema.

Other types of eczema which arise as a result of causes within the body include: seborrheic eczema, discoid or nummular eczema, pompholyx or dyshidrotic eczema, juvenile plantar or foot eczema and lichen simplex.

Eczema can cause a wide range of symptoms. All types of eczema cause itch, with the exception of seborrheic. The main symptoms (one or all may be present) include: redness, weeping skin, pain, heat, tenderness, scaling, crusting, dryness, fissures (broken skin), and vesicles (small blisters) occur. Over time, damage to the epidermis (the upper layer of the skin) can cause it to thicken and become scaly (lichenification).

What Is Nummular Eczema?

2009-10-22T08:05:00.000-07:00

Nummular eczema is a ringworm-like rash of circular, itchy, scaling patches, widespread on the arms and legs but may also be found on the trunk and buttocks. The word "nummular" comes from the Latin nummus, meaning coin, and is characterized by round plaques of eczema. The cause of nummular eczema is not known, although minor skin injury such as an insect bite or a burn may be reported prior to the onset of the condition.

Nummular eczema also called Discoid eczema, or gravitational eczema is usually found in adults and appears suddenly. It can be complicated by a bacterial infection, which results in these areas becoming itchy with possible weeping fluid and crusting. Nummular eczema may be considered as an adult form of atopic eczema and is treated with emollients.

Eruptions of nummular eczema are often recurrent and chronic and usually appear in people who are in their 60s but can occur at any age. Nummular eczema is most common in older people with very dry skin. The skin’s main function is to provide a barrier against dirt, germs and chemicals from the outside. We don’t notice this barrier unless it gets dry, and then it’s scaly, rough and tight. Dry skin is brittle. Moist skin is soft and flexible. People with nummular eczema have a defect in their skin and it won’t stay moist. It is especially bad in winter when the heat is on in the house and the humidity is lower.

Other factors that can aggravate this condition include:

1) Hot weather- Heat and sweating. Most people with nummular eczema notice that when they get hot, they itch. They have a type of prickly heat that doesn’t occur just in humid summertime but any time they sweat. It can happen from exercise, from too many warm bedclothes or rapid changes in temperature from cold to warm.

2) Stress - Emotional stress comes from many situations. People with Nummular dermatitis often react to stress by having red flushing and itching.

3) Fabric softeners - fabric softener is the most toxic product produced for daily household use. Fabric softeners have been found to be associated with numerous illnesses and chronic conditions. The effects of its toxicity are insidious; a user becomes "chronically maladapted" to it. The exposure is so constant that it can be difficult to connect the product with the signs of reactivity it causes. The toxins used in fabric softeners are known to produce an addictive-type response. Regular users of fabric softeners (and perfumes) also often claim they "can hardly smell it". This is a direct effect of chemical ingredients on neural receptors. Listed here are the toxic ingredients and it’s effect on the skin; Alpha-Terpineol causes edema or redness of the skin. Limonene is a skin and eye irritant, sensitizer, and carcinogenic. Always wash hands thoroughly after contact, especially before eating, drinking, applying cosmetics. Do not inhale. Prevent contact with skin or eyes. Contact with Pentane can cause eye or skin irritation."

4) Allergies - Allergens are materials such as pollen, pet dander, foods, or dust that cause allergic responses. Allergic diseases such as asthma and hay fever, which flare quickly, are easy to tie to allergens. Itching and hives appear soon after exposure to these airborne allergens and last only briefly. Allergens are more subtle trigger factors. An allergen does not irritate, but may trigger a flare-up in those who have become allergic to it from prior exposure. Allergens are usually animal or vegetable proteins from foods, pollens, or pets. When exposed to an irritant or allergen to which they are sensitive, inflammation-producing cells come into the skin. There, they release chemicals that cause itching and redness. Further damage occurs when the person scratches and rubs the affected area. Food allergies can cause flare-ups. Since an allergic reaction to food (either by skin contact during food preparation or by eating the food) can trigger a flare-up, it is important to identify the trigger foods.

5) Soaps and detergents- Many laundry soaps contain chemical additives which are the actual irritants (e.g., sodium silicate, sodium phosphate, sodium carbonate). Hand cleaner soaps contain small harsh particles to assist in grease removal, such as pumice, talc, borax, corn meal or wood flour. These are sometimes irritating. Some yellow laundry soaps contain "rosin" to make the bar more soluble, which is also a sensitizer.

6) Wool clothing – Natural fiber clothing, made from wool or mohair, been shown to be sensitizers. Dermatitis may occur more frequently from the use of dark clothing. Heavy perspiration causes more bleeding of the dye (e.g., widow's dermatitis). Fabric finishes which are used to increase durability, to soften of stiffen a fabric, or to impart waterproofing, crease resistance or other properties to the fabric. Stoddard solvent or other dry-cleaning solutions will occasionally produce a clothing-oriented dermatitis, as will moth crystals. Airing the clothes for a few days before wearing them will usually prevent this.

7) Bathing more than once a day - Take short baths or showers with warm water. Hot water can make you itch more. Ask your doctor about the use of oatmeal soaking products in your bath to help control the itching. After bathing, don't rub your skin dry with a rough towel. That just irritates your skin more. Gently pat it dry to get the water off. Then put on some jojoba oil to help keep your skin from getting too dry. You can spread the jojoba oil on several times a day.

What's New in Eczema Treatment?

2009-10-16T09:35:00.000-07:00

Eczema is a common skin disease. Eczema is dry, rough, red, itchy, skin dryness, crusting, flaking, blistering, cracking, oozing, or bleeding. The most common symptom that people complain about is the itch that is a side effect of eczema. It's sometimes called the 'itch that rashes', meaning that once you start scratching, you develop a rash.

Eczema-Ltd is dedicated to helping you to find new and novel ways to treat and control your eczema!

Eczema-Ltd, our patented topical skin conditioner, was invented by a team of Eczema Researchers with 40 years of collective research led by a Johns Hopkins MD with continuing training at Harvard Medical Center - Beth Israel Deaconess & Massachusetts General, and the University of Pennsylvania at Philadelphia. Now for the first time, there have been discovered new confirmed eczema research facts about Eczema's Cause / Etiology or "Cure".

Eczema Skin Care Tips

2007-02-13T11:36:00.000-08:00

Eczema is characterized by patches of red, irritated and itchy skin.
An outbreak can be triggered by weather, stress or use of certain products, including detergents.
Here are suggested ways to prevent an outbreak, courtesy of the Princeton University Health Services:
Apply lotion immediately after getting out of the shower to keep your skin well-moisturized.
Don't take very long baths or showers, and avoid using very hot water that can dry skin.
Don't use harsh soaps or detergents that can irritate the skin.
Try to avoid becoming overheated or very sweaty.
Try to avoid becoming stressed.
Keep skin well covered during winter.
Try not to wear itchy fabrics made of wool or some synthetic fibers.

What is Seborrheic Dermatitis?

2007-01-03T11:33:00.000-08:00

Seborrheic dermatitis is a non-contagious condition that causes flaking and redness of the skin. It occurs when there is inflammation in areas of the skin where sebaceous (skin oil) glands are concentrated. It usually affects the scalp, but can also affect other parts of the body, such as eyebrows, eyelids, the folds of the nose, lips, behind or inside the ears, in the external ear, the forehead and the chin and the skin of the trunk, particularly around the navel, in the skin folds under the arms, in the groin, or under the breasts.Seborrheic dermatitis appears to run in families. Stress, fatigue, weather extremes, oily skin, infrequent shampoos or skin cleaning, use of lotions that contain alcohol, or skin disorders such as acne or obesity may increase the risk. Neurological conditions, including Parkinson's disease, head injury, and stroke can also be associated with seborrheic dermatitis. Human immunodeficiency virus (HIV) is also associated with higher incidence. Seborrheic dermatitis can be unpleasant and uncomfortable, and is usually unattractive. It can disappear spontaneously and suddenly reappear, for no known reason. Or it can stubbornly linger, resisting treatment. But as frustrating as it can be, it is readily diagnosed and is treatable.

The Use Of Cosmeceuticals In The Treatment Of Eczema

2007-01-03T11:30:00.000-08:00

It's hard to make a general statement about the effect of cosmeceuticals on skin barrier function because it's hard to define the word "cosmeceuticals."
Dr. Wu Jessica Wu, M.D., a Los Angeles dermatologist explains that there is no accepted definition, either among dermatologists or from the Food and Drug Administration (FDA), because cosmeceuticals are not regulated by the FDA.
"I think of the definition in very literal terms — a cosmeceutical is an over-the-counter product that has the characteristics of cosmetics and pharmaceuticals just as the name implies. It has the properties of a cosmetic because it is applied topically and is designed to improve the appearance of the skin, but like a pharmaceutical, it presumably has the ability to affect the structure and/or the function of the skin."
Dr. Wu says that is, of course, all based on the manufacturer's claims, which do not have to be proven.
Dr. Wu says, although cosmeceuticals can have other uses, the general perception is as anti-aging products. However, the category can also include products like hydroquinone 2 percent, which is used for the gradual lightening of hyperpigmented skin.
Not standardized
Because the category is so broad, Dr. Wu says it's impossible to generalize about the effect the products have on the skin barrier function.
The problem is exacerbated by the fact that manufacturers are not required to test for the safety or efficacy of their products. Although she says good companies and physician-developed lines are usually quality-controlled, many products made by smaller companies are not necessarily standardized.
"A lot of these are from plant-based ingredients that have hundreds of suppliers around the world and may have no verifiable or consistent strengths. There are a lot of unknowns — it's like the Wild West of skincare," Dr. Wu says.
General characteristics
There are some general characteristics of cosmeceuticals, however, that have disparate effects on the skin.
Retinoids and alpha hydroxy acids are the active ingredients in many anti-aging cosmeceuticals and may be able to effect skin cell structure and function according to Dr. Wu.
"We do know that retinol can increase the turnover of the skin cells, which can make the skin more susceptible to sun damage — and more vulnerable in general.
"When the barrier is altered you get little cracks. Just as over-washing can cause microscopic cracks in the skin, which can expose the nerve-endings making the skin more sensitive to ingredients that ordinarily wouldn't be irritating," she explains.
In the case of cosmeceuticals, it is that action by the active ingredients that increases cell turnover or epidermal shedding — making the skin look and feel smoother and less dull — improving the appearance of the skin.
But these ingredients can also irritate the skin. To combat this, often the cosmeceutical vehicle is designed to protect the skin barrier.
"If you incorporate the active ingredient in a vehicle, which will hold the water in and help restore the skin barrier, then presumably the effect is neutral. That's what a lot of over-the-counter cosmeceuticals try to do."
Some vehicle ingredients that can help restore the skin barrier include hyaluronic acid and dimethicone/cyclomethicone.
She gives the example that 20 percent glycolic acid in a moisturizing lotion will be less irritating than putting straight 20 percent glycolic acid solution on the skin.
"The active ingredient can affect the skin barrier function negatively by compromising the skin's natural protective layer. The vehicle can offset this potential damage enough so that the active ingredient can serve its intended purpose of reducing the appearance of wrinkles without irritating the skin. However, the choice of vehicle can sometimes reduce the potency of the active ingredient."
Dr. Wu recommends prescription strength retinoids to her patients if they can tolerate it, because of abundant scientific data confirming the beneficial effects in photodamaged skin. However, not everyone can tolerate prescription retinoids, even a couple of times a week.

Gut Parasites May Hold A Key To Eczema

2006-12-04T10:19:00.000-08:00

Gut parasites could hold the key to increasingly common conditions such as eczema, asthma and hay fever, according to scientists at The University of Nottingham.
Gut parasites, such as hookworm, have evolved together with their human hosts for millions of years. Over time, these parasites have developed ways of surviving in the human gut by 'turning down' the immune response directed against them, prolonging their survival inside the host.
This reduction in immune response may also have the effect of reducing allergic tissue reactions that characterise asthma and other allergic conditions.
The latest study in this area of research is led by Dr Carsten Flohr, a clinical scientist from The University of Nottingham and Dr Luc Nguyen Tuyen, from the Khanh Hoa Provincial Health Service in central Vietnam. This work was supported through research grants from Asthma UK, the Bastow Award from the Special Trustees for Nottingham University Hospitals and a Fellowship from University College, University of Oxford.
Dr Flohr has examined the links between worms and allergic diseases in Vietnamese children and found that those with the highest level of hookworm infestation were the least likely to have an allergic response to house dust mites.
These findings support the hypothesis that gastrointestinal infection with either hookworms or other micro-organisms protects against allergy and add further weight to the so-called 'hygiene hypothesis'.
Dr Lyn Smurthwaite, Research Development Manager for Asthma UK said: "The 'hygiene hypothesis' suggests that high rates of allergies and asthma in developed countries are a result of our immune systems becoming unbalanced due to improved sanitation and hygienic lifestyles that no longer expose us to the same array of bacteria, viruses or parasites. We look forward to future results in this area."
The study involved 1,600 children aged six to 18, in four neighbouring rural communities in Khanh Hoa province, central Vietnam. Their lifestyles were studied, along with their sensitivity to common allergens and their level of infestation with hookworm and other parasites.
Following on from the study just reported online in the Journal of Allergy and Clinical Immunology, Dr Flohr and his colleagues in Vietnam have conducted an intervention study in the same population during which they regularly de-wormed schoolchildren to see whether this increased the prevalence of allergic diseases. This second study is now coming to a close and the results will be published early next year.
Dr Flohr said: "The results from such an intervention study will allow us to draw firmer conclusions as to whether gut worm infestation truly protects against allergic disease and sensitisation."
Co-applicants on the Asthma UK research grant that is funding the work were Professors John Britton, David Pritchard, and Hywel Williams. The Nottingham team is collaborating with researchers from the Wellcome Trust Major Overseas Programme at the Oxford University Clinical Research Unit Hospital for Tropical Diseases in Ho Chi Minh City, where Dr Flohr has been based for his field work.
The University of Nottingham is leading the way in the investigation of links between hookworm infestation - or lack of it - and human illness. Two further currently ongoing trials are looking at the possibility that hookworm infection may alleviate symptoms of hay fever and Crohn's Disease.
If these studies show positive results, future drugs that mimic the immunological effects of hookworm infection could provide promising therapeutic options for patients with allergic and other autoimmune diseases.
http://www.nottingham.ac.uk

Primary Consideration For Eczema Sufferers

2006-11-07T10:22:00.000-08:00

The first and primary recommendation is that people suffering from eczema shouldn't use detergents of any kind unless absolutely necessary. The current medical school of thought is that people wash too much and that eczema sufferers should use cleansers only when water is not sufficient to remove dirt from skin.
Another point of view is that detergents are so ubiquitous in modern environments and so persistent in tissues and surfaces, safe soaps are necessary to remove them in order to eliminate the eczema in a percentage of cases. Although most recommendations use the terms "detergents" and "soaps" interchangeably, and tell eczema sufferers to avoid both, detergents and soaps are not the same and are not equally problematic to eczema sufferers. Detergents increase the permeability of skin membranes in a way that soaps and water alone do not. Sodium lauryl sulfate, the most common household detergent, has been shown to amplify the allergenicity of other substances ("increase antigen penetration").
The use of detergents in recent decades has increased dramatically, while the use of soaps began to decline when detergents were invented, and leveled off to a constant around the '60s. Complicating this picture is the recent development of mild plant-based detergents for the natural products sector.
Unfortunately there is no one agreed upon best kind of cleanser for eczema sufferers. Different clinical tests, sponsored by different personal product companies, unsurprisingly tout various brands as the most skin friendly based on specific properties of various products and different underlying assumptions as to what really determines skin friendliness. The terms "hypoallergenic" and "doctor tested" are not regulated (according to Consumer Reports), and no research has been done showing that products labeled "hypoallergenic" are in fact less problematic than any others.
Dermatological recommendations in choosing a soap generally include:
Avoid harsh detergents or drying soaps.
Choose a soap that has an oil or fat base; a "superfatted" soap is best.
Use an unscented soap.
Patch test your soap choice, by using it only on a chosen area until you are sure of its results.
Use a non-soap based cleanser.
How to use soap when one must
Bathe in warm water — not hot.
Use soap sparingly.
Avoid using washcloths, sponges, or loofahs.
Use soap only on areas where it is necessary.
Soap up only at the very end of your bath.
Use a fragrance free barrier type moisturizer such as vaseline or aquaphor before drying off.
Never use any kind of lotion, soap, or fragrance unless your doctor tells you to or it's allergen free
Never rub your skin dry, elsewise your skin's oil/moisture will be on the towel and not your body.

Eczema Winter Skin Care

2006-11-01T09:38:00.000-08:00

Your face bares the brunt of harsh winter conditions so it often gets extra special treatment, but it's not the only exposed area of skin that needs extra care. Your hands and your neck are often exposed to the drying winter temperatures and need to be protected from chafing, cracking and drying out. Even the skin that is warmly wrapped can suffer due to the drying effects of central heating.
Skin care during winter can be a challenge for some people, especially if your skin has a natural tendency to dryness. Skin can become sore and itchy and some people experience patches of eczema as a direct result of winter weather.
The good news is that simple, common sense steps can help reduce the harsh effects of winter on your skin. Here's how to top up your moisture levels:
Though the cold mornings mean that it's tempting to take long, hot showers or baths, bathing in hot water strips skin of its natural acid mantel. Without this, your skin is prone to dryness.
Avoid soap-based products for both your face and body, though you should be avoiding these in summer as well. Switch refreshing summer shower gels for richer, more moisturising shower creams for your body and richer cream cleansers for your face for dry skin types.
Moisturisers help protect your skin against the harsh winter elements. Applying a good quality, rich moisturiser after a bath or shower will help to seal in moisture and the body's natural oils. Even skin that's not exposed during the winter can dry out, especially in centrally heated homes. Apply moisturiser to your entire body, but you should pay extra attention to the areas that will be more exposed, perhaps with a second application in the evening.
Moisturiser is an effective barrier against cold temperatures and dry air that can trigger eczema. This is because dry skin can be itchy and become overly sensitive, resulting in fragile skin and possible eczema and dermatitis. The prevention of excessive loss of moisture is important to avoid further complications of dry skin. If you develop dry and itchy skin or eczema, don't let the condition get worse. Take action and start using a good quality skin care range suitable for sensitive skin.
Carry around hand cream and apply after washing. Gloves can also prevent cracked and split cuticles and fingernails.
For your face, apply an alcohol-free toner to prevent loss of moisture from your skin. This is often neglected by many, yet it is a very important step for dry skin. The astringent effect of toners help to close the opened pores to actively prevent loss of moisture.
Apply sunscreen to all exposed skin when you're outdoors, even in winter. You should also protect your lips by using lip balms and ensure you are drinking enough water, even if you don't feel thirsty. Too many people only drink enough fluids when it's hot or when the thirst mechanism kicks in, but waiting to feel thirsty before drinking dehydrates your body, and skin. Your body's minimum requirement of 1.5l doesn't change just because the weather cools down.

The Eczema Symptom Picture

2006-10-31T09:26:00.000-08:00

Eczema is characterized by a rash, dryness of skin, itching, and redness of skin.

The symptoms of eczema occur due to the overproduction of damaging inflammatory skin cells and continue to worsen as a result of certain factors in the environment.

The cause of eczema can be traced to environmental factors. Foods, shampoos, soaps, laundry detergents, synthetic fabrics, stress, and temperature changes are capable of irritating already existing eczema and may even be the cause of a new eczema condition.

Although eczema is a chronic skin condition, there are various forms of treatment and interventions available to help control eczema. One such mild yet effective treatment is Dermatitis-Ltd.

Eczema is a hereditary condition and thus is not contagious to others.

A general picture of eczema can encompass different stages.

Some people may have only a small patch of affected skin while others may have larger patches all over the body. An individual may experience one mild eczema outbreak while others experience chronic severe incidences of eczema.

In some cases after an eczema outbreak the skin remains more reactive than it was prior to the outbreak. The eczema-affected skin is very sensitive and the individual must be aware of the trigger factors and try to avoid them.

Dust Mites May Affect Eczema

2006-10-18T10:19:00.000-07:00

Dust mites, which infest even the cleanest homes and thrive in bedding and carpets, disrupt the protective function of the skin, leaving it vulnerable to other allergens and irritants in the environment, a study has found.
House dust mites and their droppings have long been linked to attacks of asthma and eczema, and a group of researchers in Japan has offered an explanation as to how that happens.
In a paper to be published in the Journal of Investigative Dermatology, the researchers found that mites and their faeces contain an enzyme, which destroys the protective function of the skin, leaving it vulnerable to other irritants.
"People go to hospital only after they develop severe (skin) disease, but little is known as to what happened or what caused it," Toshiro Takai of the Atopy (Allergy) Research Center at the Juntendo University School of Medicine in Tokyo told Reuters.
"Our study suggests that it may be due to the disruption of the barrier function of the skin (by the dust mite)."
In their experiment, the scientists dabbed hairless mice with solution containing the mite enzyme and observed that the rodents soon suffered water loss on their skins.
They then dabbed the mice with riboflavin - or vitamin B2 - which is accepted in the scientific community as a substitute for allergens and irritants in the environment.
"We observed in the mice transepidermal water loss, which is an indication of disruption of the skin barrier. We also observed the penetration of riboflavin into the skin," Takai said.
Takai said the finding provides an explanation for skin-related allergies in humans and he hopes dermatologists would investigate more closely into the role of the dust mite.
"In a healthy person, the barrier is complete and irritants can't get into the skin. But partial disruption of the barrier facilitates passage of allergens and other irritants," he said.
According to the World Health Organisation, asthma affected 300 million people worldwide in 2005, killing 255,000 of them. The death figure is expected to increase by 20 percent in 10 years' time if urgent action if not taken.

Reuters Health

AN ECZEMA VACCINE?

2006-10-11T11:32:00.000-07:00

A Swiss firm has developed a vaccine that it says can ward off common allergies such as asthma, eczema and hay fever. The vaccine by Cytos Biotechnology has been tested on humans and contains harmless DNA similar to that found in the TB bug, reported the online edition of Daily Mail. Rates of asthma have doubled in the past 20 years, with the condition affecting five million in England alone. Figures for hay fever have also soared, with one in four suffering an allergy to pollen. Up to 2,400 children a year are taken to hospital with severe eczema, contributing to the health service's annual one billion pounds bill.According to Muriel Simmons, chief executive of the charity Allergy UK, the new jab has the power to transform people's lives. In a trial, 20 men and women with asthma and house dust mite allergy were given the vaccine once a week for six weeks. Eight months later, symptoms in 17 of the 20 had all but disappeared. Tests showed they were at least 100 times more tolerant to dust mites than before. "The results we have had look quite spectacular. We think this is a one size fits all treatment," Cytos chief executive Dr Wolfgang Renner said. It is hoped the single jab with the power to protect against asthma, eczema and hay fever will be on sale by 2010. Source-IANSSRM Medindia on General Info about Allergy People who are known to be allergic, respond to harmless allergens in an exaggerated manner thus resulting in irritations and discomfort to the body.There are several types of allergies like: Hay Fever, Asthma, Eczema, Hives, Contact Dermatitis (Skin Reactions), Conjunctivitis...
Read More...For More Information

Symptoms Of Eczema

2006-09-22T11:16:00.000-07:00

The symptoms of eczema include itching, redness, dry/flaky skin, and even blisters. Usually the first symptom of eczema is intense itching; this itching can be very uncomfortable and individuals may tend to scratch the skin. The itchy feeling is an important symptom in eczema, because scratching and rubbing in response to itching worsen the skin inflammation characteristic of eczema. Scratching should be avoided because it can only make the eczema symptoms worse. The dry skin will become redder in color and may even crack due to scratching. Scratching may also lead to infection. It is a good idea, therefore, to keep fingernails cut short and to keep the hands occupied during the day in order to control the urge to scratch. The urge to scratch symptom becomes a repetitive cycle: the more you scratch, the more it itches.

2006-09-15T10:28:00.000-07:00

National Eczema Week
16 to 23 September 2006

This year in National Eczema Week the National Eczema Society will be promoting a revised and updated booklet that addresses the psychosocial impact of living with eczema. Healthcare professionals are being encouraged to take advantage of the free information available through the National Eczema Society’s professional membership scheme. The Society plans "to remind the world at large that those of us who have eczema are real people with real emotions, albeit sometimes locked inside an angry skin." A variety of events is planned locally and nationally.

Theories on Allergic Responses

2006-09-07T10:56:00.000-07:00

Between 6 million and 7 million Americans suffer from food allergies, and they represent a growing group, says Robert Wood, a pediatrician and allergy expert at Johns Hopkins Children's Center in Baltimore. "It's similar to the increase in all the allergic diseases, including asthma and eczema, that we have seen in the last 15 to 20 years."
In particular, the number of people with peanut allergies has grown. These reactions are responsible for about 100 deaths per year and one-half of all emergency room visits caused by food allergies. A recent study found that the number of peanut-allergic kids doubled between 1997 and 2002.
Unlike the U.S. and other Western nations, the world's less developed countries have not become allergy-ridden. The contrast has sparked the "hygiene" hypothesis: The fewer germs an immune system is exposed to, the more likely it is to create antibodies to fight substances that are not in fact harmful. These antibodies can cause allergic reactions.
This is not an excuse to keep a dirty house, but the theory has led to experiments in which pregnant women are given probiotics, or friendly bacteria, found naturally in the intestinal tract, to occupy their babies' immune systems. "We are optimistic that in 10 to 15 years there will be ways to play with the immune system that may tip it away from developing allergies," says Wood.
TNX-901, a drug that works to prevent peanut reactions by fighting peanut-sensitive antibodies, has tested very well in preliminary trials and is expected to be available to the public within a few years.
Greater awareness of food allergies is partly responsible for the increase in diagnoses, says Anne Munoz-Furlong, director of the advocacy group Food Allergy and Anaphylactic Network. "Also, our diet has changed. We are eating peanuts more, and at an earlier age," she says. The American Academy of Pediatrics recommends that in families where at least one parent is allergic, kids should not have peanut products before age 3, eggs before age 2, or cow's milk before age 1.
Some toddlers shed their allergies along with their blankies. Wood found that 20 percent of children under the age of 4 do outgrow their peanut allergy, but if they have not it is unlikely that they ever will. The reason isn't understood but may be genetic.
In the meantime, strict avoidance of dangerous foods is the only way to manage allergies, and that is more difficult than it seems.

Dealing With Cradle Cap

2006-08-29T11:31:00.000-07:00

Cradle cap is a crusting and scaling rash found on the scalps of many healthy babies. The sebaceous glands in their skin are hyper-activated often because of mom’s hormones that crossed the placenta just before birth. These glands pump out a greasy substance that keeps the old skin cells attached as it dries. Cradle cap can occur in any baby, and most commonly begins sometime in the first 3 months. The baby develops patchy scales and redness on the scalp, even though the early baby pictures showed beautiful baby skin. The scales may appear cracked, greasy, or even weeping. The same rash is often prominent around the ear or the eyebrows. It may appear in other locations as well, where it is called seborrheic dermatitis rather than cradle cap.

Tips For Treating Eczema

2006-07-10T11:43:00.000-07:00

Initial and ongoing treatment for eczema should include: Avoiding dry skin. Keep your skin hydrated through proper bathing and using moisturizers. This includes bathing in warm water, bathing for only 3 to 5 minutes, avoiding gels and bath oils, and using only nondrying soaps; Apply a moisturizer immediately after bathing; avoiding irritants that causes a rash or make a rash worse. These include soaps that dry the skin, perfumes, and scratchy clothing or bedding; Avoiding possible allergens that cause a rash or make a rash worse. These may include dust and dust mites, animal dander, and certain foods, such as eggs, peanuts, milk, wheat, or soy products; Controlling itching and scratching. Keep your fingernails trimmed and filed smooth to help prevent damaging the skin when scratching. You may want to use protective dressings to keep from rubbing the affected area. Put mittens or cotton socks on a baby's hands to help prevent him or her from scratching the area.

Discoid Eczema

2006-07-10T11:42:00.000-07:00

Discoid or nummular eczema is a name given to a stubborn, sometimes itchy rash that forms coin-shaped patches on the skin. The lesions as they get older may clear in the center resembling ring worm or fungus. The condition tends to be chronic, with periods of quiescence and exacerbation.The cause is unknown although it is more common in the winter. Nummular eczema is frequently associated with dry skin. Wool, soaps and frequent bathing (more than once a day) often worsen the condition. People with eczema have skin that is dry and easily irritated by soap, detergents, and rough wool clothing. Clothes washed or dried with liquid or sheet fabric softeners such as Cling, may also irritate the skin. Hot and cold weather often aggravates eczema. Certain allergies may worsen eczema, but they don't cause it.

Improving The Baby Eczema Picture

2006-06-27T07:46:00.000-07:00

Adding prebiotics to formula feed can help cut the risk of babies developing a form of eczema, research suggests.Milan's Center for Infant Nutrition found atopic dermatitis was less likely in babies given supplemented formula than those given the standard form.
Prebiotics encourage the growth of beneficial bacteria in the gut. The study, published in Archives of Disease in Childhood, suggests they might prevent atopic dermatitis by giving a boost to the immune system. Lead researcher Professor Guido Moro said the risk of atopic dermatitis was reduced by over 50% in the prebiotic-fed infants. He said: "To our knowledge this is the first time that it has been shown that prebiotics can not only produce favourable changes in the gut flora, but that these changes can lead to a genuine clinical benefit. "It appears that prebiotics can strengthen the immune system and so reduce the risk of atopic dermatitis during the first months of life." The research focused on 192 healthy children considered to be at high risk of developing allergies. At least one parent of each child had been diagnosed with an allergic disease. Breastfeeding advice Parents of every child considered for the study were advised to breastfeed their children. However, none of the children who ended up taking part was breastfed. The children of those who, nevertheless, decided to start with formula feeding were assigned to one of two groups. Half the children received formula milk supplemented with a prebiotic mixture made up of two types of carbohydrates called galacto-oligosaccharides and long chain fructo-oligosaccharides. Previous research has suggested this mixture has a similar impact to breast milk on the bacteria living in the gut, boosting beneficial bugs, and inhibiting growth of bugs that can cause disease. After six months, 10.6% of the group given prebiotics showed signs of atopic dermatitis, compared with 22.4% of those given formula supplemented with a placebo. Analysis showed the proportion of "friendly" bifidobacteria was significantly higher in the stools of infants fed on the prebiotic. Muriel Symmons, of the charity UK Allergy, said: "This study adds to our knowledge of the role of prebiotics in helping to prevent the development of eczema in infants. "More work of this kind is needed to establish whether prebiotic supplements can help those babies whose mothers are unable or choose not to breast feed." Nina Goad, of the British Skin Foundation, said: "We know that atopic dermatitis is a condition in which many factors can influence its development and severity." Details of the study were presented at the Royal College of Paediatrics and Child Health Spring Meeting in York.

Skin Allergy or Eczema

2006-06-16T11:33:00.000-07:00

The cause of eczema can be tough to figure out - even for dermatologists. Eczema, or dermatitis as it is sometimes called, is a group of skin conditions which can affect all age groups. In the United Kingdom, up to one fifth of all children of school age have eczema, along with about one in twelve of the adult population. "Patch testing of the skin can tell us if a rash is being caused or exacerbated by an allergy, and can help us to distinguish a skin allergy from other skin conditions, such as eczema, irritant dermatitis or psoriasis," says Joshua L. Fox, dermatologist and founder of the Center For Laser And Cosmetic Surgery.
The severity of eczema can vary. In mild forms the skin is dry, hot and itchy, whilst in more severe forms the skin can become broken, raw and bleeding. Although it can sometimes look unpleasant, eczema is not contagious. With treatment the inflammation of eczema can be reduced, though the skin will always be sensitive to flare-ups and need extra care. Atopic eczema is thought to be a hereditary condition, being genetically linked. It is proposed that people with atopic eczema are sensitive to allergens in the environment which are harmless to others. In atopy there is an excessive reaction by the immune system producing inflamed, irritated and sore skin. Other types of eczema are caused by irritants such as chemicals and detergents, allergens such as nickel, and yeast growths. In later years eczema can be caused by a blood circulatory problems in the legs. There are a number of ways to manage eczema, all of which begin with an effective skin care routine. Emollients are necessary to reduce water loss from the skin, preventing the dryness normally associated with eczema. When eczema is under control only emollients need to be used. However in flare-ups, when the skin becomes inflamed, a steroid cream may be needed. Steroids act by reducing inflammation and are used in most types of eczema. As long as steroids are used appropriately and as directed by your doctor, the likelihood of side effects is very rare.

Botox May Improve The Symptoms Of Hand Eczema

2006-06-06T12:10:00.000-07:00

While botulinum toxin A, or BTXA, is widely known for its use in dermatology and aesthetic medicine, a review article in the Journal of Cosmetic Dermatology explores the drug's other successful applications. BTXA is popularly used to treat hyperhidrosis (excessive sweating) or to diminish wrinkles, but it is also a highly effective natural substance that normalizes muscle activity and can be used to reduce pain and itch. Benefits of BTXA have been observed in treatment of hand eczema and is effective in blocking secretion of sweat, saliva and mucus in cases of Hailey-Hailey disease (a blistering disease usually treated by surgery or laser) among other ailments. In addition, "botulinum toxin A has important applications in proctology where it has become the most powerful non-surgical therapy for anal fissure," according to Uwe Wollina, author of the review. "The substance in the hands of the experienced doctor is safe, provides effective treatment of several complaints, and is capable of reducing the need for surgery in many cases." This article is published in the Journal of Cosmetic Dermatology.

Early Exposure To Cats May Increase Eczema Risk In Infants

2006-05-31T09:10:00.000-07:00

Children who are exposed to cats soon after birth face an increased risk of developing eczema, an inflammatory condition that causes the skin to become red, scaly and itchy, says a study.
Esmeralda Morales at the University of Arizona in Tucson and other researchers studied 486 children and asked their parents how many cats and dogs they had in the house at the time the child was born, according to science portal EurekAlert.
The researchers then followed up one year later to see which children had been diagnosed with eczema. Of the 134 children with cats in the household, 27.6 percent had eczema by one year of age, compared with 17.8 percent of 286 children without cats.
Previous studies have found that people with eczema have a higher chance of also having allergic conditions, including hay fever and asthma.
"Other studies have found that having cats or dogs at home seems to be protective against allergic diseases, so we expected to have similar findings," said Morales.
Being exposed to two or more dogs at home suggested a slightly protective, but not significant, effect on children’s risk of developing eczema, he however said.
"Pets are a source of a compound called endotoxin, and if a child is exposed to endotoxin early in life, the immune system may be skewed away from developing an allergic profile," she said.
It is possible that the children in the study who developed eczema at age one might end up having a reduced risk of asthma or other allergic diseases later in life, Morales noted.
"The findings do seem to add more questions about pets and asthma and allergies," she said. "Since there are a lot of contradictory data out there already, clearly it’s a topic that needs further research."

The Eczema Fabric Fiber Picture

2006-05-31T09:06:00.000-07:00

An Osaka-based textile maker has developed a new fiber that is effective in soothing the itchiness of atopic dermatitis.
About 80 out of 100 atopic dermatitis sufferers found in clinical testing that their itchiness was reduced when wearing underwear made from the fiber.
Those who suffer from atopic dermatitis, more commonly called eczema, have intense itchiness of skin. And the attendant excessive scratching further aggravates the skin condition by bacterial infection and bleeding, causing more itchiness.
Drawing on research conducted by Shinshu University and other institutions, the textile maker, Daiwabo Neu Co., dyed a fiber with iron phthalocyanine, an organic chemical that destroys the protein that accelerates itchiness.
As a result, the firm found that the fiber decomposes allergens such as dust mites and house dust, which are a major cause of itchiness.
In the tests, around 100 sufferers wore underwear made of the fiber when they went to sleep at night. In the morning, they answered questions about how itchy they felt. Doctors also checked their skin for the presence of scratches on their bodies.

Eczema: What It Is And What Causes It

2006-05-22T10:46:00.000-07:00

Eczema is characterized by a rash, dryness of skin, itching, and redness of skin (Rouse). The symptoms of eczema occur due to the overproduction of damaging inflammatory skin cells and continue to worsen as a result of certain factors in the environment. The cause of eczema can be traced to environmental factors. Foods, shampoos, soaps, laundry detergents, synthetic fabrics, stress, and temperature changes are capable of irritating already existing eczema and may even be the cause of a new eczema condition. Although eczema is a chronic skin condition, there are various forms of treatment and interventions available to help control eczema. Eczema is a hereditary condition and thus is not contagious to others. A general picture of eczema can encompass different stages. Some people may have only a small patch of affected skin while others may have larger patches all over the body. An individual may experience one mild eczema outbreak while others experience chronic severe incidences of eczema. In some cases after an eczema outbreak the skin remains more reactive than it was prior to the outbreak. The eczema-affected skin is very sensitive and the individual must be aware of the trigger factors and try to avoid them.

Eczema on Infants' Arms and Joints Linked to Future Atopic Dermatitis

2006-05-16T10:43:00.000-07:00

Skin lesions on infants' arms and at their limb joints best predicted atopic dermatitis by age three, according Danish researchers
"Although the predilection sites in the first years of life have been reported to be the head, trunk, and the extensor surfaces of the extremities, to our knowledge the early presentation and progression of eczema lesions have not been described prospectively in detail," said Hans Bisgaard, M D , of Copenhagen University here, and colleagues, in the May 16 issue of the Archives of Dermatology
For 356 high-risk children (208 female), in a prospective, longitudinal birth cohort, the cumulative incidence of atopic dermatitis by age three was 44% (155 children) The prevalence rate peaked at age two for boys and at age 2 5 for girls, although there were no other sex differences in the proportion of children who developed atopic dermatitis, the researchers reported
The earliest sign of dermatitis leading to atopic dermatitis was recorded at one month, with the highest incidence occurring during the second half-year of life, according to the researchers For those with complete follow-up, the cumulative incidence of atopic dermatitis was 31% (109) at one year, 41% (147) at age two, and 44% (155) at three years
All children participated in the Copenhagen Prospective Study on Asthma in Childhood (COPSAC) Of 411 children at the outset, 356 completed the study, and all were born to mothers with a history of asthma, while 48% of the mothers also had a history of atopic dermatitis
A comparison of the skin lesions during the first year and a half of life between children who eventually were or were not diagnosed with atopic dermatitis found that eczema at the arms and around the arm and leg joints had the highest predictive value
When the risk of atopic dermatitis at age three was estimated for 10 body regions, early lesions presenting on the arms and joints showed a strong correlation to later development of the skin disorder (OR, 7 5-11 8; maximum 95% CI 2 7-50 9), the researchers said
By comparison, the odds ratio for the trunk was lower (OR 5 6 CI 2 9-10 6), while the diaper area showed no correlation (OR 1 9 CI 0 9-4 1)
The cheeks were affected in almost 80% of the children with atopic dermatitis, but cheek lesions were seen in more than 40% of children without atopic dermatitis, the investigators said
Seborrheic dermatitis should not be mistakenly diagnosed as atopic dermatitis, the researchers cautioned, inasmuch as it was diagnosed equally in children with and without the inflammatory skin disease and also in those without other skin lesions, Dr Bisgaard said
Severity was scored using the Scoring Atopic Dermatitis (SCORAD) index, which included the extent, intensity, and subjective symptoms, such as pruritus and sleeplessness According to the SCORAD index, mild symptoms were (<15>40 points)
Most infants presented with mild eczema, and the severity declined with age, with an increased fraction of mild cases, a reduced fraction of moderate to severe cases, and no obvious sex differences Even if the present cohort is at high risk for atopic dermatitis, the severity of the symptoms should not necessarily be expected to increase compared with children from a non-risk population, Dr Bisgaard noted
In following the course, though not the significance, of the lesions, the researchers wrote that skin involvement for infants with atopic dermatitis began at the scalp, forehead, ear, and neck, and continued down to the trunk, finally affecting the flexor sides of the extremities However, the eye area, palm of hand or foot sole, and nose regions were very rarely affected
As for treatment, topical corticosteroids (mild, mid-strength, and potent) were prescribed in 7 6 courses per child during the first three years of life, with a mean ±SD of 15 ±14 days per treatment period Seven children with respiratory symptoms received systemic corticosteroids on eight occasions, while children with other types of lesions also received topical corticosteroids
The risk of misclassification in this study was low, the researchers wrote, because the diagnosis, detailed phenotyping, and management of skin lesions were controlled solely by the research unit's physicians However, they added, results from high-risk children in this high-risk cohort cannot be generalized, and validation in unselected populations may be needed
"This improved description of the progression of skin lesions facilitates early diagnosis of AD in infancy and allows studies examining early intervention and prevention strategies," Dr Bisgaard concluded
Although the children in Danish study were treated with topical corticosteroids, an editorial in the same issue of the Archives of Dermatology by Harvard's Abrar Qureshi, M D , and Michael Fischer, M D , warned about the use of topical calcineurin inhibitors, Protopic (tacrolimus) and Elidel (pimecrolimus), for atopic dermatitis for adults and children younger than two years
The FDA is concerned, Drs Qureshi and Fischer wrote, that the drugs are being inappropriately marketed to pediatricians and non-dermatologists who may be otherwise hesitant to use a topical steroid
Data so far suggest that a significant number of prescriptions are being written for both Protopic and Elidel for children in this age group, despite this being an off-label use of both drugs, the researchers wrote
A Black-Box warning issued by the FDA last January stated that reasons for this action include sporadic reports of lymphoma and skin cancer in some individuals using these topical calcineurin inhibitors; concerns about systemic absorption resulting in greater systemic exposure in a subpopulation of treated patients; unusually aggressive and inappropriate marketing of topical calcineurin inhibitors as first-line agents; and early carcinogenicity in animals treated with very high systemic doses
The editorialists concluded: "When the next promising new agent is approved by the FDA, we hope that medical professionals will provide the guidance our patients so sorely need by choosing patients for new drugs carefully, monitoring them closely, and encouraging them to enroll in post-marketing research studies whenever possible "

A General Picture Of Eczema

2006-05-10T07:10:00.000-07:00

Eczema is characterized by a rash, dryness of skin, itching, and redness of skin.
The symptoms of eczema occur due to the overproduction of damaging inflammatory skin cells and continue to worsen as a result of certain factors in the environment.
The cause of eczema can be traced to environmental factors. Foods, shampoos, soaps, laundry detergents, synthetic fabrics, stress, and temperature changes are capable of irritating already existing eczema and may even be the cause of a new eczema condition.
Although eczema is a chronic skin condition, there are various forms of treatment and interventions available to help control eczema.
Eczema is a hereditary condition and thus is not contagious to others. A general picture of eczema can encompass different stages. Some people may have only a small patch of affected skin while others may have larger patches all over the body.
An individual may experience one mild eczema outbreak while others experience chronic severe incidences of eczema. In some cases after an eczema outbreak the skin remains more reactive than it was prior to the outbreak. The eczema-affected skin is very sensitive and the individual must be aware of the trigger factors and try to avoid them.

The Healing Picture of Eczema

2006-05-01T12:41:00.000-07:00

With any treatment, Be patient! Results may not be immediate. The healing process takes several days, even with a tissue as active as skin.
Remember that treating skin disease is a mixture of both science and art, and fine-tuning may improve the outcome, even with relatively small changes. It's best to make these in close partnership with your trusted provider. A small proportion of persons with eczema will learn that their disease is primarily based on an allergic reaction to something. Indeed, the hope of every person with eczema is for a real cure, but at this writing there isn't one in sight. The clinical management of this disease remains quite complex, with much trial and error required. It's always a good idea to look into any rumored new therapy, whether you actually try it or not. And if you do try it, don't be too put off by apparent failures, or too ecstatic at what appear to be promising results. Although your disease is stubborn, it is also manageable. This information sets forth current opinions from recognized authorities, but it does not dictate an exclusive treatment course. Persons with questions about a medical condition should consult a physician who is knowledgeable about that condition.

Therapeutic Treatment For Atopic Dermatitis

2006-04-27T05:53:00.000-07:00

Topical vitamin B12--a new therapeutic approach in atopic dermatitis-evaluation of efficacy and tolerability in a randomized placebo-controlled multicentre clinical trial.

Vitamin B(12) is an effective scavenger of nitric oxide (NO). As the experimental application of a NO synthase inhibitor, N omega-nitro-L-arginine, led to a clear decrease in pruritus and erythema in atopic dermatitis, it would be reasonable to assume a comparable effect of vitamin B(12).

The efficacy and tolerability of a new vitamin B(12) cream as a possible alternative to current therapies was examined. METHODS: A prospective, randomized and placebo-controlled phase III multicentre trial, involving 49 patients was conducted. For the treatment duration of 8 weeks, each patient applied twice daily (in the morning and evening) the vitamin B(12)-containing active preparation to the affected skin areas of one side of the body and the placebo preparation to the contralateral side according to the randomization scheme.

On the body side treated with the vitamin B(12) cream, the modified Six Area Six Sign Atopic Dermatitis score dropped to a significantly greater extent than on the placebo-treated body side (for the investigational drug 55.34 +/- 5.74 SEM, for placebo 28.87 +/- 4.86 SEM, P < 0.001). At the conclusion of the study, the investigator and patients awarded mostly a 'good' or 'very good' rating to the active drug (58% and 59%, respectively) and a 'moderate' or 'poor' rating to the placebo (89% and 87%, respectively).

Topical vitamin B(12) is a new therapeutic approach in atopic dermatitis. These results document a significant superiority of vitamin B(12) cream in comparison with placebo with regard to the reduction of the extent and severity of atopic dermatitis. Furthermore, the treatment was very well tolerated and involved only very low safety risks for the patients.

The Perioral Dermatitis Picture

2006-04-26T10:49:00.000-07:00

Perioral dermatitis is a rash composed of tiny red bumps that are primarily around the mouth, but can also be seen around the nose and on other areas of the face.

II. Causes:
Perioral dermatitis is a disease that occurs mostly in young and middle-aged women.
Perioral dermatitis can be caused by prolonged therapy with topical corticosteroids (hydrocortisones).
The contraceptive pill, cosmetic usage and emotional stress can worsen perioral dermatitis.
Toothpaste containing lauryl sulfate may cause perioral dermatitis.
The affected area is often worsened by sunlight and almost always by wind, heat, chlorinated pool water and even by washing with hot water.
If you have this condition, premenstrual flare ups are common.

III. Treatment:
The first step in treating perioral dermatitis is to discontinue all topical corticosteroids.
Toothpaste without lauryl sulfate can be purchased from Squigle, Inc. toll free at 877-718-0718.
Oral tetracyclines four times a day for about three weeks is a successful source of treatment. Minocin and doxycycline are also effective treatments.
There is no medicine that you can apply directly to the skin which will help perioral dermatitis.

The Keratosis Pilaris Picture

2006-04-18T09:16:00.000-07:00

Keratosis pilaris is a common skin disorder. Although it isn't serious, it can be frustrating because it's difficult to treat.
Keratosis pilaris occurs most often in children. It results from the buildup of a protein called keratin in the openings of hair follicles in the skin. This produces small, rough patches — usually on the arms, thighs and face. The exact cause isn't known, but it may be associated with eczema.
Keratosis pilaris typically causes no pain or itching. Treatment is directed at softening the keratin deposits in the skin and may include medicated creams containing urea or lactic acid. Even with treatment, this condition tends to remain for years. If associated with eczema, keratosis pilaris may improve with treatment of the underlying eczema.
Summer weather and swimming in clorinated pools may improve the condition in some.

The Picture of Hand Eczema

2006-04-10T11:41:00.000-07:00

Hand eczema often results from a combination of causes, including genetic makeup, injury, contact with irritants and allergy. It is frequently caused or aggravated by work, when it is known as occupational dermatitis. Hand dermatitis is particularly common in industries involving cleaning, catering, metalwork, hairdressing, healthcare and mechanical work.Hand dermatitis varies in severity. It may affect the backs of the hands, the palms or both sites. Often it starts as a mild intermittent complaint, but it can become increasingly severe and persistent. The affected skin initially becomes red and dry, then progresses to itchy bumps and fluid-filled blisters, scaling, cracking, weeping and swelling. Bacterial infection can result in pustules, crusting and pain. Longstanding dermatitis at the ends of the fingers may result in deformed nails. Hand dermatitis can spread to affect other sites, particularly the forearms and feet.

Eczema's Gene Mutation Picture

2006-03-29T11:53:00.000-08:00

Recent research has discovered the gene defect that causes genetic skin conditions such as eczema. Although shielding lotions are effective treatment for eczema in many cases, if you find you are resistive to treatment, you may be one of the estimated 60 million people worldwide that carry these gene defects, and it may be causing your eczema.The research, conducted by experts on genetic skin disorders at the University of Dundee, with collaborators in Dublin, Glasgow, Seattle and Copenhagen, was published in two consecutive papers in the March and April editions of Nature Genetics.The defect involves a gene that produces filaggrin, a protein that helps form a protective layer on the skin surface to keep moisture in, and toxins out. It is normally found in large quantities in the outermost layers of the skin.When the level of filaggrin is inadequate, the protective barrier is compromised, causing the skin to dry out too easily and the outer layers to flake off. Additionally, the lack of protection allows toxins to enter the skin, which then causes the inflamed condition known as eczema. The researchers also concluded that, in addition to causing eczema, the absorption of the toxins through the skin, which then later enter the lungs, may also lead to the asthmatic conditions which often accompany the skin problems.The Dundee group is currently working on developing methods to treat the underlying causes of the defect, and to thereby find something to treat and prevent the diseases.One report also stated that the currently available treatments for eczema only relieve the symptoms - emollients to prevent the skin from drying out, and steroids to treat the inflammation – and this discovery presents the opportunity to treat the cause.Although the discovery of filaggrin deficiency may open the door to some form of treatment in the future, there is a solution available right now that thousands of doctors recommend – shielding lotions. A good barrier then locks in your own natural oils and moisture, keeps the irritants out, and allows your skin to heal.

Hand Eczema May Be Caused By Soaps And Other Irritants In The Workplace

2006-03-21T11:37:00.000-08:00

Hand eczema caused by soaps and other irritants in the workplace may lead to unemployment or prolonged sick leaves from work for some individuals, according to an article in the March issue of Archives of Dermatology.
Hand eczema or dermatitis is characterized by redness and inflammation of the hands, often due to irritants in soap, chemicals or detergents. "Occupational hand eczema (OHE) has become a disease of increasing importance during recent decades because of its serious consequences, such as frequent eruptions and risk of prolonged sick leave," background information in the article states. OHE also greatly affects quality of life (QOL). Past studies name OHE as the most frequently recognized occupational disease in Denmark and many Western countries.
Rikke Skoet Cvetkovski, M.D., Ph.D., of the University of Copenhagen, Hellerup, Denmark, and colleagues studied patients with OHE to identify predictive risk factors for the disease. Patients listed in the Danish National Board of Industrial Injuries Registry as having OHE between Oct. 1, 2001, and Nov. 10, 2002, received questionnaires regarding sick leave, loss of job, depression, health-related quality of life and their eczema's severity. A follow-up questionnaire was sent one year after the first was returned. Of the 621 patients who responded to the first questionnaire, 564 (386 women and 178 men) completed the follow-up.
During follow-up, 25 percent of surveyed patients had persistently severe or aggravated OHE, 41 percent improved and 34 percent of patients experienced unchanged minimal or mild to moderate OHE. The groups most affected by OHE were butchers, kitchen workers and cooks, hairdressers and patients aged 25 to 29 years. Having a severe case of OHE, being 40 years of age or older and having a low self-rated quality of life predicted unemployment and prolonged sick leave (more than five weeks in the past year). Also, patients with a lower socioeconomic status (based on education and job status) were at high risk for prolonged sick leave, a change of job and unemployment.
"Predictive factors could be used by clinicians to guide treatment and to select early risk management strategies," the authors write. "To avoid prolonged sick leave that may lead to social and economic decline, physicians must try to identify subgroups of patients who are at greater risk of a poor outcome."

Basic Skin Care For Eczema

2006-03-17T12:02:00.000-08:00

Initial and ongoing treatment for dermatitis should include:
Avoiding dry skin. Keep your skin hydrated through proper bathing and using moisturizers. This includes bathing in warm water, bathing for only 3 to 5 minutes, avoiding gels and bath oils, and using only nondrying soaps;
Apply a moisturizer immediately after bathing; avoiding irritants that causes a rash or make a rash worse. These include soaps that dry the skin, perfumes, and scratchy clothing or bedding;
Avoiding possible allergens that cause a rash or make a rash worse. These may include dust and dust mites, animal dander, and certain foods, such as eggs, peanuts, milk, wheat, or soy products;
Controlling itching and scratching. Keep your fingernails trimmed and filed smooth to help prevent damaging the skin when scratching. You may want to use protective dressings to keep from rubbing the affected area. Put mittens or cotton socks on a baby's hands to help prevent him or her from scratching the area.

Immunosuppressant May Help in Refractory Eczema

2006-03-14T10:31:00.000-08:00

The immunosuppressant Imuran (azathioprine) may offer some relief to patients with eczema that is refractory to standard topical treatment, according to researchers here.
Twelve weeks of treatment with the drug resulted in modest but significant improvements in eczema symptoms and overall quality of life, reported Simon J. Meggitt, M.D., a dermatologist at the Royal Victoria Infirmary here, in the March 11 issue of The Lancet.
The parallel-group, double-blind, placebo-controlled trial included 63 patients with moderate-to-severe eczema not responding to topical steroid treatment. Two-thirds received Imuran and one-third placebo once-daily. Dosing of Imuran was based upon ability to metabolize the drug, as judged by measurements of the activity of the thiopurine methyltransferase enzyme.
At week 12, the treatment group had a 37% reduction of symptoms compared with 20% for the placebo group. This 17% difference was statistically significant (95% confidence interval=4%-29%).
Compared with placebo, the treatment group also had significant improvements in global assessment and quality of life scores as rated by patients (P=.05) and investigators (P=.01).
Although the difference in symptom reduction between the treatment and placebo groups was modest, the authors said, "in view of the significant improvements that were also seen in secondary outcome variables, we feel that overall azathioprine treatment does produce a clinically relevant change in eczema severity, in particular because quality of life and global response are thought to be meaningful indicators of change in eczema."
Adverse events were generally mild, with nausea the most commonly reported side effect, which necessitated dose reduction in seven individuals. Four participants could not tolerate even small doses and withdrew from the study. Drug hypersensitivity (fever and myalgia) occurred in two participants.
There was a wide variation among individuals in response to the drug, and its mechanism of action in atopic eczema is not known, the investigators said.
The results of this study warrant further investigation of Imuran for eczema and other inflammatory disease, they concluded.
In the United States, the drug is used to treat rheumatoid arthritis and to prevent rejection of kidneys after transplant. Off-label uses include treatment of inflammatory bowel disease and lupus erythematosus.

Tips For Living With Eczema

2006-03-10T08:59:00.000-08:00

Even though there is no cure for eczema, there are lots of things you can do to feel better if you have it:

Don't scratch! Sometimes this can seem like the hardest thing to do. But when you scratch, it makes your skin sore. The skin can even break open, bleed, and become infected with bacteria.

Keep your fingernails cut short. You're less likely to break your skin open if you scratch an itch.

Take short baths or showers with warm water. Hot water can make you itch more. Ask your doctor about the use of oatmeal soaking products in your bath to help control the itching.

After bathing, don't rub your skin dry with a rough towel. That just irritates your skin more. Gently pat it dry to get the water off. Then put on some moisturizing lotion to help keep your skin from getting too dry. You can spread the lotion on several times a day.

Do your skin a favor and drink lots of water, increasing your water intake, increases the moisture in your skin.

Wear loose clothing to help your skin feel better. Make sure you wear cotton or other natural fibers. Wool and synthetic cloth can make you feel itchy all over.

Relax. You may find that your eczema gets worse when you're stressed. Find ways to deal with things that bother you.

Keep a diary of anything you ate or came in contact with just prior to a flare. If you're allergic to any foods or other things that may make your eczema flare up, you'll want to be sure to avoid them.Unfortunately, eczema cannot be cured, though certain types will eventually clear up and others can be resolved by avoiding particular triggers. For many sufferers however, this is a lifetime condition that has to be carefully managed and monitored.
It is thought that eczema may be an outlet for one's emotions and is aggravated by stress. It could equally be said that eczema may cause emotional stress. Either way, eczema can justifiably be described as a condition you 'wear'. The psychological aspects of eczema are very imprecise but undoubtedly there are psychological factors in many illnesses.The person with eczema may be quite sensitive about their condition. Self-consciousness is common. People may withdraw socially, believing that skin conditions carry a stigma. This can affect the person's social and emotional development.
No one knows for certain what conditions specifically cause eczema, although problems with the body’s immune system may be to blame. Substances and events that are often perceived to cause the condition are actually triggers. The triggers cause underlying skin conditions to flare up and existing skin rashes to worsen, but they don’t actually cause the condition.Research into human genetics may hold the key to discovering the root cause of eczema. Until then, sufferers should attempt to avoid substances known to trigger skin rashes.

Top Ten Contact Dermatitis Allergens Identified

2006-03-07T12:48:00.000-08:00

Almost anything that comes in contact with the skin can cause allergic contact dermatitis. It occurs when the body's immune system senses a known allergen and reacts to expel it. This skin reaction or inflammation usually manifests with swollen, reddened and itchy skin.
The top ten contact dermatitis allergens indentified in this study were:

Nickel (nickel sulfate hexahydrate)Nickel is found in many products.
It can be found in jewelry, buckles, zippers, snaps, buttons, hair-pins, and metal clips. Be aware that any metal product may contain nickel.

Gold (gold sodium thiosulfate)Gold is a precious metal often found in jewelry and also used in the denistry field.

Balsam of Peru (myroxylon pereirae)Balsam of Peru originates from a tree resin and is used in fragrances, skin care products, flavoring in foods, health and beauty aids, and medicinal creams and oitments. Not only is Balsam of Peru aromatic, but it delays evaporation and also acts as a mild antibacterial, antifungal and antiparasitic.

Thimerosal Thimerosal is a mercury compound used in local antiseptics and in vaccines. It is used as a perservative in many items such as cosmetics, pharmaceutical products, vaccines, and skin prict test antigens.

Neomycin sulfate Neomycin sulfate is an antibacterial used widely in first-aid or antibiotic creams and ointments, eye and ear preparations. It is also used in combination with other antibacterials corticosteroids. These combination preparations treat a variety of skin, eye, and ear infections.

Fragrance mix Fragrance mix is a sceening agent that is used to pinpoint the cause of a large percentage of skin allergies. This fragrance mix contains eight known skin sensitizers which are found in foods, cosmetic products, insecticides, antiseptics, soaps, perfumes, and dental products.

Formaldehyde Formaldehyde is a chemical widely used in many building materials and household products. It is a preservative with multiple uses. Some of the sources of formaldehyde include paper products, paints, medications, household cleaners, cosmetic products and fabric finishes. It is impossible to list all the sources of formaldehyde exposure.

Cobalt chloride Cobalt chloride is a metal that is found in medical products such as Vitamin B12 preparations, metal prostheses and dental plates. It is also present in many metal plated objects such as snaps, button, or tools. Because cobalt pigment produces light brown shades of hair, it is used in hair dye. It can also be found in antiperspirant preparations. Cobalt blue pigment can be found in porcelain, glass, pottery, ceramics, enamels, and blue or green water colour paints and crayons.

Bacitracin Bacitracin is a topical antibiotic that is used for a variety of localized skin and eye infections.

Quaternium 15 Quaternium 15 is a formaldehyde-releasing preservative found in cosmetics products such as eye make-up, foundations, powders. It can also be found in shampoos, soaps, self-tanners, baby powders, nail polish and sunscreen. Commercial and industrial products such as adhesives, floor waxes or polishes, latex paints, paperboard, laundry starch, and water based inks also may contain Quaternium.

New Drug Extends Remission of Atpic Dermatitis

2006-03-03T11:14:00.000-08:00

Stiefel Laboratories, the world's largest independent pharmaceutical company specializing in dermatology, announced that a recent study shows MimyX(TM) Cream extends the remission period of atopic dermatitis (AD) by 48 percent when used in conjunction with an emollient compared to emollient alone. MimyX(TM) Cream, Stiefel's new product for managing the signs and symptoms of atopic dermatitis, is a steroid-free, topical Rx therapy for the management of the disease, commonly referred to as eczema.
Most eczema patients will experience periods of "flares" where they have noticeable signs and symptoms of AD alternating with periods of remission where no symptoms are present. According to the 12-week MimyX study involving 74 individuals, MimyX(TM) Cream extends AD remission by 48 percent and may actually reduce the total number of flares a person experiences. The study also shows a 25 percent greater incidence of AD flare-ups on the side of the body where only an emollient was used, as opposed to the side of the participant's body where MimyX(TM) Cream was used in conjunction with an emollient.
"The data collected in this study is very beneficial for understanding and managing atopic dermatitis," said Dr. Joseph Fowler, University of Louisville. "By extending the remission of eczema, we can reduce the total number of flares a patient may experience, and quite possibly lessen the need for adjunctive therapy such as steroids, immunomodulators and systemic antihistamines."
MimyX(TM) Cream is unique from other eczema treatments in that it can be used throughout the AD continuum. MimyX(TM) Cream can be used along with a short-term anti-inflammatory agent during flares and it can also be used without the anti-inflammatory for daily management during remission. (1)
According to Jim Hartman, Vice President, U.S. Marketing, Stiefel, this is a significant finding.
"This study justifies MimyX(TM) as a potential foundation therapy for atopic dermatitis," Hartman said. "Not only is it useful for the management of the signs and symptoms of AD, it has also been shown clinically to extend remission periods of the disease."
Time To Flare Study Background
The objective of the MimyX(TM) Cream Time to Flare (TTF) study was to determine the efficacy of twice daily application of MimyX(TM) Cream added to twice daily emollient maintenance therapy in reducing the risk of relapse of chronic AD. Specifically, the addition of MimyX(TM) Cream to emollient therapy was compared to emollient therapy alone with regard to time until flare.
This was a six-center, investigator-blinded, randomized bilateral study in which subjects with AD were assigned to one of two groups. Group 1 applied MimyX(TM) Cream twice daily to all affected areas on the right side of the body. Group 2 applied MimyX(TM) Cream twice daily on all affected areas on the left side of the body. After applying MimyX(TM) Cream, subjects in both groups applied a non-medicated emollient (Eucerin® Cream) twice daily to the same areas on both sides of the body and any other areas of dry skin. Therapy occurred over a 12-week period with examinations of the subjects initially (week 0, visit 1) and at weeks 2, 4, 6, 8, 10 and 12 (visits 2-7). Rescue medication (Triamcinolone Cream 0.1%) was provided in the event of flare.
Approximately 4 percent of patients experienced adverse events (possibly or probably) related to the use of MimyX Cream like burning (n=1), uticaria (n=1) and headache (n=1) during the study.

Is Milk A Factor In The Eczema Picture?

2006-02-27T12:43:00.000-08:00

Most North Americans grew up being told to drink milk “for healthy bones and teeth”. Scientists have questioned the validity of this dictum for years, and have found evidence that milk not only fails to live up to this promise, it can even cause a host of medical conditions, including eczema. In fact, eliminating milk and dairy from your diet, along with a topical eczema treatment to alleviate the dry, itchy condition of the skin, is often just what the doctor orders.Milk has been the subject of medical studies for decades – although the majority have been done on children. From 1988 to 1993, over 1500 articles were published about milk in medical journals. Dr. Robert M. Kradjian of the Johns Hopkins School of Medicine culled these articles to omit inconclusive and irrelevant subjects and did a thorough study of the 500 articles remaining. Not one article referenced milk as the excellent food we have been led to believe. In fact, highlighted in the reports were conditions that are known to cause and be indications of eczema - intestinal colic, intestinal irritation and bleeding, allergic reactions, and asthma. Many with eczema also suffer from these conditions, and elimination of their causes often results in elimination of the eczema.According to Dr. Frank Oski, chief of pediatrics at John Hopkins School of Medicine, it is possible that 50 percent of all schoolchildren are allergic to milk. Other researchers think this estimate is too conservative. A study published in the Journal of Investigative Allergy and Clinical Immunology found that the frequency and severity of eczema and allergies are reduced for as long as five years when breast feeding mothers stop drinking cow’s milk for at least three months. Even the late Dr. Benjamin Spock, guru of children’s health and long-time milk advocate, withdrew his support of cow’s milk for children in his 1998 edition of "Baby and Child Care."More recent studies are also finding that the promise of healthy bones and teeth, the main reasons we’ve been told we need milk, doesn’t have any basis in science. In March 2005, Pediatrics published a review article stating that "scant evidence" has been found that milk and dairy products promote child and adolescent bone health.Eczema is caused by a combination of external and internal elements. A healthy gut is a major influence, as is the presence of allergies. Both are indicators of an overload of toxic substances. In the gut, the ‘bad’ and ‘good’ bacteria are out of balance, and in the case of allergies, the body is telling you that whatever you’re having the reaction to needs to get out. Skin problems like eczema result from the body trying to expel these toxins. The results can be unsightly, and very uncomfortable – especially for a child – as anyone who has seen a child with red, sore rashes can attest. Eliminating milk and other products that are known to cause intenstinal stress and allergic reactions is definitely called for.

Winter Causes Eczema Flares

2006-02-24T09:11:00.000-08:00

With cold dry weather of winter approaching, you should be aware that it can make your eczema (also called atopic dermatitis) flare up by drying out your skin and causing it to crack, and become chapped. Although eczema is a chronic condition, remission is possible and control is definitely available. Here are some tips to help you "weather" the winter months:
Avoid things that can worsen your eczema, such as wool, irritating clothing, harsh soaps and cleansers
Use a mild soap that is especially designed for sensitive skin. Avoid using cleansers that dry your skin.
Also avoid spot creams and alpha hydroxyl acids.
Moisturize daily, or more often.
Start active treatment with either topical cortisones or the new non-steroidal creams or ointments prescribed by your doctor.
Relax and avoid excessive outdoor activity.
If you are sure that external factors such as allergens are a factor, you should consider seeing an allergist for allergy testing or a dermatologist for skin allergy testing called patch testing.
Speak to co-workers about your condition in order to help them better understand this skin disorder.

Photodynamic Therapy May be Helpful For SOme Eczema Conditions

2006-02-22T08:33:00.000-08:00

Authors: Nestor MS, Gold MH, Kauvar AN, Taub AF, Geronemus RG, Ritvo EC, Goldman MP, Gilbert DJ, Richey DF, Alster TS, Anderson RR, Bank DE, Carruthers A, Carruthers J, Goldberg DJ, Hanke CW, Lowe NJ, Pariser DM, Rigel DS, Robins P, Spencer JM, Zelickson

Photodynamic therapy (PDT) has significant promise in improving outcomes of patients with a variety of cutaneous conditions. A group of experts met to review the principles, indications, and clinical benefits of PDT with 5-aminolevulinic acid (ALA). They also reviewed PDT with methyl aminolevulinate. The experts established consensus statements for pretreatment, posttreatment, ALA contact time, light sources, and numbers of sessions associated with ALA PDT for actinic keratosis and superficial basal cell carcinoma, photorejuvenation and cosmetic enhancement, acne, sebaceous skin, rosacea, and rhinophyma. They based consensus recommendations on their clinical experience and the medical literature. They also suggested future applications of ALA PDT. Experts concluded that ALA PDT is a safe and effective modality for the treatment of conditions commonly encountered in dermatology. Since downtime is minimal, the technique is suitable for patients of all ages and lifestyles. Appropriate light sources are available in many dermatology offices. The expanding clinical and financial benefits of PDT justify the purchase of an appropriate light source.

Wet Wraps Can Be Beneficial For Severe Eczema

2006-02-14T08:57:00.000-08:00

If it seems that absolutely nothing will alleviate that red, cracked, and unbearably itchy skin, you may want to ask your dermatologist about wet-wrap therapy. Studies show that wet-wrap therapy can effectively re-hydrate and calm the skin. In one such study, children with severe atopic dermatitis who had not responded to other treatments were treated with wet-wrap therapy. The study found that the children experienced significant improvements. In just one week, these children averaged a 74% reduction in itch and experienced less sleep loss. Improvements to their skin lasted well beyond the two (2) weeks of treatment.1 Wet-wrap therapy also has been shown to significantly improve hand eczema.As the name implies, wet-wrap therapy involves wrapping wet bandages around the affected skin. The steps recommended by your dermatologist may differ slightly to accommodate a patient’s specific needs. However, the basic technique is as follows. Before the bandages are applied, the patient soaks in a bath with bath oil; then moisturizer is applied. Medication also may be spread on the skin affected by eczema. The wet bandages, which are generally moistened by soaking them in warm water or moisturizer, are then wrapped around the area. Wet bandages can be used on any area of the body that the patient will tolerate, including the face. To lock in moisture, dry bandages are wrapped over the wet ones. The benefits of wet-wrap therapy include:
Skin re-hydration
More restful sleep
Reduced redness and inflammation
Less frequent itching
Decrease in the Staphylococcus aureus (staph) bacteria found on the skin
However, wet-wrap therapy does have some drawbacks. It is time-consuming. If you are treating a child, it requires a great deal of patience and supervision. Children tend to squirm when the bandages are being applied and may try to remove the bandages. As one parent said, “It’s not a nice thing for any parent to have to do.” However, most parents agree that the results are worth the effort when other therapies are not effective.When treating an infant or very young child, moistened pajamas may be used instead of wet wraps. Special care must be taken to prevent these children from becoming chilled.Wet-wrap therapy is generally only used for a week or two. To maintain the results afterwards, you must apply moisturizer frequently throughout the day and after bathing. Additionally, triggers must be avoided, and it may be necessary to continue using medication. If you feel that nothing will bring relief, be sure to talk with your dermatologist about wet-wrap therapy. It may be exactly what is needed to “wrap up” severe eczema.
Reference:1 Wolkerstorfer A et al. “Efficacy and safety of wet-wrap dressings in children with severe atopic dermatitis: influence of corticosteroids dilution.” British Journal of Dermatology, 2000 November;143(5)999-1004.

Another Option In Eczema Skin Care

2006-02-07T11:43:00.000-08:00

Dermatitis-Ltd III. is a great option for individuals whose skin has been left sensitive and delicate by over-the-counter or prescription medications which often are messy, smelly, stain clothing, or thin the skin such as steroids. Skin appears more conditioned, even, elastic, and calm with Dermatitis-Ltd III. The ingredients of Dermatitis-Ltd are: zinc oxide, sodium chloride, magnesium stearate, polyethylene glycol, iron oxide, copper oxide, and sulfur. Zinc oxide is well known for its ability to protect and heal the skin.

The Baby Eczema Picture

2006-02-03T11:43:00.000-08:00

If your baby has an itchy skin rash the problem may be eczema (also called atopic dermatitis). Baby eczema can crop up on a baby's cherubic skin when a child is as young as 2 months old. It generally appears on the forehead, cheeks, or scalp and sometimes spreads to the arms or chest. The rash often shows up as dry, thickened scaly skin, but is sometimes made up of tiny red bumps that may ooze or become infected if scratched. Eczema is thought to be a reaction to allergy-causing substances in the environment. About 10 percent of infants have eczema at some point, but many improve before they're 2 years old. Because the condition is often inherited, your child is more likely to develop eczema if you or some other close family member has any kind of allergic condition, says Amy Paller, professor of pediatrics and dermatology at Northwestern University Medical School in Chicago.

Eczema And Skin Care

2006-02-01T08:47:00.000-08:00

The skin is supposed to be slightly acidic which protects us from harmful bacteria, but most people use alkaline soaps that destroy the skin’s acid mantle and remove much needed moisture. Use pH balanced non-soap cleansers. Soap residue left in clothes can also irritate (use 1/3 of recommended and a brand like All Free & Clear). Most problems come from the use of harsh or sensitizing chemicals on the skin.

Internally speaking, the skin is the largest eliminative organ. Cleaning the body on the inside by detoxifying can be very beneficial in reducing the allergic (atopic) component. Greens are one of the best ways to do that (juice, blend, drink and eat them). Drinking enough water to hydrate from within along with taking your good fats like fish, borage and flax oil, as well as glucosamine, will help the skin retain moisture. To rebuild the skin, you need protein/amino acids. Vitamins, minerals, enzymes for digestion and beneficial bacteria as well as maintaining your alkaline pH on the inside are all crucial, and there’s a whole world of information on the how’s and why’s of that.
Food allergies and certain foods such as wheat, gluten, dairy and nuts can trigger eczema outbreaks. Hydrochloric acid deficiencies may also be associated as well as overproduction of candida (yeast) and consequently leaky gut syndrome. Further, underproduction of the delta-6 desaturase enzyme and overproduction of delta-5 desaturase enzyme which are involved in inflammation may be a key factor.

Nutrition, detoxification, anti-stress coping skills and external practices are all a part of healing eczema. The body is trying to tell you something, and it’s not just a defective on/off switch in the inflammatory cycle. Inflammation is the process that fights infection; and, if there is a bacterial or fungal overcolonization, steroids (which stop the inflammation process) may actually make the problem worse by allowing infection to run wild. Changing your body’s chemistry internally and externally to provide the proper environment for skin health can bring about a permanent change in this condition.

The Eczema Diagnosis

2006-01-30T13:12:00.000-08:00

Eczema diagnosis is generally based on the appearance of inflamed, itchy skin in eczema sensitive areas such as face, chest and other skin crease areas. However, given to the many possible reasons of eczema flare ups, a doctor is likely to ascertain a number of other things before making a judgment:
An insight to family history
Dietary habits
Lifestyle habits
Allergic tendencies
Any prescribed drug intake
Any chemical or material exposure at home or workplace
To determine whether your eczema flare is resulting from an allergen, a doctor may suggest a blood test called radioallergosorbent test (RAST). In the test, blood is mixed with an allergen; antibodies developing in the blood are the sign of an allergy.
The diagnosis may also involve a skin lesion biopsy; removal of a small piece of skin for examination in a laboratory.
Blood test and biopsy are not regular procedure for eczema diagnosis. However, doctors at times do follow it in order to draw a conclusive judgment.

AAD Disagrees With FDA Warnig For Protopic And Elidel

2006-01-24T11:29:00.000-08:00

The American Academy of Dermatology (Academy) has issued a statement in response to the U.S. Food and Drug Administration's (FDA) announcement that a black box warning will be added to the labeling and a medication guide will be distributed for the topical calcineurin inhibitors (TCIs), pimecrolimus and tacrolimus.
These topical medications effectively reduce the inflammation and other symptoms associated with the skin disease eczema.
"The American Academy of Dermatology disagrees with this action taken by the FDA. We believe that the data does not prove that the proper topical use of pimecrolimus and tacrolimus is dangerous," said dermatologist Clay J. Cockerell, M.D., president of the American Academy of Dermatology. "Because these medications are applied to the skin, virtually none of it gets inside the body. It's not the same as taking a pill. These are valuable medications, and if used properly, they allow millions of our patients with eczema to live normal lives."
This past summer, the Academy held a conference to discuss the scientific, regulatory, clinical, and public concerns raised by this potential FDA action. The dermatologists, patients, pharmacists and immunologists participating in the conference reviewed the current literature and safety data for these medications. It was determined that the addition of a black box warning and medication guide was unwarranted and could limit access to TCIs, or limit treatment options if qualified patients decide not to use these medications based on fear of a malignancy risk.
"The health, safety and welfare of our patients being treated with these topical medications are of paramount importance to dermatologists," said Dr. Cockerell. "We are concerned that this warning will confuse and unnecessarily worry our patients. We urge patients to get the facts on how to appropriately manage their eczema from their dermatologist."

Elidel And Protopic Receive Black Box Warnings

2006-01-20T07:48:00.000-08:00

The labels on two prescription creams to treat eczema will have to bear "black box" warnings of possible cancer risks.
The Food and Drug Administration's action Thursday follows an agency advisory committee recommendation last February that Elidel cream and Protopic ointment carry the label warnings.
The new labeling also will clarify that the two drugs are recommended for use only after other prescription topical medicines have been tried by patients, the FDA said. The agency is also issuing a guide updating patients of its concerns.
A black box warning is the most serious type of warning in prescription drug labeling. The warning will be located lower on the labels of the two drugs than is typical, although a statement higher on the labels will refer to the risk.
"This is something that is a possible risk, is a long-term possibility and is something that still needs to be researched," FDA spokeswoman Susan Cruzan said.
As of October, the FDA has received reports of 78 cases of cancers, including skin and lymphoma, in patients treated with the two drugs, said Dr. Stanka Kukich, the acting director of the FDA's dermatologic and dental drug products division.
Novartis Pharmaceuticals, which makes Elidel, said in a statement Thursday that it remained confident in the safety and efficacy of Elidel.
"While Novartis believes this action is not substantiated by scientific or clinical evidence, Novartis has agreed to make the requested changes," the company said.
Astellas Pharma Inc., formed through the merger of Protopic maker Fujisawa Healthcare Inc. and Yamanouchi Pharmaceutical Co., said in a statement that its drug "is safe and effective when used in a manner consistent with its label."
"It addresses a theoretical risk — a potential risk, not a demonstrated link," Dr. Joyce Rico, vice president for medical sciences research and development at Astellas, said of the warning.
While the two manufacturers dispute whether there is a cancer link, the FDA felt it had to convey notice of the cancer reports to doctors and patients, said Dr. Julie G. Beitz, an acting director of one of the FDA's drug evaluation offices.
Along with the small number of cancers reported in both children and adults treated with the drugs, animal tests have shown an increase in cancer associated with the drugs, the FDA said last year.
No causal link between use of the drugs and cancer has been established, Beitz said.
The long-term safety of the drugs has not been established, according to the FDA. While both companies are studying that issue, the results may not be known for years, the FDA said.
Elidel and Protopic are applied to the skin to control eczema by suppressing the immune system.
The companies estimate that roughly 10 million people combined have used the two drugs.

Chronic Actinic Dermatitis

2006-01-19T10:28:00.000-08:00

Written by Dr James Ferguson, consultant dermatologist

Chronic actinic dermatitis (CAD), sometimes known as photosensitivity dermatitis/actinic reticuloid syndrome (PD/AR), is a condition in which the skin becomes inflamed, particularly in areas that have been exposed to sunlight or artificial light.In addition, the majority of CAD patients have allergies to some substances that come into contact with their skin, particularly various flowers, woods, perfumes, sunscreens and rubber compounds.

The condition particularly affects men over the age of 50, but also arises in women and is increasingly found in young male or female patients with atopic eczema.

This is not a life-threatening condition, but it does require significant changes in lifestyle to avoid contact allergies and intense sources of light.

Although the cause is not known, it is suspected that the body's defence system over-reacts to substances within the skin that are made 'allergic' by ultraviolet and visible light.

Many patients are spontaneously cured, but this may take several years and in the intervening period, patients have to learn to live with the condition, managing it by minimising their exposure to ultraviolet and visible light as well as chemicals.

Because the photosensitivity involves non-sunburn wavelengths of light (longwave ultraviolet and visible wavelengths), patients can develop the problem even on cloudy days, and windows and clothing offer no protection (unless the clothing totally blocks the light out). As a result, it is not always obvious that light is the source of the problem, and doctors may have difficulty in diagnosing the condition. One helpful tip is to check the parts of the patient's skin that are not exposed to light, such as under a watchstrap, to see if the condition is present there.

Phototesting using specialised equipment is possible in some university dermatology centres. Phototesting consists of having areas of skin exposed to known amounts of light of specific wavelengths and then looking at the reactions with comparison to the average population response. This procedure is painless and can be repeated to assess improvement. Patch testing, another way of confirming CAD diagnosis, is conducted by most dermatologists. A range of chemicals is applied to the skin and left for two days. The skin is then assessed for reactions.

Treating CAD involves the following:
Avoid direct exposure to sunlight between the hours of 11am and 3pm, with outdoor activities being limited to the earlier and later hours of the day.
Wear appropriate clothing along with a wide-brimmed hat and a neckerchief to protect the back of the neck.
Avoid direct exposure to ultraviolet sources at home or at work (such as fluorescent and metal halide lights).
Use protective plastic film on home and car windows. This can be of the clear, sticky-backed variety and is not noticeable when in place.
Avoid contact allergies.
Use a broad-spectrum sunscreen (seek medical advice).
Topical (ie, applied to the surface of the body) steroid creams/ointments are useful when a flare has occurred. Potent varieties should be used only in the short term.
Occasionally, treatment with tablets, which are prescribed by your dermatologist. Like all other potent therapies, the benefits have to be weighed up against the risks and it is useful to discuss this with your doctor.

There is good evidence that this condition will completely clear in a significant number of patients without the need for therapy. This may, however, take many years and it is important to discuss this with your doctor.

Improve Eczema Skin With Sake

2006-01-13T11:15:00.000-08:00

It's often said that master sake brewers have beautiful hands with smooth, white and youthful skin. But now it seems there may actually be some truth behind these words judging by a recent experiment by a major sake brewery.
Ozeki, based in Nishinomiya, Hyogo Prefecture, asked 11 of its employees to drink 270 milliliters of sake, and then measured the moisture content of their skin two hours later. The results showed that the moisture content of the skin on their arms had risen by 30 percent.
In a comparative experiment, the volunteers drank a non-sake alcoholic beverage used as a control, which turned out to produce no effect on their skin.
Many sake breweries are now developing skin care products, utilizing sake-derived substances believed to have moisturizing effects.
Among them is Yushin-Brewer, based in Ryonancho, Kagawa Prefecture.
The company produces sake-derived extracts, which it says have a beautifying effect. The extracts are made using sake brewing techniques, which make use of such microorganisms as koji mold, lactic acid bacteria and yeast. The company says it has discovered 36 active substances in these extracts that produce positive effects.
It has called one of these extracts Rice Power No. 11 and obtained approval from the Health, Labor and Welfare Ministry for its use as a skin moisturizer. The extract promotes the production of ceramide, a type of lipid that fills crevices in the surface layer of the skin. It also prevents dryness and irritation caused by water evaporation and keeps the skin smooth.
According to research by Tokushima University Prof. Seiji Arase, when he applied Rice Power No. 11 to the skin, the surface layer absorbed twice the normal amount of water over a two-hour period. The extract also helped the skin protect itself, potentially making it a suitable treatment for atopic dermatitis.
Yushin-Brewer has started selling lotion containing the extract, and is now working on anti-ulcer products.
Because different bacteria are used at each stage of the brewing process, sake brewers need very precise temperature management--a process that has been developed through a long process of trial and error.
Yushin-Brewer President Takashi Tokuyama says: "As sake-making shows, Japan's brewing culture is a product of wisdom accumulated over a long period of time. I'd like to use that wisdom to produce new foods and other products."

Controlling Eczema In The Winter

2006-01-10T11:16:00.000-08:00

Dry winter air can cause skin cracking, chapping and irritation, and the winter sun can be as damaging to skin as it is in the summer, says the American Society for Dermatologic Surgery (ASDA). Dr. Rhoda Narins, a dermasurgeon and past president of the ASDA, offers the following winter skin care advice:
Moisturizers help protect your skin against the harsh winter elements. Apply moisturizer immediately after a bath or shower to seal in necessary waters and oils.
Gloves are a simple, easy way to protect your hands from cold temperatures and dry air that triggers eczema. Gloves can also prevent cracked and splitting cuticles and fingernails.
If you develop dry and itchy skin or eczema, don't let the condition get worse. Consult a doctor.
Apply sunscreen to all exposed skin when you're outdoors.
Protect your lips by using lip balms or lipsticks that have a high SPF.
Don't take long, hot showers, which can strip skin of its natural elements and cause dry skin. Take shorter showers with lukewarm water.

Infections Common With Atopic Dermatitis

2006-01-04T11:39:00.000-08:00

The red, cracked, and unbearably itchy skin that develops when atopic dermatitis (AD) flares is not only uncomfortable. It also makes one more susceptible to infection.

Research shows that about 90% of people with AD have the Staphylococcus aureus (staph) bacteria present on their skin. By comparison, less than 5% of people without AD have staph on their skin. When a person with AD scratches, the skin often breaks. This allows microorganisms on the skin, such as bacteria, viruses, and fungi, to enter the body. Additionally, a study shows that people with AD cannot produce effective amounts of two natural antibiotic proteins that the immune system needs to fight infection. With staph constantly present on the skin and the immune system unable to adequately fight infection, it is easy to see why people with AD develop infections when their skin flares and they scratch.

Children and teens with AD are especially prone to developing skin infections caused by staph (bacteria) and herpes simplex (virus). Fungal infections may also occur. It is important to recognize the signs and symptoms of infection, and consult your dermatologist as soon as they appear. An untreated infection may be the reason AD does not respond to treatment.

Signs and symptoms to watch for are:
Honey-colored crusting and pus-filled blisters. When a bacterial infection, such as one caused by staph, occurs, honey-colored crusts usually form. This is a sign of infection. Another sign is the appearance of pus-filled blisters that form over patches of AD. These blisters may pop, weep, and form crusts.
Redness. When the skin becomes infected with bacteria, it becomes very red. Widespread red scaly patches and plaques that may crust and discharge pus, usually indicate a staph infection. Streaking or spreading redness also indicates infection.
Swelling/Inflammation. If the area feels enlarged or unusually warm, it may be infected.
Fever. When infection develops, the body’s temperature sometimes rises to create an unfavorable environment for the microorganisms, such as bacteria, viruses, or fungi, causing the infection.

Lesions that resemble cold sores or fever blisters. These may be signs of eczema herpeticum, a viral infection that also causes cold sores. Eczema herpeticum can spread rapidly. In the early stages, you will see numerous small blisters filled with clear fluid that are surrounded by bright red halos. Within one or two days, the blisters will break, leaving small round breaks in the surface of the skin. The skin may become very sore, and the patient will feel quite ill.

Even a person with mild AD can develop a severe infection from the virus. For this reason, it is important to seek medical attention if you see these signs. In rare cases, eczema herpeticum can be life-threatening.

Be sure to keep children with AD away from anyone who has a cold sore.

New Research For Eczema

2005-12-20T11:28:00.000-08:00

The Pediatric and Adolescent Dermatology office at Children's Hospital in San Diego is conducting a research study to help treat pediatric eczema.
This new study is assessing a skin cream compared to a placebo (no active ingredient) to help treat the condition. The study is enrolling children 6 months to 12 years of age with mild-to-moderate eczema.
The research site is in San Diego.
More Information
Please see http://www.centerwatch.com/patient/studies/cat625.html.

New Treatment For Eczema Receives FDA Clearence

2005-12-16T07:45:00.000-08:00

More than 15 million Americans are diagnosed with atopic dermatitis, commonly referred to as eczema. The chronic inflammatory disease that affects 90 percent of patients within the first five years of their lives, is characterized by red, dry, itchy skin that rashes. This uncomfortable and unpleasant condition largely affects children but can also affect adults and often leads to sleep interruption due to the severity of the itch.
While many products to treat eczema are currently available, the FDA has recently cleared a new approach in managing the signs and symptoms of eczema called Mimyx cream. Unlike current prescription therapies, Mimyx is safe enough to be used on patients of any age and there is no limit on the duration of use.
The new therapy is currently available by prescription only. For more information on Mimyx cream, including complete prescribing information, contact Stiefel laboratories at 1-800-724-1565.

Botox May Help in The treatment of Hand Eczema

2005-12-13T09:19:00.000-08:00

While botulinum toxin A, or BTXA, is widely known for its use in dermatology and aesthetic medicine, a review article in the Journal of Cosmetic Dermatology explores the drug's other successful applications. BTXA is popularly used to treat hyperhidrosis (excessive sweating) or to diminish wrinkles, but it is also a highly effective natural substance that normalizes muscle activity and can be used to reduce pain and itch.

Benefits of BTXA have been observed in treatment of hand eczema and is effective in blocking secretion of sweat, saliva and mucus in cases of Hailey-Hailey disease (a blistering disease usually treated by surgery or laser) among other ailments. In addition, "botulinum toxin A has important applications in proctology where it has become the most powerful non-surgical therapy for anal fissure," according to Uwe Wollina, author of the review. "

The substance in the hands of the experienced doctor is safe, provides effective treatment of several complaints, and is capable of reducing the need for surgery in many cases."

This article is published in the Journal of Cosmetic Dermatology. Professor Uwe Wollina, Dr. Med. Habil., is Director of the Department of Dermatology at the Hospital Dresden-Freidrichstadt in Dresden, Germany. He is currently Chairman of the Regional Officers of the International Society of Dermatology and a Board Member of the European Society of Aesthetic and Cosmetic Dermatology.

Consumers Find Weakness In FDA Approved Medications

2005-12-09T09:17:00.000-08:00

Tens of millions of people may have been unknowingly exposed to the rare but serious side effects of 12 relatively common prescription drug types – several used regularly by many senior citizens. Consumer Reports says in its investigative report that the risk include an increased likelihood of heart attack, stroke, cancer, or suicidal tendencies but were undetected or underestimated when the drugs were approved by the Food and Drug Administration (FDA).
The risks still may not be apparent to some people, reports CR, since many of these drugs have been advertised directly to consumers and only some carry a “black box” warning, which is the FDA’s most serious label alert. The story is in the January issue of CR.
CR’s investigation suggests that its list of 12 is not exhaustive. Even a perfect drug-safety system might miss some of the less common adverse effects of medicines before they hit the market. But serious flaws in both the drug-approval process and the monitoring of products after they reach the market compound the overall problem. Despite recent signs of improvement at the FDA, extensive reforms are needed.
Almost all of the 12 drug types are used to treat common conditions that are not usually life threatening, such as acne, eczema, and head lice.
Each of the 12 types has legitimate medical uses, especially when other treatments fail.
“But the potential risks are sufficiently serious that until more is known, these drugs should be prescribed only when other options have failed, should be avoided by people whose medical conditions make them especially vulnerable to harmful reactions, or should be used only with careful monitoring for adverse reactions,” said Dr. Marvin M. Lipman, Consumers Union’s Chief Medical Adviser.
The 12 drugs include:
● Celecoxib (Celebrex), a pain reliever; ● Estrogen alone (Premarin and others) or with progestin (Prempro and others) to treat symptoms of menopause; ● Isotretinoin (Accutane) for severe acne; ● Malathion (Ovide) for head lice; ● Medroxyprogesterone injections (Depo-Provera), a contraceptive; ● Mefloquine (Lariam) to prevent malaria; ● Rosuvastatin (Crestor) for high cholesterol; ● Salmeterol* (Serevent) for asthma; ● Sibutramine (Meridia) for weight loss; SSRIs such as sertraline (Zoloft), and other antidepressants such as venlafaxine (Effexor), particularly when prescribed to young people; ● Tegaserod (Zelnorm) for irritable bowel syndrome with constipation; and ● topical immunosuppressants pimecrolimus (Elidel) and tacrolimus (Protopic) for eczema.
The nation’s drug-safety system has extensive weaknesses that put users of prescription medicines at risk.
These include:
• Rush to approve: Working under tight deadlines and with sometimes skimpy, unrepresentative data, the FDA reviews drugs at a pace that may make sound decisions difficult. Some FDA reviewers say that their bosses have pushed them to approve medications despite their reservations about safety.
• A powerless FDA: The agency lacks the effective power to force companies to complete studies after drug approval, compel doctors to report adverse reactions, or dictate new warning labels. The agency’s regulatory might also has been undercut by limited resources, dependency on drug company fees to help finance the review process, and what critics claim is a lack of will to enforce tough requirements.
• Risks hidden: Some companies have withheld studies showing unexpected risks or poor efficacy.
• What Consumers Can Do: Until adequate reforms occur, the following guidelines can help you protect yourself:
> In general, if you’re taking any of the 12 high-risk types, don’t just stop. Ask your doctor whether the benefits outweigh the risks in your case and whether other options can achieve adequate results.
> Don’t let the direct-to-consumer advertising for a medication move you to pressure your doctor to prescribe a drug, particularly a new one, unless other options haven’t helped and there’s strong evidence that you need it.
> For any new drug, ask whether studies show that it’s more effective and apparently safer than older options. If not, older ones with longer track records may be a better bet. Older drugs also tend to cost less.
> Ask your doctor or pharmacist for a list of the drug’s known adverse effects.
> Report any serious drug reactions to your doctor, or print the form from the FDA’s Web site, www.fda.gov/medwatch/report/consumer/consumer.htm, and bring it to the doctor or file it yourself.
The full report is available free at www.ConsumerReports.org. Consumer Reports Medical Guide features a free related story at http://www.consumerreports.org/crmg/risks_benefits.htm. An additional source of information for drug safety and effectiveness is www.CRBestBuyDrugs.org.
CR Note: After we went to press, the FDA requested that makers of Serevent Diskus Advair Diskus, and Foradil Aerolizer add new label warnings and issue patient information stating that, when used for asthma, these drugs “may increase the chance of severe asthma episodes, and death when those episodes occur.” (For more information, go to the FDA’s Web site, www.fda.gov/cder/drug/advisory/LABA.htm.)
The January 2006 issue of Consumer Reports is on newsstands. To subscribe, call 1-800-765-1845.
Consumer Reports is published by Consumers Union, which describes itself as "an expert, independent nonprofit organization whose mission is to work for a fair, just, and safe marketplace for all consumers and to empower consumers to protect themselves. To achieve this mission, we test, inform, and protect. To maintain our independence and impartiality, CU accepts no outside advertising, no free test samples, and has no agenda other than the interests of consumers. CU supports itself through the sale of our information products and services, individual contributions, and a few noncommercial grants."

An All Natural Eczema Treatment

2005-12-05T11:34:00.000-08:00

To make an herb-infused oil/salve: get dried herbs, or dry fresh herbs out somewhat in the oven on the lowest setting. Cover them with the oil of your choice, plus about an inch, and heat to between 100-120 degrees (this can be done in the oven on the lowest setting, in a double boiler, or in a crockpot) for 2-5 hours.

To turn into a salve, grate beeswax and microwave until it melts, then add to your oil. A good rule of thumb for amounts is an ounce and a half of beeswax to a pint of oil, or one teaspoon beeswax to an ounce of oil (there are five teaspoons in an ounce of beeswax).

Blend avocado and castor oils (both good for eczema, wheatgerm oil is good too) infused with nettles, chamomile, calendula and red clover, then blend it with shea butter. You have to be careful blending shea butter with oils, as you can't really heat it or it forms grains.

Make one cup of herb-infused olive oil (or other base oil of choice) with the following herbs:
3 tbsp Burdock Root
2 flowers Calendula
3 tbsp chamomile flowers
2 tbsp comfrey leaf
2 tbsp fenugreek
1 tbsp red clover
1 tbsp rue
2 tbsp sarsaparilla root
4 tbsp lavender

Add beeswax if you wish to make it a salve instead of an oil.

The Picture Of Winter Seborrhea

2005-12-01T10:56:00.000-08:00

According to Diane Berson, M.D., a NYC-based dermatologist, "For someone who is already predisposed to developing dandruff, stress can definitely make the condition worse. We don't know why this is so, but, we do know, without question — that dermatological disorders, such as dandruff, are exacerbated by stress."
Dandruff is a mild inflammation of the scalp, and it occurs when the scalp sheds larger than normal amounts of dead skin cells at an excessive rate. Dandruff and seborrheic dermatitis, a more severe form of dandruff, can, according to many dermatologists, increase with stress — regardless of whether the stress is caused by a negative event, such as losing a job, or a positive one, such as getting married.
While dandruff can cause plenty of embarrassment despite routine shampooing, the good news is that the condition responds readily to treatment. And, with a little attention, it's easy to keep it under control, regardless of your stress level.
First line of defense — schedule a visit with your dermatologist who can prescribe a specific medication meant to treat dandruff and seborrheic dermatitis.
According to Dr. Berson, "If you're on a particular dandruff maintenance therapy to prevent flare-ups, and you know you're going to have an especially stressful week, you might want to step up the regimen, just in case."
In addition, dandruff sufferers may want to practice some anti-stress techniques to help keep dandruff flare-ups at bay. "Tapes, books and videos on relaxation may help," suggests Dr. Berson. "Yoga or medication may also help — even a long, hot bath."

The Preception of An Itch

2005-11-29T09:37:00.000-08:00

There are no special itch sensors in the skin. It is normally agreed that itch and pain are elicited by unspecialised free nerve endings in the skin. However, recent research indicates that the actual transmission of the itch sensation is through a separate subset of dedicated nerve fibres.
The itch-transmitting nerve fibres enter the spinal cord where it links up with a relay nerve cell, which then carries the impulse to the thalamus and then to the brain. At this linking junction in the spinal cord, the nerve impulse may be dampened or amplified by inhibitory or excitory circuits related to local nerve cells or to nerve cells from higher up in the central nervous system.
Apart from peripheral stimulation of nerve endings causing itch, there is also the important concept of “central itch”, i.e. itching which is perceived to occur in the skin but which actually originates in the brain due to abnormal processing of sensory information.
Itch can be caused by peripheral stimulation in the skin by:
Physical factors like light touch, stroking and vibration.
Chemical factors like mild acids, mild alkalis and venoms (for example, from caterpillars and moths).
Special substances released by cells. The most important of these is histamine. Others include substance P, interleukins and prostaglandins. These mediators are important in the causation of itch in the majority of skin disorders.
Apart from peripheral stimulation, factors that affect the control mechanism for regulation and interpretation of itch impulses in the brain may cause itch. For instance, heat aggravates itch and the heat stimulus appears to act centrally. Parasitophobia (delusions of parasitic infections of the skin) is a well-known cause of psychogenic itch, which can result in widespread excoriations in the skin.
An itch can be trivial and scratching certainly can be pleasurable. However, in certain disease states, itching can be so severe that scratching brings no relief. In fact, severe itch can be a great distress, causing poor sleep, depression, agitation, difficultly in concentrating and reduced sexual desire and function. Some severely affected patients may even contemplate suicide.

Another Winter Eczema: Nummular Eczema

2005-11-17T10:58:00.000-08:00

Nummular eczematous dermatitis (nummular eczema or nummular dermatitis) is a name given to a stubborn, itchy rash that forms coin-shaped patches on the skin (nummular means coin in Latin). The lesions as they get older may clear in the center or become scaly and then resemble fungus (ring worm) or psoriasis. The condition tends to be chronic, with periods when it gets much better or worse.

The cause is unknown. Only occasionally does this turn out to be a medication allergy, although this is often considered in the evaluation. It is more common in the winter.

Nummular eczema is frequently associated with dry skin. Wool, soaps and frequent bathing (more than once a day) often worsen the condition. People with eczema often have skin that is dry and easily irritated by soap, detergents, and rough clothing. Clothes washed or dried with liquid or sheet fabric softeners such as Kling, may also irritate the skin. Hot and cold weather often aggravates eczema. Certain allergies may worsen eczema, but they don't cause it. This is not the same condition as atopic eczema, a much more common skin problem that can be allergic.

Unfortunately, there is no cure. However, there are effective ways of controlling it. Very strong prescription strength cortisone ointments applied to the skin are the best medicines for controlling nummular eczema. When used for an extended period of time, or over large areas of the body, periodic dermatology exams are necessary. Strong cortisone ointments shouldn't be applied to the face, armpits, groin, or rectal area. When using cortisone ointments always remember to use just a little and massage it in well. In most cases, application once daily does as much good as using it more often. For stubborn scaly nummular eczema, coal tar can be added by the pharmacist into an ointment. Although this can be helpful, it smells and stains the clothing. The sites of nummular dermatitis are prone to infection ("Staph") and often a week or two of oral antibiotics are very helpful. Severe cases can be calmed down with internal treatments of oral or injected cortisone. Persistent itch outbreaks can be controlled with ultraviolet light treatments given in the dermatology office.In general, keep the skin lubricated. Apply oil such as Neutrogena body oil or Alpha-Keri oil to the skin at the end of ones shower. Vaseline is even more helpful if not too greasy. Do not take more than one bath or shower a day. Use lukewarm water, as hot water dries out the skin. When toweling dry pat, don't rub. Blot the skin so there is still some water left on the skin. Soap irritates and dries the skin, so keep it away from the eczema. When bathing limit the use of soap to the face, armpits, genital area, and feet. For soap, use Cetaphil, Oil of Olay, Dove or Basis. Avoid contact with wool or rough clothing. Cotton clothes (100%) are best. When laundering the clothes, use no fabric softener, Kling or dryer sheets. Wash the clothes using dye free, fragrance free detergents such as the "All free" detergent. It is possible to find a treatment routine that controls nummular eczema.

The Asteatotic Eczema Picture

2005-11-15T10:54:00.000-08:00

First described by Brocq in 1907, using the term eczema craquelé, asteatotic dermatitis is characterized by pruritic, dry, cracked, and polygonally fissured skin with irregular scaling. It most commonly occurs on the shins of elderly patients, but it may occur on the hands and the trunk.
In 1971, Domonkos described the appearance of this dermatitis as cracked porcelain. The pattern of cracking has been likened to a crazy pavement pattern. In 1999, Fitzpatrick likened asteatotic eczema to a dried-up riverbed. According to Caplan, superficial bleeding and fissures can occur as the epidermis loses water, as it splits, and as it cracks deeply enough to disrupt papillary dermal capillaries. The inflammation can be associated with asymmetric leg edema. Eczema with increased lichenification occasionally supervenes as patients rub and scratch the pruritic areas.
The eruption can be generalized or localized. Generalized asteatosis is a distinct entity and should provoke a search for possible associated diseases. Guillet divides the localized forms into 4 types:
Asteatotic eczema of the lower extremities in elderly persons secondary to aging, dehydrated skin, and malnutrition
Cracked erythema secondary to irritant contact dermatitis from soaps or detergents
Eczema craquelé in areas in which corticosteroid therapy was discontinued
Asteatotic eczema in neurologic disorders
Initially, excess water loss from the epidermis results in dehydration of the stratum corneum with upward curling of corneocytes. The outer keratin layers require 10-20% water concentration to maintain their integrity. A significant decrease in free fatty acids in the stratum corneum is present in people with asteatotic dermatitis. Stratum corneum lipids act as water modulators, and cutaneous loss of these lipids can increase transepidermal water loss to 75 times that of healthy skin. Elderly persons with decreased sebaceous and sweat gland activity, patients on antiandrogen therapy, people using degreasing agents, and people bathing without replacing natural skin emollients lost to bath water are at risk for asteatotic eczema.
When the stratum corneum loses water, the cells shrink. A significantly decreased cellular volume can stress the skin's elasticity, creating fissures. Edema in the dermis leads to additional stretch on the overlying epidermis. Fissures rupture dermal capillaries, causing clinical bleeding. The disruption of cutaneous integrity can result in inflammation with risk of infection. Transepidermal absorption of allergens and irritants is increased as the epidermis is damaged, increasing susceptibility to allergic contact dermatitis and irritant contact dermatitis. Allergic contact dermatitis and irritant contact dermatitis may cause a persistent and possibly more extensive dermatitis despite therapy. Furthermore, low environmental humidity contributes to xerosis, creating a clinical picture of asteatotic dermatitis in some dermatologic conditions, such as atopic dermatitis.

Christina K Anderson, MD,
Consulting Staff,
Department of Dermatology,
Center Care Clinic

THE WINTER ECZEMA PICTURE

2005-11-13T06:36:00.000-08:00

Many names have been used to describe this condition but perhaps this is the most descriptive term. Winter eczema only occurs in that season and is confined to people with a tendency for dry skin. Central heating giving a dry atmosphere, plus frequent, long, hot showers with liberal use of soap are the trigger factors in this condition. Winter eczema tends to become more common and more severe as we grow older and this tendency is probably due to older skin being less able to produce oil and retain moisture. In some elderly people winter eczema persists year round.
The first change seen in the skin is some mild flaking which is associated with itch. Soon redness, cracking and scaling appear. The commonest sites for winter eczema are the flanks and the lower limbs but any area can be affected.

The Eczema - Rosacea Picture

2005-11-11T03:49:00.000-08:00

Nothing in the medical literature links rosacea and eczema. The two diseases may share some symptoms, but also have many differences. Rosacea is more common in fair-skinned individuals and nearly always affects the face only, causing redness, visible blood vessels, bumps and pimples and sometimes swelling of the nose from excess tissue. Eczema is more common in individuals with dry skin and can appear in various areas of the body, producing bumps and pimples, scales, crusts and scabs that can itch or burn.

The Eczema Medication and Treatment Picture

2005-11-08T12:05:00.000-08:00

The following medications are most commonly used to treat eczema:
Antihistamines such as diphenhydramine which is used to help decrease the amount of itching. These medications may cause drowsiness. Some new antihistamines are also available that do not cause drowsiness;
Topical steroid creams used to help to decrease the inflammation in the skin, thus decreasing the itching and swelling. Many topical steroids in various strengths are available. Steroids, if overused, are potentially damaging to the skin.
Other options include oral antibiotics;
oral cyclosporine designed to suppress the immune system;
phototherapy;
topical immunomodulators which are a new class of drugs for the treatment of eczema. These drugs are used topically to alter the immune response.

BEFORE AND AFTER ECZEMA TREATMENT PICTURES

2005-11-04T04:46:00.000-08:00

In trying to evaluate the success of an eczema treatment, before and after eczema pictures can reveal amazing insight into the progression of your eczema and it'd healing process. Your eczema treatment pictures are living proof that you can recover from eczema and regain beautiful and healthy skin.

Your eczema treatment and recovery may involve home remedies, special diet, perscription creams and ointments and lifestylke changes.

In the clinical picture of eczema there can be more than one cause and more than one effective treatment.

Eczema Skin Care Tips

2005-11-01T12:09:00.000-08:00

* Use light coloured loose, cotton clothes. Avoid using nylon, polyester and other synthetic materials.
* Avoid having hot water bath as it can dry the skin. Have bath twice a day, preferably with cold or warm water.
* Avoid sun exposure between 12 noon and 4 pm. Use sunscreens with SPF (Sun Protection Factor) more than 15 on exposed parts one hour before going out in the sun. Also use umbrella / caps for sun protection.
* Avoid oily cosmetics. Use talcum powder/prickly heat powder after bath.
* Drink at least 8 - 10 glasses of water a day and fluids like fresh fruit juices, buttermilk, and coconut water regularly to keep the skin hydrated.
* Consume at least three servings each of fruits and vegetables daily as they provide us with all vitamins and minerals.
* Consume 1 -2 tablespoons of ground flax seeds as they contain omega 3 fatty acids which are very helpful in maintaining a healthy and flawless skin.

The Eczema Self-Help Picture

2005-10-28T09:52:00.000-07:00

National Eczema Association for Science and Education
National network. Founded 1988.Provides support for persons with atopic dermatitis (a common, chronic, non-contagious, inflammatory skin condition), as well as other forms of constitutional eczema. Promotes education and research. Offers information and referrals, networking, and newsletter. Donations accepted.WRITE:Nat'l Eczema Assn. for Sci.and Education4460 Redwood Highway, Suite 16-DSan Rafael, CA 94903E-MAIL: info@nationaleczema.orgWEBSITE: http://www.info@nationaleczema.orgVERIFIED: 10/8/2004

The Cold Weather Eczema Picture

2005-10-24T05:57:00.000-07:00

The National Eczema Society in London England revealed some shocking statistics about our United States citizens. Of all the countries surveyed, the US had by far the most sufferers of eczema. The research conducted by NOP World Health stated that there were 17.4 million patients in America.

Anyone who has witnessed the degree of discomfort that these 17.4 million people go through when the affliction is at its worst cannot help but empathize with them. The saddest part is that a large proportion of them are children.

Eczema sufferers, or those that care for someone with eczema, know that a flare-up can be anything from dry skin which can be mildly annoying to cracked bleeding skin, which is agonizingly painful. To watch a child go through that is perhaps more difficult for the observer than it is for the victim because there is reputedly no cure for this disease.Certain times of the year make it even more difficult. In cold weather the skin gets chapped and when we seek refuge in a heated area, the heat dehydrates the skin making it worse. The best thing to do to combat these seasonal flare-ups is to keep the skin moisturized as much as possible but beware!

Did you know that bathing and certain brands of moisturizers actually irritate the condition even more? When bathing one should always use a natural soap without any perfume and add a mild non-perfumed oil. The same applies to moisturizers that have a perfume added, as it is the astringent properties of these products that irritate the condition.

Defining the Eczema Picture

2005-10-21T11:30:00.000-07:00

THE DERMATITIS-LTD TREATMENT PICTURE

2005-10-20T09:26:00.000-07:00

Dermatitis-Ltd III Dermatitis-Ltd will improve the appearence of the various forms of eczema and seborrheic dermatitis.

The ingredients of Dermatitis-Ltd III are: zinc oxide, sodium chloride, magnesium stearate, polyethylene glycol, iron oxide, copper oxide, and sulfur (sulfur is used externally only and is not to be confused with sulfa which is taken internally only). Dermatitis-Ltd does not contain any potentially irritating preservatives, such as methylparaben, propylparaben, and Quaternium-15, and contains no irritating fragrances. Dermatitis-Ltd has a pH of 7.0 which is the perfect pH balance to allow the skin to normalize itself and heal itself

The Discoid Eczema Picture

2005-10-18T04:21:00.000-07:00

Discoid eczema, also called nummular eczema or gravitational eczema is usually found in adults and appears suddenly as a few coin shaped areas of red skin; normally on the trunk or lower legs. It may look similar to ringworm. These areas become itchy and can weep fluid. Usually discoid eczema is treated with emollients (and steroid creams if necessary).It can be considered as an adult form of atopic eczema. It can be complicated by a bacterial infection which causes weeping and crusting.
The word "nummular" comes from the Latin nummus, meaning coin, and is characterized by round plaques of eczema. Eruptions of nummular eczema are often recurrent and chronic and usually appear in people who are in their 60s but can occur at any age. The cause of nummular eczema is not known, but it usually occurs in cold weather and is most common in people who have dry skin. Hot weather and stress can aggravate this condition, as can the following:
Fabric softeners
Allergies
Soaps and detergents
Wool clothing
Bathing more than once a day.
Nummular eczema most commonly appears on the arms, back, buttocks, and lower legs that may be crusted, scaling, and extremely itchy. Neurodermatitis most commonly appears as scaly patches of skin on the head, lower legs, wrists, or forearms caused by a localized itch that becomes intensely irritated when scratched. Minor skin injury such as an insect bite or a burn may start it off.

The Picture of Infantile Eczema

2005-10-15T10:52:00.000-07:00

Infantile seborrheic eczema is a common condition affecting babies under one year old, the exact cause of which is unknown. Also referred to as cradle cap, it usually starts on the scalp or the diaper area and quickly spreads. Although this type of eczema looks unpleasant, it is not sore or itchy and does not cause the baby to feel uncomfortable or unwell. Normally this type of eczema will clear in just a few months.
The greasy yellow scales look unpleasant but they are not uncomfortable or itchy and will resolve in a number of months. The reason for this is the continuing secretion of the greases seen on a baby right after birth. When this dries up, the scalp will clear. In the meantime, gentle shampooing and massage with warm olive oil will help.

The Light Sensitive Eczema Picture

2005-10-13T09:35:00.000-07:00

Eczema that is caused by sunlight is rare. If it happens it is likely to occur on the face, hands and arms. Using high factor sun creams can treat it. Sometimes this eczema can be caused when people are taking medication that reacts to sunlight e.g. antihistamines and arthritis medications. Ingredients in soaps and cosmetics may also cause this.

Understanding the Varicose Eczema Picture

2005-10-09T03:40:00.000-07:00

Varicose eczema or stasis dermatitis occurs in the middle to late years of life and appears on the lower legs. It is caused by poor circulation. It is also called stasis eczema. It affects the ankles, which become speckled, itchy and inflamed. It is frequently treated with emollients and steroid creams. If untreated, an ulcer may develop.
A common problem that is associated with varicose ulcers is contact allergic eczema caused by medications applied to the skin such as steroids, topical antibiotics, lanolin and also preservatives in various preparations. If this is suspected, skin patch testing may help to identify the problematic substance.
For more information see stasis dermatitis at http://www.internationaleczema-psoriasisfoundation.org/stasis_dermatitis.php4

The Eczema Craquele Picture

2005-10-07T05:39:00.000-07:00

Eczema Craquele also known as asteatotic eczema occurs in older people who have thinner and dryer skin. Large dry scales may form on the skin giving a "crazy-paving" appearance to the skin. It is extremely common in communities of elderly people and may be triggered by soap remaining on the skin after a bed bath. Using a good moisturizing routine and switching from soap to a cleansing bar for dry sensitive skin (such as Cetaphil “moisturizing gentle cleansing bar or Dove) can alleviate it. Steroid creams are generally best avoided because the underlying skin is already very thin and delicate.

Fair-skinned, sensitive or elderly people who bathe a lot in hot showers or tubs can develop an asteatotic eczema that can be extremely intractable. Remembering that the skin's pH is acidic, around 5.0, and all water is slightly alkaline, especially if there are many calcium and magnesium salts in it, it is easy to see how this happens. Cessation of bathing and showering for a while may be necessary to clear the skin of these unfortunate patients. An alkaline skin is increasingly susceptible to the irritant effects of water alone, and the hyper-irritability of the skin can be prolonged; it takes 3 months for a fracture to heal, similarly with the skin. The skin must be put at rest and allowed lubrication for that length of time before it recovers.

The Atopic Eczema Picture

2005-10-05T11:11:00.000-07:00

Atopic eczema is the commonest form of eczema and is closely linked with asthma and hay fever. It can affect both children and adults, usually running in families. Atopic eczema is thought to be a hereditary condition. You do not inherit eczema as such – you inherit a predisposition to it. If there is anyone in the family who has an atopic condition, there is a chance that a new member of the family will have it too.

It is estimated that one in three people are affected by atopy. However, the development of atopic eczema in a person who has a predisposition to it is likely to be greatly influenced by the environment.

One of the most common symptoms of atopic eczema is its itchiness which can be almost unbearable. Other symptoms include overall dryness of the skin, redness and inflammation. Constant scratching can also cause the skin to split, leaving it prone to infection. In infected eczema the skin may crack and weep (‘wet’ eczema).

It is thought that people with atopic eczema are sensitive to allergens in the environment which are harmless to others. In atopy there is an excessive reaction by the immune system producing inflamed, irritated and sore skin. Other types of eczema are caused by irritants such as chemicals and detergents, allergens such as nickel, and yeast growths. In later years eczema can be caused by a blood circulatory problem in the legs. The causes of certain types of eczema remain to be explained, though links with environmental factors and stress are being explored.

The Cradle Cap Picture

2005-10-03T11:42:00.000-07:00

A Factual Picture of Eczema

2005-09-30T01:55:00.000-07:00

The Eczema - Steroid Connection

2005-09-28T07:52:00.000-07:00

For those people who suffer from eczema, the use of topical corticosteroids is high up on their list of concerns: How should they be used? And are they safe? New research to be launched today (Monday 26 September 2005) at the British Pharmaceutical Conference in Manchester shows that pharmacists can drastically reduce patients worries about using steroids by more than 50% when they intervene to address patients' needs and concerns.
The study, undertaken by Pharmacy Alliance, the Medicines Management Division of UniChem, investigated the contribution of community pharmacists in meeting the needs of patients with atomic eczema, in collaboration with GPs. In the UK, atopic eczema affects 15% of children(1,2) and up to 10% of adults(2). Treatment is often complex and confusing, and patients' concerns about using topical corticosteroids can often prevent them from treating their condition effectively.
In this new study 48 community pharmacies recruited 370 patients diagnosed with atopic eczema, and followed them up 8 weeks later. Patients' needs and concerns were assessed using a patient questionnaire. Patients were referred to their GP when their needs could not be met in the pharmacy.
The results showed that, following help and advice from a pharmacist, or pharmacy staff:
- Steroid concerns reduced from 68% to 30%
- Poor understanding of atopic eczema fell from 43% to 6%
- The need for lifestyle advice dropped from 51% to 20%
The research also found that:
Community pharmacists identified a total of 1,597 problems. Of these:
- 20% involved steroid concerns
- 15% required lifestyle advice
- 12% of patients had unmet treatment goals
- 11% of patients had poor understanding of atopic eczema
Pharmacist Caroline Tinkler who led the study said that said that it is extremely important for patients to be appropriately educated about eczema and its treatment. "If patients are empowered they are able to make informed decisions about their eczema condition and self-management," she says.
"This study proves that many of the problems or concerns patients experience with eczema or its management, particularly around the use of topical corticosteroids, can be suitably addressed by community pharmacists."
Notes to Editors
References
1. Graham-Brown R, Bourke J. Mosby's colour atlas and text of dermatology. Pub. Mosby, London 1998: 160-169.
2. McHenry P, Williams H, Bingham E. Fortnightly review Management of atopic eczema. BMJ 1995; 311: 843-847.
The British Pharmaceutical Conference is being held Monday 26 - Wednesday 28 September 2005 at the Manchester International Convention Centre. The conference theme is A common vision for health: Linking science with practice.

The Eczema Prevention Picture: Jewelry and Nickel

2005-09-27T05:20:00.000-07:00

Contact allergic dermatitis to nickel may develop at any age. Once this nickel allergy has occurred, it persists for many years, often life-long. Nickel allergy is more common in women, probably because they are more likely to have pierced ears than men, although this is changing. The degree of allergy varies. Some people develop dermatitis (also called eczema) from even brief contact with nickel-containing items, while others break out only after many years of skin contact with nickel.
In jewelry necklaces, necklace-clips, earrings, bracelets, watch-straps and rings may contain nickel. "Hypoallergenic", solid gold (12 carat or more) and silver jewelry should be safe. Nine carat gold and white gold both contain nickel. Plastic covers for earring studs can be obtained. Coating the stud with nail varnish is not recommended.

The Eczema Prevention Picture: Footwear

2005-09-25T11:48:00.000-07:00

The chief cause of eczema in footwear is the thermoplastic or rubber-boxed toes, and the cements and dichromates used in tanning. Dyes, anti-mildew agents, formaldehyde and nickel eyelets or nickel in arch supports also can cause dermatitis. A waterproofing silicone spray externally applied to the shoe can also be the cause. The dermatitis usually begins on the big toe and spreads to the rest of the foot. Socks washed in Bold or bleached with a strong whitener can also cause dermatitis.
Formaldehyde is used in the tanning of white leather shoes in "elk," "white kid" and "new bucks." Tannins obtained from trees are used to tan leather (vegetable tanning) and do not cause dermatitis. However, if the shoe is made of vegetable-tanned leather, the lining should not be chrome- tanned.
Sweat leaches out chromates from the leather, so controlling perspiration is essential. Zeasorb Powder (Stiefel) and Dr. Scholl's foot granules in soap are excellent for reducing some of this.

The Eczema Prevention Picture: Soaps And Detergents

2005-09-22T03:59:00.000-07:00

Dishwashers, housewives, laundresses and surgeons, often show dehydration or shriveling of the keratin layers, which leads to irritation (primary irritant type dermatitis). Coconut-oil-containing soap is often the worst culprit. Neutral soaps, such as Cetaphil, Lowila, Basis, Oilatum, or Dove are much less drying. Many of the stronger antibacterial soaps, such as Dial, Zest, Lifebuoy, Safeguard, Coast and Palmolive Gold, are sensitizing as well as drying, and may be photosensitizing.
Contact with clothing washed in strong soaps or detergents (for instance sheets used by bed patients) can lead to dermatitis. This is especially true if bleach or whitener is used. The laundry detergents most likely to cause a reaction include Axion, Bold, Ajax Detergent, Cold Power, Salveo Tabs, Coldwater All, Amway, Arm & Hammer, Era and Dynamo.

The Eczema Prevention Picture: Rubber

2005-09-20T01:44:00.000-07:00

Fully finished and polymerized plastics seldom cause an allergic contact dermatitis, whereas fully "cured" rubber articles do so quite frequently. Of the antioxidants used to prolong the life of the rubber, monobenzyl ether of hydroquinone (which can depigment skin) and phenyl-beta-naphthylamine are the most common sensitizers. The accelerators, mercaptobenzothiazole, tetramethyl thiuram monosulfide and diphenyguanidine, and the peptizer, thio-beta napthal, are the chemicals causing most of the dermatitides attributable to rubber. Two other accelerators, disulfuram (Antabuse) and thiuram, will produce itching, redness and hives in those exposed who ingest alcohol. Thiuram is also used as a lawn fungicide (Tersan). Occasionally bleach will activate a rubber accelerator, zinc dibenzyl dithiocarbamated (ZDC) to become highly allergenic.
Elastic in hair nets may cause dermatitis, and ribbons or wrap-around hair nets may have to be substituted. Where an eruption is due to a rubber condom, Fourex (Schmidt) fish-skins can be substituted.
Adhesive tape can cause a miliaria-like occlusion of poral openings, although true contact dermatitis spreads beyond the margin of the contact with the tape.
Latex cements are used in the shoe and textile trade. Vulcanizing solutions come in two solutions which, when mixed, seal punctures. It takes a few hours to cure, and sensitization can occur from the various chemicals. Non-vulcanizing rubber solutions are used in the shoe industry and automobile trimmings and can cause dermatitis.
Non-rubber Adhesives. These are chiefly synthetic resin adhesives which can sensitize, although fish glues generally do not. Glues made from cotton (e.g., cellulose acetate) are not sensitizers, and neither is collodion. Vegetable gums such as karaya, acacia and tagacanth are sensitizers.

The Eczema Prevention Picture: Cosmetics

2005-09-17T08:51:00.000-07:00

Most commonly occurs from hair dyes, nail polishes, perfumes, lipsticks and sunscreen agents. The chief site of the eruption is the eyelids area, with ears and neck next.
Eye makeup, such as mascara, eye shadow and eye pencil, seldom causes dermatitis (although eyeliner often does) whereas nail polish, while seldom causing trouble around the fingernails, affects the eyelids first. Lower eyelid dermatitis is often form wetting solutions or eye drops. Various formaldehyde resins are used in nail lacquers and nail lacquers and nail hardeners, as are sulfonamide derivatives, both of which sensitize.
Lipsticks contain waxes and fats (occasionally cocoa butter sensitizes), perfumes (occasionally sensitize), and dyes (especially tetrabromofluorescein), which may occasionally dry the lips and produce photosensitivity. Special lipsticks are available which contain neither fluorescent dyes, nor perfumes, like, such as, Almay (Texas Pharmacal) or Ar-Ex.
Sunscreen preparations containing PABA (para-aminobenzoic acid), hydroquinone or digalloy trioleate can sensitize, and in some cases, photosensitize. Bleaching creams are sensitizers too, either mercury, or hydroquinone being the culprit.
Toothpaste and mouthwashes can cause dermatitis from oils, cinnamon or other flavoring, or antiseptics. This is called peri-oral dermatitis. Using a non-tartar, non-fluoride toothpaste can often help in these cases.
Hair dyes are mostly of the permanent or "oxidation" type, containing para-phenylene diamine (PPDA), soap, ammonia and other modifiers which penetrate and color the hair when mixed with 20 volumes of peroxide. This type of dye accepts shampoos and cold waves and sensitizes most commonly. The azo and aniline dyes produce a semi-permanent coloring which is tolerated well in most PPDA-sensitive patients, but lasts through only a few washings. Metallic hair dyes (Romans used a lead comb dipped in vinegar to darken gray hair) are also referred to as hair "restorers" and are mostly still based on lead and do not sensitize. Vegetable rinses are usually made form henna, which is non-sensitizing, although some pyrogallol combinations are sensitizing. Methylene PPDA can cross-react with PABA in sunscreens, local anesthetics and sulfonamides-thiazides (Diruil), tolbutamide (Orinase), chlorpropamide (Diabinase) and saccharin.
Permanent-wave solutions, usually thioglycolates, are alkaline reducing agents which make the hair malleable; the hair is "waved" on rollers and then "fixed" with an oxidizer (hydrogen peroxide, perborate, bromates of citric acid). Thioglycolates rarely sensitize, but do occasionally cause primary irritation if not carefully mopped up, and can split and break the hair.
The adhesive used to attach toupees and false eyelashes occasionally cause dermatitis. Bleaching or freckle creams usually contain mercury or quinones, and all can sensitize; Benzoquin (Elder) is a very potent sensitizer. Face powders and rouge rarely cause dermatitis. For toupees and ileostomy stoma irritated by other rubber cements, Duo brand surgical adhesive (Johnson & Johnson) is well tolerated by many.
People should be advised to apply perfume to their clothes if possible rather than to their skin and certainly should avoid using photosensitizing perfumes (one such example is Shalimar) on their skin in bright sun.

The Eczema Prevention Picture: Cotton Clothing

2005-09-15T16:55:00.000-07:00

Wool and some synthetic fabrics can irritate your skin. Most people with sensitive skin feel better in clothes made of cotton or a cotton blend. In clothing metal zips, bra hooks, suspender clips, hair-pins, buttons, studs, spectacle frames etc. are likely to contain nickel which can irritate eczema. Use substitutes made of plastic, coated or painted metal or some other material.
Natural fiber clothing, made from wool, cotton, linen and mohair, have never in themselves been shown to be sensitizers. Sizing and stiffening cotton with starch or rosin may produce dermatitis. Dermatitis may occur more frequently from the use of dark clothing. Heavy perspiration, especially in oily-skinned individuals, causes more bleeding of the dye (e.g., widow's dermatitis).
Fabric finishes which are used to increase durability, to soften of stiffen a fabric, or to impart waterproofing, crease resistance or other properties to the fabric. The use of formaldehyde or its resins in clothing is widespread, but the incidence of resulting dermatitis is comparatively low. These are used to make fabrics crease resistant, water-repellent and shrink resistant. Dermatitis occurs mostly in obese women who demonstrate a dermatitis starting in the axilla and later affecting the sides of the neck, the antecubitals and the inguinals. In men, it is usually in the inner thighs, gluteal folds and back of the knees.
Stoddard solvent or other dry-cleaning solutions will occasionally produce a clothing-oriented dermatitis, as will moth crystals. Airing the clothes for a few days before wearing them will usually prevent this.
Management of clothing dermatitis involves the use of Decadron spray, which contains isopropyl myristate, a film or "spray-on-shield" which suppresses sweat and may protect the fabric and acts as a deodorant. Weight loss in obese women sometimes seems to help, as well as avoidance of panty girdles. Those who are sensitive to formaldehyde must avoid wash-and-dry or wash-and-wear and drip-dry clothing.

The Eczema Prevention Picture: Wear Gloves

2005-09-12T06:36:00.000-07:00

One thing that can help in the eczema prevention picture is to wear vinyl or plastic gloves for work that requires you to have your hands in water. Also, wear gloves when your hands will be exposed to anything that can irritate your skin. Wear cotton gloves under plastic gloves to soak up sweat from your hands. Take occasional breaks and remove your gloves to prevent a buildup of sweat inside your gloves.
Wear gloves when you go outside during the winter. Cold air and low humidity can dry your skin, and dryness can make your eczema worse.

The Eczema Terminology Picture

2005-09-10T17:05:00.000-07:00

This glossary defines commonly used dermatitis terms, including products and medications used in the treatment of dermatitis and other skin conditions that co-exist with dermatitis, such as acne, rosacea, eczema, and psoriasis.

Things That Can Irritate Eczema

2005-09-07T00:46:00.000-07:00

Some things that may irritate your skin include household cleansers, detergents, aftershave lotions, soap, gasoline, turpentine and other solvents. Try to avoid contact with things that make you break out with eczema. Because soaps and wetness can cause skin irritation, wash your hands only when necessary, especially if you have eczema on your hands. Be sure to dry your hands completely after you wash them.

Cancer Treatment Fills The Eczema Picture

2005-09-05T09:40:00.000-07:00

A therapy traditionally used on esophageal cancer and lung cancer is causing a buzz in dermatology circles as a way to treat precancerous skin lesions, sun damage and acne.
Called photodynamic therapy, or PDT, it is gaining popularity with claims that it's more convenient and less painful, and that it brings fewer side effects than conventional treatments.
The Food and Drug Administration has approved PDT only for the treatment of certain tumors and actinic keratoses, which are scaly or crusty bumps that form on the skin surface from too much sun. But now the procedure also is being widely used for sun damage and acne on an "off-label" basis.
"There are exciting new and improved cosmetic indications," says Dr. Ron Berne, an Elmwood Park, Ill. dermatologist who began using PDT on his patients in March.
He explained that PDT can improve sun damage such as blotchy complexion, fine lines and telangiectasia, which are dilated superficial blood vessels such as are found with rosacea. The procedure improves the entire area treated, creating a more uniform color, texture and tone, rather than just spot treating with liquid nitrogen or other techniques.
The procedure involves applying a topical solution called 5-aminolevulinic acid (Levulan Kerastick) directly to the skin, then activating it with a light source for a specific time. The solution is absorbed by the abnormal keratin in precancerous or sun-damaged cells or oil glands, depending on what is being targeted.
A variety of light sources may be used, from lasers and intense pulsed light to blue light, which refers to the light wavelength. Therapy can be repeated several times at the same site if necessary.
PDT also can dramatically improve mild to moderate inflammatory acne when used in combination with other treatments, Berne says, eliminating the need for oral antibiotics or the controversial drug Accutane. The Levulan is absorbed into the oil glands, significantly reducing them.
Accutane has a much higher risk of side effects, such as birth defects and liver problems, according to Berne.
Kim Nguyen, 32, of Chicago, Ill., is allergic to many antibiotics and benzyl peroxide, so she is limited in her choices of acne treatment. She has had two PDT treatments.
"I can see a reduction in the acne and scars, and the redness is less intense," she says.
She has two more treatments scheduled, and her health insurance has covered a portion of the cost.
A PDT treatment typically ranges from $250 to $350.
In general, patients must avoid all sunlight and even brightly lit rooms for 36 hours or risk getting a severe burn due to heightened skin sensitivity to light.
"Plan a day and a half inside in the shadows," Berne says.
Even with that drawback, Berne prefers PDT as a treatment for actinic keratoses.
The standard treatment uses liquid nitrogen to freeze off the lesions. But doctors can't treat more than a couple at a time, so return office visits are required, according to Berne.
"For multiple actinic keratoses, conventional therapy can be painful and inconvenient," he added.
PDT targets only abnormal cells, so all lesions can be treated at one time, or repeated if necessary, according to Berne.
The use of PDT in dermatology, however, isn't universally hailed, says Dr. Gregg Menaker, director of dermatologic surgery at Evanston Northwestern Healthcare and assistant professor of dermatology at the Feinberg School of Medicine at Northwestern University, Evanston, Ill.
While director of the dermatologic surgery unit at Massachusetts General Hospital (Boston), "I saw a steady parade of people from our lab to my surgical unit for lesions that didn't go away with PDT," he says.
In patients with multiple actinic keratoses, not every lesion may be an actinic keratosis, he explains. The lesion could be a squamous cell, a common skin cancer. "There are other treatments that are faster, cheaper and more effective," he says.
As for using PDT for acne, Menaker says, "Our standard acne therapies are going to end up being the preferred way to treat acne. Acne patients are mostly kids who are in school and don't want to come to the dermatologist. From a scheduling standpoint it's difficult. And there is no long-term data to support its use."
But PDT is in use at the Texas Dermatology Research Institute, where Dr. William Abramovits, a professor of dermatology at Baylor University Medical Center in Dallas employs it to treat actinic keratoses, acne and other skin diseases.
He says, however, that because low-energy light may not be able to penetrate deep enough into thick lesions, PDT may fail to destroy squamous cell cancers or thick actinic keratoses.
"Many centers, particularly in Europe, are exploring the potential of newer sensitizers, and light of wavelengths that will penetrate deep enough to destroy thicker lesions," Abramovits says. "The results are very promising.

Understanding Seborrheic Keratosis

2005-09-02T11:59:00.000-07:00

Seborrheic keratoses are raised growths on the skin. Seborrheic means greasy and keratosis means thickening of the skin. There may be just one or clusters of dozens. They are usually start off light tan, and then may darken to dark brown or nearly black. They may be oval spots a fraction of an inch across, or form long Christmas tree like patterns on the torso inches long.

The consistent feature of seborrheic keratoses is their waxy, pasted-on or stuck-on look. The look is often compared to brown candle wax that was dropped onto the skin. They may be unsightly, especially if they begin to appear on the face.These are not contagious and do not spread. They have no relationship to skin cancer and do not pose a risk to health. They get darker after sunless tanning creams have been used. Unlike moles (Nevi), they never turn into melanoma.

As people age they may simply develop more, and some people grow more than others. Sometimes seborrheic keratoses may erupt during pregnancy, following hormone replacement therapy or as a result of other medical problems.They are mostly hereditary and not caused by sun exposure. One often inherit the pattern and favored locations they grow on.

They often are found on the trunk and where the face meets the scalp. A different type of seborrheic keratosis may grow in liver or age spots (solar lentigines), but there are usually only a few of these. Some rough, brown keratoses on the face are actually actinic keratosis from sun damage.

Clothing rubbing against can get them irritated and make them grow. Alpha-hydroxy lotions and mild topical steroid creams may help this. If they get very itchy, irritated and bleed easily they should be removed. When a seborrheic keratosis turns black it may be difficult to distinguish from a skin cancer without a biopsy.

Because the keratoses are superficial, their removal shouldn't result in much scarring. Local anesthetics can be used to make the treatment painless. There may be a little discomfort as the treated area heals. Most often liquid nitrogen (cryosurgery) is sprayed on the spots, and produces blisters that lift up the seborrheic keratosis. These form into scab-like crusts that fall off within a few weeks. Occasionally there may be a small dark or light spot or a scar. These will fade over time. Sometimes part of the growth will eventually return.Another treatment often done is scraping off with a curette (ED&C). This is more useful when only a few need to be done, and one really want them not come back. It is also used when one spot needs a biopsy, since the scrapings can be sent to a lab. Healing is slower and scarring is more common. Sometimes seborrheic keratoses are burnt off with an electric needle or laser, especially if they are small.

The Clinical Picture of Actinic Keratosis

2005-08-29T08:56:00.000-07:00

Actinic keratosis is a scaly or crusty bump that forms on the skin surface. They are also known as a solar keratosis. Dermatologists call them "AK's" for short. They range in size from as small as a pinhead to an inch across. They may be light or dark, tan, pink, red, a combination of these, or the same color as ones skin. The scale or crust is horn-like, dry, and rough, and is often recognized easier by touch rather than sight. Occasionally it itches or produces a pricking or tender sensation, especially after being in the sun. It may disappear only to reappear later. Half of the keratosis will go away on their own if one avoid all sun for a few years. One often sees several actinic keratoses show up at the same time.

A keratosis is most likely to appear on sun exposed areas: face, ears, bald scalp, neck, backs of hands and forearms, and lips. It tends to lie flat against the skin of the head and neck and be elevated on arms and hands.Why is it dangerous? Actinic keratosis can be the first step in the development of skin cancer, and, therefore, is a precursor of cancer or a precancer. It is estimated that up to 10 percent of active lesions, which are redder and more tender than the rest will take the next step and progress to squamous cell carcinomas.

The Keratosis Pilaris Picture

2005-08-26T02:29:00.000-07:00

Keratosis pilaris is a common skin disorder. In its clinical picture, althoughkeratosis pilaris isn't serious, it can be frustrating because it's difficult to treat.
Keratosis pilaris occurs most often in children. It results from the buildup of a protein called keratin in the openings of hair follicles in the skin. This produces small, rough patches — usually on the arms, thighs and face. The exact cause isn't known, but it may be associated with eczema.
Keratosis pilaris typically causes no pain or itching. Treatment is directed at softening the keratin deposits in the skin and may include medicated creams containing urea or lactic acid. Even with treatment, this condition tends to remain for years. If associated with eczema, keratosis pilaris may improve with treatment of the underlying eczema.

THE ECZEMA SKIN PICTURE

2005-08-23T01:15:00.000-07:00

Differences in the skin of people with eczema may contribute to the symptoms of the disease. The epidermis, which is the outermost layer of skin, is divided into two parts: the inner part, which contains moist, living cells; and the outer part, which consists of dry, flattened, dead cells. Under normal conditions, the outer layer of skin acts as a barrier, keeping the rest of the skin from drying out and protecting other layers of skin from damage caused by irritants and infections. When this barrier is damaged or is naturally thin, irritants act more intensely on the skin.
The skin of a person with eczema loses too much moisture from the epidermal layer. This allows the skin to become very dry, which reduces its protective abilities. In addition, the skin is very susceptible to recurring disorders, such as staphylococcal and streptococcal bacterial skin infections, warts, herpes simplex, and molluscum contagiosum (which is caused by a virus).

The Cheilitis Picture

2005-08-18T02:56:00.000-07:00

Cheilitis refers to persistent inflammation of one or both lips. Scaling, cracking, and swelling may occur on the vermilion border, which is the area where lip mucosa meets the normal skin of the face.
There are several types of cheiliits:

actinic cheilitis, painful swelling of the lip(s) and development of scaly crust and erosions on the vermilion border after overexposure to sun rays; it may be acute or chronic. Called also solar c.

angular cheilitis, perlèche.

apostematous cheilitis, see c. glandularis.

commissural cheilitis, cheilitis affecting principally the angles (commissures) of the mouth. See also perlèche.

cheilitis exfoliati¢va, persistent exfoliation of the lip caused by inflammation of the mucous membrane, similar to but not identical with dermatitis seborrheica.

cheilitis glandula¢ris, a rare disease in which the lower lip becomes enlarged and later everted, exposing the openings of the accessory salivary glands, which are inflamed and dilated; the glands themselves are enlarged and sometimes nodular. It may be associated with carcinoma of the lip. There are three types: the simple type is characterized by multiple painless, pinhead-sized lesions, with central depressions and dilated canals, and may develop into one of the other types; the superficial suppurative type (called also Baelz's disease) is characterized by painless swelling, induration, crusting, and ulcerations of the lip; the deep suppurative type is a deep-seated infection with abscesses and fistulous tracts that eventually form scars. Called also apostematous c., c. glandularis apostematosa, and myxadenitis labialis.

cheilitis glandula¢ris apostemato¢sa, see c. glandularis.

cheilitis granulomato¢sa, granulomatous cheilitis, an inflammation of the lips characterized by granulomas and swelling; it is sometimes part of Melkersson-Rosenthal syndrome. Called also Miescher's granulomatous c.

impetiginous cheilitis, impetigo of the lips.

Miescher's granulomatous cheilitis, granulomatous c.

migrating cheilitis, perlèche.

solar cheilitis, actinic c.

cheilitis venena¢ta, that due to a toxic substance.

The Cosmetic Eczema Picture

2005-08-14T08:35:00.000-07:00

Cosmetic eczema is an unpredictable itchy, red reaction to a cosmetic applied to the face or lips. It is usually caused by skin-irritating chemicals present in a cosmetic, but may also represent a true allergy or sensitivity to one or more of the components of the cosmetic. Such an allergy may lead to more severe itching, burning, and swelling of the skin and lips.
A cosmetic allergy results when an individual develops a sensitivity to certain ingredients (such as dyes in lipsticks or flavoring agents). Allergies are unpredictable and can happen even in reaction to well-manufactured products made by reputable companies. Since sensitivities often develop and increase over time, a reaction can occur from an ingredient in a product even if you have used the product for years. Unfortunately, once an allergic reaction occurs, it will generally happen again.
Individuals who develop an allergic reaction to cosmetics should immediately discontinue their use. They should individually test cosmetic formulas to find one which will not affect them. If the reaction continues, they should see their physician.