Understanding eczema

New types of creams have revolutionized the treatment of eczema, a very itchy, unsightly skin disorder also known as dermatitis. As these guidelines suggest, altering your lifestyle, environment and even diet are often key to clearing up your patches of red, rough skin.

Eczema can first appear as cradle cap in babies. It then disappears, and may recur elsewhere on the body later in childhood. Ultimately, most children outgrow eczema. In those adults who do have this disorder, the skin perceives an irritation as a threat, and the immune system mounts a defense reaction. This includes initiating inflammation with a release of chemicals that cause red, itchy blotches. (Eczema means "to boil out" in Greek.)

These lesions usually appear on the scalp, wrists and hands, as well as at the crease of the elbows, in back of the knees, and sometimes elsewhere on the body. Because the discomfort to the skin occurs before the rash appears, eczema has been dubbed "the itch that rashes" rather than the reverse.

There are several different types of eczema, but most are related to a personal or family history of allergies. If your eczema flares after contact with certain foods, drugs or animal dander, you have atopic dermatitis, a chronic form of the disorder.

If handling certain metals, fragrances or cleaning products triggers your eczema, the diagnosis is contact dermatitis, which usually goes away once the offensive substance is removed. Emotional stress can also set off eczema (neurodermatitis), as can poor circulation in the legs (stasis dermatitis), and extremes in weather and humidity.

• Identification and elimination of eczema triggers.
• Over-the-counter or prescription creams and ointments to control eczema.
• Oral medications for hard-to-treat cases.

1. Use gloves. Moisturize your hands well and don cotton gloves for any "dry" work around the house or on the job — especially when working with problematic substances. Wearing loose-fitting vinyl gloves over the cotton gloves will protect your hands when doing dishes and "wet" work.
2. Wash away irritants. Use a liquid, rather than a powder, laundry detergent, and wash new clothes before wearing them to rinse out fabric-sizing chemicals. Make sure every trace of soap is purged from your garments by adding an extra rinse cycle, if necessary.
3. Don't put up with pain. If any topical treatment you're using stings or is painful, stop using it and tell your doctor. You can be switched to a different cream or ointment that doesn't hurt as much.