When Nicki Myers’ son, Reece, was 18 months old, he itched so much he bled from scratching. Reece suffers from eczema, a non-contagious, inflammatory skin condition that may be caused by an array of triggers. “He had a moderate to severe rash on his lower legs and arms that became so inflamed and irritated he would scratch in his sleep,” says Myers. “He’d wake up with open wounds, and it was quite hard to manage.” The Ladue mom recalls slathering her child’s legs with various prescription and over-the-counter creams and ointments, and then wrapping them with gauze and compression bandages to prevent Reece from continuing to scratch.
Allergy testing confirmed that Reece was ‘allergic to everything,’ Myers notes. In particular, food allergies seemed to be associated with Reece’s eczema outbreaks. Myers spent months carefully planning and monitoring Reece’s diet to determine what foods seemed to trigger the rash.
Reece is 5 now, and his eczema usually is well-controlled. Myers continues to monitor his diet, ensuring he stays away from trigger foods and noting any changes in Reece’s skin. “I’ve gathered a lot of information, and I try to apply it,” she says. “I’ve had to develop a plan that’s going to allow him to eat and grow and be nourished, and that involves some give and take. And there’s still a lot of analyzing and contemplating and thinking involved.”
Although Reece’s eczema seems clearly related to food allergies, a specific cause of eczema outbreaks can be elusive, says Dr. Mary George, a dermatologist on staff at SSM DePaul Health Center. “It’s made worse by cold, dry weather, and there is often a genetic predisposition,” she says. “Some cases can also be exacerbated by allergies to products our skin comes in contact with, such as shampoo, skin care products or fragrances. And stress makes many dermatologic conditions worse, including eczema.”
Also known as dermatitis, there are various types of eczema, explains Dr. Joseph Muccini, a dermatologist with the Mid-America Skin Health and Vitality Center. “Dermatitis is basically an inflammation of the skin. Eczema refers to the reaction pattern, but not the cause,” he says. “I tell patients that eczema is a talent. It’s part of a repertoire of potential reactions. It’s a thing the patient’s skin knows how to do.”
Atopic eczema (endogenous dermatitis) is inherited and often appears in infancy or childhood. Children may outgrow the outbreaks or experience less frequent and much milder outbreaks as adults. Allergic eczema (allergic contact dermatitis) occurs when an individual comes in contact with an allergen that causes the reaction, such as poison ivy.
“The goal of treatment isn’t to be cured of eczema, because that is impossible,” Muccini says. “The goal is to be very, very well-controlled so that it doesn’t bother you for long periods of time. It’s about managing the problem.”
That management should include keeping the skin well-moisturized with thick lotions and air humidifiers, he says. Bathing in warm (not hot) water and using hypoallergenic soaps and household products also are basic preventive strategies. Over-the-counter and prescription topical corticosteroids and oral antihistamines can help control outbreaks.
Atopic eczema often becomes worse during the spring and summer allergy seasons, so take preventive steps now—moisturize, moisturize, moisturize—and see your primary-care physician if the condition affects your quality of life.