Skin Barrier Protection or Emollient Therapy to Treat and Prevent Eczema.
Emollients moisturize dry skin and prevent healthy skin from becoming dry. It is recommended that if you have eczema, or your child has eczema, emollients can be applied as often as you need. If you have dry skin or eczema, this can be 2-3 times a day. Applying emollients 2-3 times a day can be time consuming but many that suffer from eczema say it is worth it and can prevent eczema from flaring.
What Are Emollients?
Emollients are lotions, creams, ointments, moisturizers or oils. Emollients are used to keep the skin supple and moist. Regular application of emollients is very important as a day-to-day treatment for individuals suffering with eczema.
How Do Emollients Work?
Eczema skin is very dry and cracked. This dry, cracked skin often becomes inflamed and turns into patches of eczema. Emollients puts much needed moisture into the irritated skin to help it repair itself and the layer of emollient protects it from irritants. Protecting from irritants can also prevents inflammation and itching and can reduce the amount of flares. In summary, emollients can reduce eczema flare-ups and minimize the symptoms of eczema.
How to Choose an Emollient?
Emollients can range from thin water based lotions to thick, greasy ointments. The difference between emollients (lotions, creams, ointments) is the amount of lipid oil ratio to water. Lotions have the least amount of lipids and ointments have the highest amount of lipids. Creams are between lotions and ointments. The higher the lipid amount, the greasier and stickier it feels. Unfortunately, the greasy, sticky emollients are far superior for eczema. They protect and treat better and last longer on the skin. The best way to manage emollients is to apply a dry wrap or a damp wrap and dry wrap over the damp wrap. This type of wrapping is called dry and wet wrap therapy for eczema. This type of treatment is extremely effective and has been advocated by doctors as a safe and effective treatment for eczema for 20 years. This type of treatment is not only extremely effective, it also cuts the needs for drugs with side effects such as topical steroids. These wrap helps the emollient stay on the eczema and makes it less messy for the individual applying it. Dry wrapping is effective with mild to moderate eczema. Wet wrapping is ideal for moderate to severe eczema. The damp wrap in wet wrapping infuses much needed moisture into the inflamed eczema allowing it to repair the skin barrier. Wet wrap therapy also calms the itch during treatment so it is very helpful at minimizing the symptoms of eczema. It is very important to make sure the dry wrap and or wet wrap is the proper fabric for eczema. Breathable, natural fabrics are required for proper treatment. There are specialty medical undergarments for wet and dry wrap therapy. Although they are expensive, they are far superior for treating eczema and extremely comfortable and soothing to the sufferer. This is not the case with cotton or synthetic fabrics. Cotton can be rough to the eczema sufferers' skin and when wet it becomes baggy, loose and uncomfortable. Synthetic fabrics should not be used and are not recommended for wet and dry wrap therapy. If you are planning to purchase specialty medical wet and dry wrap therapy garments, make sure they are regulated by the FDA. There are some new companies attempting to sell these specialty medical undergarments in the U.S. without registering with the FDA. Their fabrics are synthetic and unregulated. Be careful what you are applying to your eczema or your child’s eczema. They may be cheaper than FDA designated garments, but they are also unregulated and risky to use especially on inflamed, red, irritated eczema.
Which is the Best Emollient to Use?
The best emollient for your eczema depends on the dryness of your skin. Vaniply and Vanicream are great for eczema and are given the National Eczema Assoication’s Seal of Acceptance. Products eligible for the National Eczema Association’s Seal of Acceptance™ are those that have been created or intended for use by persons with eczema or severe sensitive skin conditions and that have satisfied the National Eczema Association’s Seal of Acceptance™ criteria.
National Eczema Assoication’s Seal of Acceptance™ criteria includes a list of ingredients and contents that should be avoided because they contain known irritants. Depending on the product, the National Eczema Association’s Seal of Acceptance™ Review Panel considers testing data on sensitivity, safety, and toxicity, as well as the ingredients, content, and formulation data.
There are other emollients on the market that are beneficial for eczema. Check out the National Eczema Association or talk to your doctor or nurse about an emollient for eczema. Avoid trying or purchasing products from your pharmacy or grocery store without researching the ingredients. Many over the counter products have irritants that can flare your eczema or make it worse.
How to Properly Apply an Emollient. The Soak and Seal Method for Eczema Treatment.
The Soak and Seal Method is a wonderful way to manage eczema and is recommended by the National Eczema Association and most dermatologists and allergists in the United States.
Soak: Soak in a lukewarm tub or shower for at least 10 minutes. Do not use hot water – this will strip the skin of natural oils. Use just water or a mild, fragrance free soap given the Seal of Acceptance from the National Eczema Association.
Seal: Pat your skin dry. Do not rub skin, only pat dry. Rubbing will irritate the eczema. Apply an emollient immediately to the skin before the skin completely dries. This will lock in the moisture from the shower and help repair the skin barrier. Vaniply is a wonderful emollient for the Seal step. Apply the emollient liberally to the whole body not just the affected area. Do not rub the emollient, instead apply it by smoothing it into the skin along the line of hair growth. You can not overdose on emollient. Use as much as you need to completely cover your skin.
Apply a Wrap: Apply a dry wrap over the emollient for mild to moderate eczema. Apply a damp wrap to moderate to severe eczema and apply a dry wrap over the damp wrap.
Using Emollients and Topical Steroids Together
Many individuals with eczema are prescribed a topical steroid to apply during an eczema flare. Make sure you read the instructions for use that come with your prescriptions. Topical Steroids have side effects and must be used properly. There is new research emerging on Topical Steroid Addiction and Red Skin Syndrome from misuse of topical steroids. Topical Steroids should be used sparingly and only during a flare. New research states the Soak and Seal Method for Eczema and Dry and Wet Wrap Therapy can cut the need for Topical Steroids in Eczema Sufferers. Use the Soak and Seal and Dry and Wet Wrap Therapy regularly to minimize topical steroid use. Talk to your doctor or your child’s doctor about how to use topical steroids with emollients. Also visit http://www.itsan.org for information on Topical Steroid Addiction and Red Skin Syndrome and side effects from misuse of topical steroids.
Should I Stop Using an Emollient When My Eczema Improves?
A common mistake eczema sufferers make is stopping the Soak and Seal when the skin improves. An eczema sufferer should always be performing daily skin maintenance. There are fissures or small cracks in the skin that are not visible to the naked eye. Bacteria and irritants can still penetrate these small cracks and start and eczema flare. Keeping up on the daily skin maintenance can prevent a future flare so an eczema sufferer can never put their guard down on daily skin maintenance.
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