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Managing Your Eczema in the Winter

Even in Texas where the sun shines on us most of the year, the winter months can turn dry and chilly, which causes even people with healthy skin to reach for the nearest lotion bottle. But if you have eczema, the seasonal change can send your skin into a tailspin of symptoms like itchy, red, painful, and scaly skin.

We understand. Many of our patients with Atopic Dermatitis (the medical term for inherited eczema) or other forms of chronic eczema come to see Dr. Matthew Mittelbronn at Lakeview Dermatology for help with their flare-ups and severe symptoms brought on by the colder, dryer air.

That’s why we’ve put together this list of strategies and tips to help you manage your eczema symptoms throughout the colder months so your skin stays healthy and ready to celebrate the holidays and winter months beyond.

Avoid your triggers

If you’ve had eczema for a while, you know how important it is to avoid your triggers — the things that seem to set off your eczema symptoms and cause a flare-up. Common triggers include:

Unfortunately, another very common trigger is cold, dry weather. Since you can’t control nature, the best you can do is prepare your skin for the coming cold weather with the following tips.

Pay attention to your pH

pH is measured on a scale of 0-14, and determines how ‘acidic’ (lower numbers) or ‘basic’ (higher numbers) a liquid or product is. One example people may be familiar with is measuring the pH of a swimming pool so that is safe to swim in.  While overall the body’s optimal pH level is around 7, the skin has an optimal pH level of around 4-5, which serves as an important mechanism to protect us from harmful bacteria and other agents that want to enter the body. When the skin’s pH level is out of whack, your eczema will often flare-up.

That means if you use a soap that has a very high pH of 9 or 10 (very ‘basic’ - similar to Ivory Soap), you’ll dry out your skin and aggravate your eczema. Best to look for soaps that contain no lauryl sulfate. Some of these won’t lather as well, but they are much gentler on your skin.  Some inexpensive examples of ‘good pH-level’ soaps include Dove and Olay soaps, along with Cetaphil washes.

Take a bleach bath

Because eczema compromises your natural protective barrier and visible cracks or (more commonly) ‘micro-cracks’ form, bacteria can breach your skin’s surface more easily than on those with healthy skin — and that can lead to skin infection acting to worsen your regular eczema symptoms.  In fact, even invisible bacterial infection of eczema lesions makes it harder to control - even if using medications that normally improve eczema.

Although it may sound odd, one of the best ways to combat eczema-related symptoms and bacterial infections is to bathe in bleach — not straight out of the bottle, but very diluted bleach. About a quarter cup or half a cup per 40 gallons of water (the capacity of a standard bathtub) will do the trick. 

Just slip in and slide down so the water covers you up to your neck, relax and soak for 5-10 minutes or more.  After you’ve had a nice soak, rinse off in normal water, gently pat your skin dry, and apply a good moisturizer. For bad eczema flares, you may want to do this every other day for a week or so.  If you have regularly bad eczema, then consider doing so once weekly to help prevent infection.

Keep your skin moist (!!!!!!!!)

Your skin has a couple of major jobs to do: it holds your insides in and keeps the outside elements out. But in order to do that, it needs to be healthy and strong. 

If you have recurrent or chronic eczema, it is due to mild abnormalities in how your skin works that we believe could be inherited.  Because the skin in these cases is not able to perform the protective barrier functions necessary, it needs us to artificially do this ourselves.  This can easily be done by one act  --- MOISTURIZE your skin!!  It is really that simple.  The more you do this simple action (once, twice, three times a day- depending)  the less your eczema will be a problem!  But don’t grab just any moisturizer on the shelf - the right choice is pretty important.

Moisturizer Choices

If In general, moisturizers come in 3 main forms:  lotions, creams, and ointments.  Most simply, each is a combination of varying amounts of oil and water. Ointments have the highest amount of oil and little water (think plain Vaseline / petroleum jelly).  Creams have less oil and a bit more water (think Noxema or Cetaphil), And lotions have much less oil and even more water (think Lubriderm or Vaseline ‘Intensive Care’).  The thickest are ointments, then creams, then lotions.  In terms of moisturizing and repairing eczema and other dry skin, the thicker the better!  Every person is different, so choose the thickest moisturizer you personally are able to tolerate.

It is also important to choose a moisturizer with no cheap ‘filler’ ingredients or added chemicals (like perfumes, dyes, vitaminE, lanolin, etc).  Depending on the person, these unnecessary ingredients can actually worsen the eczema, even if they sound like they might help.  Best rule of thumb is ‘the less additional ingredients the better’.  Unfortunately, the cheaper ‘no name’ or generic brand moisturizers tend to have more of these fillers and unnecessary ingredients, but even quality brands will sometimes add vitaminE, lanolin, shea butter, among others for marketing purposes - so try to avoid when possible.  

Some quality brands we generally like are Cetaphil, Cera-Ve, Aquaphor, Eucerin, Neutrogena, and Lubriderm, among others.

When winter eczema gets out of hand

Despite your best efforts, you may find that your eczema symptoms have gotten out of control and you need some expert assistance. If that happens, Dr Mittelbronn and his team at Lakeview Dermatology are happy to help. 

He will assess your individual situation and determine a treatment plan that works best for you.  Most often, topical medications when used correctly are enough to help keep your eczema improved.  However, if this is not so, then Dr Mittelbronn has extensive experience in other treatment options to help you get your eczema under control and will discuss these with you.

The good news is that you don’t have to live with unbearable eczema symptoms this winter!

Contact us at Lakeview Dermatology at 817-369-8098 to set up a consultation today and get your skin ready for the winter holidays. 

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