Published: February 08, 2008 12:09 am            

What itches you?

Itchy, flaky skin, chapped hands and cracked lips are conditions that many people think they have to put up with during the winter months.

And while wintry conditions can irritate and chap the skin and lips, these symptoms also can be signs of eczema, an inflammation of the skin often caused by underlying allergies that result in skin hypersensitivity.

Eczema often is aggravated in cold months by low humidity, dry air and overly heated homes. The condition affects people of all ages, and while it is not curable it can be treated to reduce symptoms. But first, a physician must determine what type of eczema is affecting a patient.

"There are two types of eczema," said Dr. Thomas Johnson of New England Allergy, Asthma & Immunology P.C.

"The first is the classical allergy, or atopic, eczema that you see in elbow and knee creases," he said. "This is usually seen in adults."

In children, he said, allergic eczema can manifest in these places, on the face, or anywhere on the body. The condition is believed to be hereditary, and many people with atopic eczema also suffer from other allergy-related problems such as hay fever and asthma.

"Of those children diagnosed with allergic eczema before the age of 5, over 75 percent may develop asthma," Johnson said.

The second type, non-allergic eczema - or contact dermatitis - can be caused by contact with certain metals, poison ivy, chromium in leather goods, and harsh detergents. Latex can cause both types of eczema, Johnson said.

To determine which type of eczema is causing symptoms, Johnson said, skin and blood testing are required. And it's important people be tested, because knowing what type of eczema a patient has is critical to knowing how to treat it. 

Recently, 8-year-old Mary Elizabeth Charity of Hampstead, N.H., patiently waited while rows of numbers were drawn on her back during a visit to Johnson's office. The clinician then took out a tray of little vials and injected a small amount of allergen at each number on Mary's back.

The allergens are numbered and correspond to plants, foods and other substances. If the patient is allergic to one or more, a reaction will appear around the site of injection.

Mary's mother, Kelly Therrien, said her daughter has had red patches periodically on her face and trunk over the past two years that were diagnosed as eczema.

Mary's 11-year-old brother also has eczema, while her other siblings are not affected. 

Eczema can be a frustrating condition, not just because of the constant itch, but also because of cosmetic concerns, especially if it is on the face. In severe cases, it can cause the skin to become thickened, scaly and leathery.

While people with eczema can participate in most activities, they need to take precautions such as rinsing off immediately after swimming in chlorinated pools to get the chemicals off the body. Skiing in cold, dry air can crack the skin, and moisturizers must be liberally applied.

Sweat is another trigger, so sufferers are advised to limit excess physical activity when they have a flare-up, so as not to worsen symptoms. Heat from the sun is another culprit. Acute or chronic eczema can become infected, and then antibiotics are needed.

Eczema is not to be confused with another skin condition called psoriasis, Johnson said.

"Psoriasis is caused by a problem with the immune system," he said. "Normal skin cells mature and fall off the body in 28 to 30 days, but in psoriasis they mature in five to six days and pile on top of each other, causing a thickening of the skin."

The results are lesions on the skin that are covered by silvery white scales, which look different than eczema.

Treatment for eczema involves a combination of environmental control - for instance, running a humidifier and frequent dusting, diet, limiting exposure to triggers like pollen and pets, and application of topical ointments prescribed by a health practitioner.

Johnson also said, "Some patients respond to a course of desensitizing allergy shots."



Suzanne Laurent writes for The Eagle-Tribune of North Andover, Mass. E-mail her at slaurent@eagletribune.com



Cold weather tips for eczema sufferers

Stay moisturized with frequent applications of skin lotions as recommended by a physician.

Use a heavier moisturizer, such as Cetaphil cream, with a higher oil content in the winter.

Rub moisturizer into fingernails to prevent them from becoming brittle and cracking in the cold.

Use sunblock.

Avoid wool and other scratchy fabrics.

Wear gloves outside.

If hands sweat inside winter gloves or mittens, wear cotton gloves as a first layer to soak up sweat.

School-age children should sit away from classroom heat sources, such as a vent, radiator or sunny window.

Use humidifiers at home.

Drink lots of water to stay hydrated.

Take short showers in warm or cool water.

Use mild soaps only, and moisturize within three minutes of exiting the shower.



Source: Eczemaresource.com





What if it's just dry skin?

 Use moisturizers regularly, especially after showers or baths.

Avoid long, hot showers and baths.

If you have very dry and scaly skin, your doctor may recommend you use an over-the-counter (nonprescription) cream that contains lactic acid.

 

Source: Mayoclinic.com





Identifying eczema

Eczema looks different than psoriasis, another skin condition.

In the most common type of psoriasis, patches of skin, called "lesions," become inflamed and are covered by silvery white scales.

Unlike eczema, psoriasis is not caused by allergies or contact with irritants. Rather, it's an immune system disorder.

        

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