Managing Acute and Chronic Itch

Dos and Don’ts of Childhood Eczema

Dos and Don’ts of Childhood Eczema

Conditions & Symptoms, Eczema, Manage My Itch, Managing Acute and Chronic Itch, Sidebar Feature , ,

If you have a child with eczema (or atopic dermatitis), then you know how difficult it is to weed through all of the advice and old wives tales on how to stop the relentless itching and painful flare-ups. From bleach baths to taping socks on your child’s hands; family, friends and the Internet offer a plethora of “treatments” that are said to cure your child’s eczema. Parents desperate to help their child will try almost anything, but some of the advice is just plain wrong and can actually worsen your child’s skin conditions. So, what is a parent to do?

First and foremost, parents need to understand what causes eczema flare-ups and learn how to prevent them. Many children will experience reactions when the weather changes, especially when the seasons change from being hot and humid to cold and dry. Winter clothing can also worsen the condition. Wool or polyester clothing trap in air causing the skin to overheat and become sensitive. Certain bath soaps, detergents, and even foods can all be contributing factors to your child’s eczema outbreaks. It may take some detective work, but understanding the factors that cause flare-ups can be the key to controlling them.

To help protect a child from flare-ups avoid activities that lead to dry skin. You may want to alter your child’s bath schedule from everyday to every other day and shorten bath time. When you bathe you lose a lot of moisture especially if the water is hot. It is best to take quick baths (10 minutes) in lukewarm water, and immediately afterwards apply a thick moisturizer.

Applying TriCalm on the skin after you apply the moisturizer will help stop the itch. If the skin is open or abraded, TriCalm will sting momentarily, but the stinging sensation should dissipate quickly. Most people generally feel relief between two and 12 hours with TriCalm, but because TriCalm is steroid-free, you can apply it to your child’s skin as often as needed. TriCalm can be used on children 2 and older.

Here is a quick list of do’s and don’ts if you have a child suffering from eczema.

Do

  • Do follow the advice of your dermatologist or pediatrician.
  • Do follow a daily skin care routine.
  • Do keep a record of eczema flare-ups.
  • Do bathe in lukewarm water.
  • Do use a humidifier in the house.
  • Do apply a think moisturizer.
  • Do use an anti-itch cream or gel to soothe skin

 

Don’ts

  • Don’t scratch.
  • Don’t rub the skin dry after a swim or bath. Just pat the skin with a soft towel.
  • Don’t wear wool, nylon or heavy synthetic fabrics.
  • Don’t use petroleum jelly unless it is used immediately after a bath or shower.
  • Don’t wear pajamas or clothing that causes excessive sweating.
  • Don’t use harsh detergents for clothes or bedding.

 

Sources:

http://www.eczemacanada.ca/en/Tutorials/Dos-and-Donts

http://pediatrics.about.com/cs/conditions/a/eczema_kids.htm

http://www.webmd.com/parenting/baby-eczema-questions-answers

http://www.nationaleczema.org/

 

 

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“Every day my patients ask me how they can prevent wrinkles and brown spots. My advice is to first and foremost protect yourself from the sun and UV rays.” –Dr. Gigler

Living with Sensitive Skin

Living with Sensitive Skin

Itch 101, Itch Basics, Managing Acute and Chronic Itch, Sidebar Feature , ,

Living with sensitive skin can be difficult in today’s world. With the plethora of skin care products available to you, navigating through the ingredient list to discern what causes your irritation can be aggravating. Depending upon the level of your skin’s sensitivity, your reaction to an allergen can be a minor skin rash or a traumatizing allergic reaction requiring immediate medical attention.

There are four categories of sensitive skin:

  • Acne
  • Rosacea
  • Burning and stinging
  • Contact dermatitis (this includes allergies and irritants)

Many people determine they have sensitive skin if they frequently experience allergic reactions that can produce redness, rashes or acne outbreaks after using certain soaps or lotions. Some people have severe sensitive skin where they experience redness and tenderness with the slightest touch, inhibiting their ability to live life to the fullest.

The number of people who say they have sensitive skin has increased over the last 30 years. Some doctors credit this to factors such as climate and seasonal conditions, which can have a direct influence on one’s skin. Environmental factors such as UV exposure, frequent contact with water, soaps and cleansers can break down the skin’s natural barrier and leave skin dry, itchy and red.

Some common causes for sensitive skin include:

Allergies: Allergies can be caused by foods you digest or chemicals found in common skin care products. Allergic reactions can include itching, rashes, hives, runny nose, itchy or watery eyes, exhaustion, nausea, swelling, redness, pain, stomach cramps diarrhea and vomiting.

Genetics: Research studies have concluded that fair-skinned people tend to develop more severe cases of skin sensitivity. This may be due to the lack of melatonin within their skin, which acts as protection from harmful environmental factors.

Poor Digestion: Poor digestion can also play a role sensitive skin. People with poor nutrition tend to have an inflamed digestive tract. This kind of inflammation can affect many other organs including skin. Studies have also shown that poor nutrition can lead to sluggish elimination. If toxins in you body are not flushed out properly through the digestive tract, they are more likely to penetrate the skin.

Treatments for sensitive skin:

If you have sensitive skin you will want to first determine the source of your reactions. If you are suddenly having acne breakouts, they may be caused by a new cleanser, lotion or even a new food you are eating. The best way to determine what might be causing your allergic reaction is to watch out for certain patterns.

Once you have discovered what might be causing your skin to react, avoid using that product or any other product with those ingredients. If your skin is dry and irritated, finding a thick moisturizing cream will help protect your skin’s barrier allowing it to heal. Using TriCalm hydrogel will help stop the itch, providing you and your skin relief.

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“Every day my patients ask me how they can prevent wrinkles and brown spots. My advice is to first and foremost protect yourself from the sun and UV rays.” –Dr. Gigler

Treatments for Itchy Skin

Itch 101, Itch Basics, Manage My Itch, Managing Acute and Chronic Itch

In the previous post on itchy skin, we discussed the data on the prevalence of itch and the lack of satisfactory itch treatments. Here, we take a deeper dive into available itch treatments and their efficacy and safety.

Topical Antihistamines

There are more than 70 distinct chemicals that are believed to mediate itch symptoms. Histamine is the most well-known of these itch and inflammation-triggering chemicals. Histamine binds to the type C nerve receptors and triggers the brain to produce an itch sensation, so antihistimines block the histamine from binding to the receptors.

A risk associated with using topical antihistamines is triggering a secondary allergic reaction identical to that experienced with poison ivy. Another common side effect of antihistimines is drowsiness.

Notwithstanding, the lack of effectiveness of topical antihistamines and their safety concerns, topical antihistamines like Benadryl™ continue to be widely sold and, presumably due to their placebo effect, consumers continue to purchase them.

Topical Local Anesthetics

Topical anesthetics are a common treatment for itch, and they essentially act as numbing agents to quiet itch symptoms in an affected area. Active ingredients like benzocaine and lidocaine are commonly used in over-the-counter products. However, benzocaine is one of the most likely ingredients to cause a secondary allergic reaction identical to that experienced with poison ivy/oak/sumac. It’s estimated that 1% of benzocaine users may experience this.

Another concern with topical anesthetics is the potential for systemic absorption. Although an unlikely occurrence when used as directed, applying topical anesthetics to large areas of the body repeatedly poses a danger of systemic toxicity, essentially drug overdose.

Risks:

  • Secondary allergic reaction identical to poison ivy, oak, or sumac
  • Systemic absorption
  • Numbing and loss of function
  • Short duration of relief, only 15 to 45 minutes[1]

Glucocorticoids (i.e., Cortizone-10)

Working on reducing the inflammation that can cause itch, these products have no direct effect on the sensory irritation, i.e., the itching, burning and stinging sensations. So they don’t work right away, they take a day or more to produce any significant benefit, and since they don’t target the itch nerves directly, they are ineffective on many common itch conditions, such as acute contact dermatitis – like poison ivy, jewelry allergies, bug bites and atopic dermatitis.

Risks:

  • Thin skin
  • Discoloration
  • Redness
  • Bruising easily
  • Stretch marks

Topical Counterirritants

These products, with ingredients such as menthol and camphor, provide no direct itch relief. Rather, they activate other nerve subsets that send a cold or “cooling” sensation to the brain, thus distracting you from the itch. They have limited effect and last only for a limited time.

[1] American Pharmaceutical Association’s Handbook of Nonprescription Drugs

Why do we still suffer from itchy skin?

Itch. It’s something I’d venture to say we’ve all experienced. When surveyed, 78% of adults reported experiencing some type of itch or skin irritation within the past year.[1] Itch, in particular, can range from as mild and temporary as a mosquito bite to as severe and chronic as psoriasis. In fact …

“… although itching is popularly perceived as a minor social or even humorous disability, it is frequently so severe and intractable as to cause the sufferer abject misery or even suicidal inclination.”

– Fitzpatrick’s Dermatology in General Medicine

Can you imagine having itch so severe you can’t sleep, think, or even function? Unfortunately for some this is a daily reality. But for most of us, itch is just an occasional annoyance. And about 49% of us head to the drugstore for a solution.[2]

Considering there are multiple triggers for itch, it is surprising how lacking the offerings are in terms of effective itch treatments. Consider this: The need for new and improved itch treatments was famously demonstrated in a 1964 study where 12 patients were treated with four different oral anti-itch medications in rotation so that each of them received each treatment during the study. The most effective treatments were 66% effective in relieving itch symptoms! And only 16% of treatments produced side effects like nervousness or grogginess, not bad. BUT here’s the catch … all the treatments were placebos!

So that means a placebo performs as well as, if not better than, many medications at relieving itch. Fitzpatrick’s Dermatology in General Medicine authors state,

“as of 1998, no specific anti-itch drug of proven efficacy was available.”

Even in 2003, leading itch scientists stated, “Currently there are no satisfactory selective anti-itch treatments.”[3]

And when it comes to over-the-counter remedies, in a 2012 Harris survey, more than one in three people surveyed said they were not satisfied with OTC options available to treat itch.[4]

Here’s a quick breakdown of what happens when your skin itches. Your skin has two types of itch nerve receptors, A-Delta nerves that produce the sharp, pricking pain of a needle, and type C nerves that cause itching, burning, stinging sensations and inflammation. Irritants such as chemicals, allergens or insect bites easily activate type C nerves. When the itch stimulus enters the skin, type C nerves send an itch signal to the brain and trigger the body to release histamine that dilates the blood vessels, causing redness and swelling.

In the next post, we’ll cover common topical anti-itch treatments and their relative efficacy and safety.

[1] 2012 Mintel Medicated Skincare Report
[2] Ibid.
[3] Itch Associated with Skin Disease: Advances in Pathophysiology and Emerging Therapies.
[4] 2012 Harris Interactive online survey of 2,213 U.S. adults aged 18+

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Skin Tip

Skin Tip #1

“Every day my patients ask me how they can prevent wrinkles and brown spots. My advice is to first and foremost protect yourself from the sun and UV rays.” –Dr. Gigler