How Antihistamines May Help Take the Itch Out of Eczema

Unbearably itchy skin is a very common eczema symptom. Nonetheless, scratching only makes the skin condition worse and invites infection, according to Harvard Health Publishing. When itching is very troublesome, eczema treatment often includes oral antihistamines (along with other medications), which are drugs used to stop the itch-scratch cycle of eczema that can bother you in the day and even keep you up at night.

“While antihistamines won’t stop the eczema flare-ups from happening, they will help to relieve some of the itchiness, and itchiness is the No. 1 complaint I hear from my patients with eczema,” says Debra Wattenberg, MD, a dermatologist in private practice in New York City.

Atopic eczema, also known as atopic dermatitis, is the most common type of eczema, according to the National Eczema Association, and is considered similar to an allergic condition.

In the case of allergies, the body mistakes harmless substances like pollen or dust mites as a threat and releases histamine, an immune system protein that helps protect cells from infection, to fight them off, according to the Mayo Clinic. Allergic symptoms like itchy eyes and skin can result.

Antihistamine drugs are often used to treat allergic conditions. They block the effects of histamine to provide relief, per the Cleveland Clinic.

Antihistamines “are the only oral medications we have to treat itching,” says Suephy Chen, MD, a dermatologist and the chair of the department of dermatology at Duke University School of Medicine in Durham, North Carolina. But, she explains, they work differently when used as an eczema treatment.

RELATED: ‘I Tried Wet Wrap Therapy for Eczema, and It Helped Reset My Skin’

Antihistamines as a Treatment for Eczema

“Eczema is not really a histamine problem, but antihistamines do seem to have some effect. The sedating effect is helpful because scratching always makes eczema worse. So if the medications keep people from scratching, indirectly they can help the eczema,” Dr. Chen says, adding that antihistamines are still not as effective as we would like in treating the itch of eczema.

In general, there are two types of oral antihistamines on the market: first-generation antihistamines and second-generation antihistamines. First-generation drugs, such as Benadryl (diphenhydramine) and Chlor-Trimeton (chlorpheniramine), affect the brain and can cause side effects like drowsiness, according to the Cleveland Clinic. These sedating antihistamines are most beneficial as a treatment for eczema, especially if the eczema symptom of itchy skin is keeping you from sleeping, says Dr. Wattenberg. And getting a good night’s sleep promotes healing and is beneficial for the immune system, according to the nonprofit Allergy & Asthma Network. When taken as directed, first-generation antihistamines are safe, even for children, according to the American Academy of Dermatology Association, though it’s important to talk to your child’s doctor first.

Because second-generation antihistamines don’t have an effect on the brain, they aren’t sedating. So, Chen says, as a treatment for eczema, second-generation drugs are “even less likely to work because of the nonsedating properties. ” Second-generation antihistamines include Claritin (loratadine) and Zyrtec (cetirizine), the Cleveland Clinic notes.

Whether you’re taking a first- or second-generation variety, just don’t get your hopes up too high. When it comes to using antihistamines to help with eczema, they aren’t a cure-all. “Antihistamines won’t prevent flare-ups because they don’t target the actual root of the disease, but they do help with the itch, which could allow your flare-up to heal faster,” says Wattenberg.

RELATED: Your Everyday Guide to Living Well With Eczema

Side Effects of Antihistamines as Treatment for Eczema

Because first-generation drugs are sedating, here are some side effects you need to watch out for, according to the National Health Service in the United Kingdom, especially if you’re taking them at times besides before bed:

• Your ability to drive or operate machinery may be impaired.
• You might not be able to think clearly, so work or school may be difficult.
• Mixing antihistamines with other sedatives, muscle relaxers, or sleeping pills can increase the sedation.

Common side effects also include dry mouth, dizziness, and decreased appetite, according to MedlinePlus. First-generation antihistamines may not be right for you. Talk to your doctor if you have any of these medical conditions:

Many first-generation antihistamines are available without a prescription at your local drugstore, says Wattenberg. Prices vary, but at one nationwide drugstore chain, a box of 24 Benadryl Allergy Liqui-Gels cost less than $9. Store brands with the same active ingredients are generally less expensive. Ask your doctor about what would be best for you, suggests Wattenberg.

RELATED: The Best Natural and Essential Oils for Eczema

Taking Care of Your Eczema

Stopping itchy eczema symptoms as soon as possible is essential to managing the condition. Sticking to your medications is very important.

“I recommend taking antihistamines in conjunction with topical steroids to improve the skin health,” says Wattenberg; she also advises against topical antihistamines, which she says may actually irritate your eczema. Your doctor might suggest a corticosteroid cream, which is a topical steroid that’s often a go-to treatment for eczema, according to the Eczema Foundation, and helps fight inflammation.

Also, you’ll want to steer clear of irritants or allergens. A study published in January 2021 in the journal Cell found that for some people with eczema, acute itching may be caused by environmental allergens like animals, dust, and mold. Also, researchers found that for those with eczema, taking antihistamines may not always help with these hyper-acute flare-ups (caused by environmental allergens) because the itch-signals are carried along different brain pathways.

And of course, don’t forget to keep your skin hydrated by using plenty of moisturizer. According to the American Academy of Allergy, Asthma & Immunology, moisturizers help improve the skin barrier.

Additional reporting by Regina Boyle Wheeler.

Study shows why antihistamine drugs fail to control severe itch in eczema patients

In addition to a skin rash, many eczema sufferers also experience chronic itching, but sometimes that itching can become torturous. Worse, antihistamines — the standard treatment for itching and allergy — often don’t help.

New research from Washington University School of Medicine in St. Louis indicates that allergens in the environment often are to blame for episodes of acute itch in eczema patients, and that the itching often doesn’t respond to antihistamines because the itch signals are being carried to the brain along a previously unrecognized pathway that current drugs don’t target.

The new findings, published Jan. 14 in the journal Cell, point to a possible new target and strategy to help eczema patients cope with those episodes of acute, severe itch.

Years ago, we used to think that itch and pain were carried along the same subway lines in the nerves to the brain, but it turned out they weren’t, and these new findings show there’s another pathway entirely that’s causing these episodes of acute itching in eczema patients. The itch can be maddening. Patients may rate their chronic itch at around a 5 on a scale of 10, but that goes up to 10 during acute itch flares. Now that we know those acute flares are being transmitted in an entirely different way, we can target that pathway, and maybe we can help those patients.”

Brian S. Kim, MD, Study Principal Investigator and a Dermatologist and Associate Professor of Medicine, Washington University School of Medicine

The typical pathway for itching in eczema patients involves cells in the skin that are activated and then release histamine, which can be inhibited with antihistamine drugs. But with this acute itching, a different type of cell in the bloodstream transmits itch signals to the nerves. Those cells produce too much of another non-histamine substance that triggers itch; therefore, antihistamines don’t work in response to such signals.

“We’ve connected acute itching in eczema to allergic reactions transmitted by an entirely different population of cells,” said Kim, also the co-director of the Center for the Study of Itch & Sensory Disorders. “In patients who experience episodes of acute itching, their bodies react in the same way as in people with acute allergy. If we can block this pathway with drugs, it might represent a strategy for treating not only itch but other problems, including perhaps hay fever and asthma.”

In recent years, several clinical studies have tested a strategy that involves blocking Immunoglobulin E (IgE), a substance produced by the immune system in response to allergens. Patients with allergies produce IgE, causing allergic reactions, but its role in itch has been unclear.

Reviewing data from clinical studies of drugs aimed at treating chronic itching, Kim found a pattern in which patients reported episodes of acute itching, often after exposure to environmental allergens. He also found that eczema patients who make IgE in response to allergens in the environment were more likely to experience those episodes of severe, acute itch.

“Environmental allergens actually promote this type of itch,” he explained. “Say a patient with eczema goes to Grandma’s house, where there’s a cat, and that person’s itching just goes crazy. It’s likely cat dander is activating IgE, and IgE is activating itch.”

Kim’s team took these observations to the laboratory, where his team made a mouse model of eczema. Studying the animals, they found that when the mice made IgE, they began to itch. But unlike standard itch signals, in which cells in the skin called mast cells release histamine, the IgE in mice with eczema activated a type of white blood cell called a basophil. Those cells then activated an entirely different set of nerve cells than the cells that carry itch signals that respond to antihistamines.

The discovery that acute itching in eczema is linked to exposure to allergens may help them avoid things that make them itch intensely, including animals, dust, mold or certain foods. Meanwhile, it also offers drug companies new targets for treating itch in eczema patients, including proteins and molecules Kim’s team has identified along this newly identified neuro-immune pathway.

Source:

Washington University School of Medicine

Journal reference:

Wang, F., et al. (2021) A basophil-neuronal axis promotes itch. Cell. doi.org/10.1016/j.cell.2020.12.033.

Best Antihistamine For Eczema – My Itchy Child

Antihistamines are commonly used to alleviate the itch from eczema. Many parents want to know what the best antihistamines are to give their children. This article will discuss the best antihistamine for eczema. As always, discuss with your child’s doctor before giving your child antihistamines. Also remember, antihistamines can help relieve your child’s itch, but it doesn’t address the cause of your child’s eczema.

How do antihistamines help relieve itching in eczema?

If you have eczema, your doctor may prescribe you medications that are classified as antihistamines. These are medicines that can help control itching due to eczema. [1] Severe itch caused by eczema often interferes with the quality of life. But why does this itch occur? Medical research shows that itch occurs as a result of increased levels of histamine in the dermis of the skin. Itch is usually associated with redness and dryness of the skin. [2]

Antihistamines block the release of histamine in the dermis of the skin. [2,3] This controls histamine levels in the body, and subsequently the itching in eczema. Some examples of antihistamines include hydroxyzine and cetirizine. [2,4]

Which antihistamine works best for eczema?

There are a number of antihistamines available in the market, but which one works the best for eczema?

Hydroxyzine is an oral antihistamine that is recommended for those who have difficulty sleeping due to itching. It has sedative effects.  [4]

Cetirizine is another antihistamine that is taken orally. [5] Drowsiness is also a side effect of cetirizine. This is commonly known as Zyrtec.

Diphenhydramine is a commonly used antihistamine medicine but it is not fully recommended for eczema because of its lack of studies and proven benefits for eczema patients. [1] This is commonly known as Benadryl.

How do antihistamines help with eczema?

Antihistamines primarily block the production and action of histamine in eczema. This helps control the itching sensation and thus is helpful for eczema and other itchy skin conditions. [6]

What are the benefits of using antihistamine for eczema?

The following are the benefits of using antihistamines for eczema: 

• Helps control acute eczema flares or times of intense itching
• Has sedating effects that can help improve the quality of sleep, which is already disrupted by the constant itching [5]

What are the side effects of antihistamine treatment for eczema?

There are antihistamines grouped as first-generation antihistamines such as chlorpheniramine. This is not recommended for the treatment of eczema because these have strong sedative effects. Chlorpheniramine stays longer in the body once taken by mouth and therefore, stays in the body even during the daytime. [6,8]

Chlorpheniramine and hydroxyzine can impair the driving ability of adults as well as the learning ability of children because they stay longer in the body. [9]

The second-generation antihistamines were developed to solve the issues associated with the first-generation antihistamines, so they do not have such an intense sedative effect. One of the many second-generation antihistamines is fexofenadine (AKA Allegra). It can help improve the itching symptoms in eczema.  [10]

Are there precautions we should take for taking antihistamines for eczema?

Antihistamines generally cause drowsiness and sedation. Hence, it is recommended to take them at bedtime. [10]

It is also advised to consult with your doctor before you start on any antihistamine.  [1]   

Are there natural antihistamines for eczema? 

There are fruits and vegetables you can include in your diet that contain a natural anti-allergic, antihistaminic and anti-inflammatory phytochemical called quercetin. [11] Quercetin can be found including broccoli, grapes, berry crops, apples (fruits), tea, and wine.

If you are looking for alternatives to pharmaceutical anti-histaimnes, you may consider quercetin as a dietary supplement. It is available over-the-counter.

If you are interested in alternative treatment options for eczema, acupuncture is also another alternative medical therapy to try which can be effective in reducing the intensity of itch associated with eczema. [12]

Conclusion

I hope this article helps you find the best antihistamine for eczema. Remember, antihistamines can help alleviate the itchiness, but will not fix the cause of eczema. As you can see, cetirizine (AKA zyrtec) and hydroxyzine are probably the antihistamine that is prescribed by many physicians. Benadryl is commonly prescribed as well, but it might not be the best for eczema, at least based on a current literature search. As always, it is best to discuss with your physician before giving your child antihistamines.

Click here to read about natural ways to deal with eczema

Itching Relief | Michigan Medicine

Topic Overview

Home remedies may relieve itching.

To relieve itching

• Avoid further contact with whatever you suspect is causing the itching.
• Keep the itchy area cool and wet. Apply a washcloth that has been soaked in ice water, or get in a cool tub or shower. But remember that repeated wetting and drying will actually dry your skin.
• Avoid taking a hot shower or bath. Keep the water as cool as you can tolerate.
• Add a handful of oatmeal (ground to a powder) to your bath. Or you can try an oatmeal bath product, such as Aveeno.
• Apply a paste of baking soda mixed with water.

If any of these home remedies make the itching worse, stop using them.

To keep itching from getting worse

You may be able to prevent itching from getting worse.

• Stay out of the sun and in a cool place. Heat increases itching.
• Use as little soap as possible. If you use soap, use a gentle one, such as Dove, Oil of Olay, or Basis. Avoid using strong soaps and deodorant soaps around blisters or a rash.
• Try a cool, saltwater compress. To make the solution for the compress, use 2 tsp of salt in 1 qt (1 L) of cool water. Wet a washcloth with the solution and apply the cloth to your skin.
• Avoid dry skin, which will worsen itching. Apply a moisturizer or calamine lotion to the skin while it is damp. For more information, see the topic Dry Skin and Itching.
• Try washing your clothes with a mild detergent such as Cheer Free and Gentle or Ecover. Rinse twice to remove all traces of the cleaning product. Avoid strong detergents when you have a rash.
• Take several breaks during the day to do a relaxation exercise, particularly before going to bed, if stress appears to cause your itching or make it worse.
  • Sit or lie down, and try to clear your mind of distracting thoughts. Concentrate on relaxing every muscle in your body, starting with your toes and going up to your head.
  • For more information, see the topic Stress Management.

Don’t scratch. Scratching leads to more itching and may cause a skin infection to develop. Cut nails short or wear cotton gloves at night to prevent scratching. Put mittens or cotton socks on the hands of babies and young children to prevent scratching.

Over-the-counter medicines for itching

If home treatment doesn’t relieve the itching, you may want to try taking an over-the-counter medicine.

• Try a nonprescription 1% hydrocortisone cream for small itchy areas.
  • Use only a tiny amount of cream on the face or genitals.
  • If itching is severe, your doctor may prescribe a stronger cream.
  • Note: Don’t use the cream on children younger than age 2 unless your doctor tells you to. Don’t use it in the rectal or vaginal area in children younger than age 12 unless your doctor tells you to.
• Calamine lotion may help dry out itchy, oozing blisters.
• Oral antihistamines may relieve the itching. Nondrowsy oral antihistamines include fexofenadine (Allegra) and loratadine (Claritin). Antihistamines like diphenhydramine (Benadryl) or chlorpheniramine (Chlor-Trimeton) are less expensive but can make you feel sleepy. Don’t give antihistamines to your child unless you’ve checked with the doctor first.
  • Read and follow any warnings on the label.
  • Avoid applying antihistamine, such as Benadryl cream, spray, or gel, or Caladryl lotion, to the skin. These products may further irritate your skin. Also, it is more difficult to control the dosage of medicine that is absorbed through the skin.

If the itching is severe and it interferes with sleep or other activities for more than 2 days, call your doctor to discuss your symptoms.

Credits

Current as of:
July 2, 2020

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP – Emergency Medicine
Adam Husney MD – Family Medicine
Martin J. Gabica MD – Family Medicine
E. Gregory Thompson MD – Internal Medicine
Ellen K. Roh MD – Dermatology

Current as of: July 2, 2020

Author:
Healthwise Staff

Medical Review:William H. Blahd Jr. MD, FACEP – Emergency Medicine & Adam Husney MD – Family Medicine & Martin J. Gabica MD – Family Medicine & E. Gregory Thompson MD – Internal Medicine & Ellen K. Roh MD – Dermatology

Eczema – ACAAI Patient

Symptoms

Symptoms of eczema include:

• A red rash or red patches of skin, especially inside the folds of the elbows and knees
• Itching
• Dry skin, which can crack and possibly bleed

The location of eczema may change with age. In infants and young children, eczema is usually located on the cheeks, outside of the elbows and on the knees. In older children and adults, eczema is typically on the hands and feet, the arms and on the back of knees.

Symptoms can be painful, including blisters, and the skin may change color. The itch associated with eczema can be severe, often interrupting sleep. Scratching of the skin may lead to an infection. Infants with eczema may rub against bedding or other things to relieve the itch.

Diagnosis

Allergists are specially trained to treat skin conditions, such as eczema, which are often related to an allergic response. You’ll likely be asked questions about the types of soap, detergent and skin care products you use, and about any other exposures that may be making your eczema worse.

Your allergist may perform a prick test, which involves a diluted allergen being applied with a prick or a puncture on the surface of the skin. The allergist observes the tested area for about 15 minutes to see if a bump (wheal) or redness (flare) develops. The test is usually done on the back or forearm in adults and on the back in children, with several allergens tested at once.

An allergist’s specialized training helps them to develop a treatment plan for your individual condition. The goal will be to enable you to lead a life that is as normal and symptom-free as possible. Your allergist might be able to determine possible allergic triggers for your eczema — and offer treatment suggestions to help provide relief from symptoms.

From 33 to 63 percent of young children with moderate to severe eczema also have food allergies. It is recommended that children under the age of 5 who have moderate to severe eczema be evaluated for milk, egg, peanut, wheat, and soy allergies, if the child continues to have eczema even after treatment. Testing is also recommended when the child has a history of reaction after eating a specific food. An allergist can help identify which foods, if any, to eliminate from your child’s diet.

Recent guidelines put infants who have severe eczema and/or egg allergy in the highest risk category for peanut allergy. These high risk infants should be seen by an allergist who can determine if they are candidates to be introduced to peanut-containing foods between 4-6 months in order to prevent peanut allergy.

Management and Treatment

Children and adults diagnosed with eczema can manage the condition with the guidance of an allergist. In cases of moderate or severe eczema, an allergist may recommend prescription medication, including topical steroids and/or antihistamines. Milder cases may be treated with ointments, such as petroleum jelly, and moisturizers. Those should be applied daily, even when the skin appears clear, to help prevent dryness.

People with eczema should avoid harsh cleansers, drink water often, wear gloves in cold weather, and avoid wearing materials such as wool, which could irritate the skin. Flare-ups of eczema can be caused by foods, cosmetics, soaps, wool, dust mites, mold, pollen, dog or cat dander, dry climate and other variables.

If you have an infant with eczema, your allergist might advise you to bathe him at least once a day and immediately apply moisturizer after the bath. Limited use of pH balanced skin cleansers should also be part of frequent bathing, along with gentle patting dry, and the immediate application of a moisturizer to “seal in” moisture. This technique is called “soak and smear” and can provide relief from the itching that comes with eczema.

In 2016, the U.S. Food and Drug Administration (FDA) approved a topical treatment called crisaborole for children 2 years of age and older and adults with mild to moderate eczema. It was the first new FDA-approved medication for eczema in more than 10 years. Clinical trials showed the medication is effective at decreasing inflammation and is well-tolerated with long term use. In 2017, the FDA approved a new drug to treat serious cases of eczema in patients 18 years of age and older. The drug, dupilumab, is a twice-monthly injection under the skin that patients can do at home. The drug was made for those whose eczema can not be controlled well by topical therapies such as ointments or creams. Dupilumab can be used with or without topical corticosteroids.

Why It’s Time to Rethink Our Use of Benadryl

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Junge, RN, BSNKathryn Obrynba, MDKatie Brind’Amour, MSKatie Thomas, APRKatrina Hall, MA, CCLSKatrina Ruege, LPCC-SKatya Harfmann, MDKayla Zimpfer, PCCKelley SwopeKelli Dilver, PT, DPTKelly AbramsKelly BooneKelly HustonKelly J. Kelleher, MDKelly McNally, PhDKelly N. Day, CPNP-PCKelly Pack, LISW-SKelly Tanner,PhD, OTR/L, BCPKelly Wesolowski, PsyDKent Williams, MDKevin Bosse, PhDKevin Klingele, MDKim Bjorklund, MDKim Hammersmith, DDS, MPH, MSKimberly Bates, MDKimberly Sisto, PT, DPT, SCSKimberly Van Camp, PT, DPT, SCSKirk SabalkaKris Jatana, MD, FAAPKrista Winner, AuD, CCC-AKristen Armbrust, LISW-SKristen Cannon, MDKristen Martin, OTR/LKristi Roberts, MS MPHKristina Booth, MSN, CFNPKristina Reber, MDKyle DavisLance Governale, MDLara McKenzie, PhD, MALaura Brubaker, BSN, RNLaura DattnerLaurel Biever, LPCLauren Durinka, AuDLauren Garbacz, PhDLauren Justice, OTR/L, MOTLauren Madhoun, MS, CCC-SLPLauryn RozumLee Hlad, DPMLeena Nahata, MDLelia Emery, MT-BCLeslie Appiah, MDLinda Stoverock, DNP, RN NEA-BCLindsay Pietruszewski, PT, DPTLindsay SchwartzLindsey Vater, PsyDLisa GoldenLisa M. Humphrey, MDLogan Blankemeyer, MA, CCC-SLPLori Grisez PT, DPTLorraine Kelley-QuonLouis Bezold, MDLourdes Hill, LPCC-S Lubna Mazin, PharmDLuke Tipple, MS, CSCSLynda Wolfe, PhDLyndsey MillerLynn RosenthalLynne Ruess, MDMaggy Rule, MS, AT, ATCMahmoud Kallash, MDManmohan K Kamboj, MDMarc Levitt, MDMarc P. Michalsky, MDMarcel J. Casavant, MDMarci Johnson, LISW-SMarco Corridore, MDMargaret Bassi, OTR/LMaria HaghnazariMaria Vegh, MSN, RN, CPNMarissa Condon, BSN, RNMarissa LarouereMark E. Galantowicz, MDMark Smith, MS RT R (MR), ABMP PhysicistMarnie Wagner, MDMary Ann Abrams, MD, MPHMary Fristad, PhD, ABPPMary Kay SharrettMary Shull, MDMatthew Washam, MD, MPHMeagan Horn, MAMegan Brundrett, MDMegan Dominik, OTR/LMegan FrancisMegan Letson, MD, M.EdMeghan Cass, PT, DPTMeghan Fisher, BSN, RNMeika Eby, MDMelanie Fluellen, LPCCMelanie Luken, LISW-SMelissa and Mikael McLarenMelissa McMillen, CTRSMelissa Winterhalter, MDMeredith Merz Lind, MDMichael Flores, PhDMichael T. Brady, MDMike Patrick, MDMindy Deno, PT, DPTMitch Ellinger, CPNP-PCMolly Gardner, PhDMonica Ardura, DOMonica EllisMonique Goldschmidt, MDMotao Zhu, MD, MS, PhDMurugu Manickam, MDNancy AuerNancy Cunningham, PsyDNancy Wright, BS, RRT, RCP, AE-C Naomi Kertesz, MDNatalie Powell, LPCC-S, LICDC-CSNatalie Rose, BSN, RNNathalie Maitre, MD, PhDNationwide Children’s HospitalNationwide Children’s Hospital Behavioral Health ExpertsNeetu Bali, MD, MPHNehal Parikh, DO, MSNichole Mayer, OTR/L, MOTNicole Caldwell, MDNicole Dempster, PhDNicole Greenwood, MDNicole Parente, LSWNicole Powell, PsyD, BCBA-DNina WestNkeiruka Orajiaka, MBBSOliver Adunka, MD, FACSOlivia Stranges, CPNP-PCOlivia Thomas, MDOmar Khalid, MD, FAAP, FACCOnnalisa Nash, CPNP-PCOula KhouryPaige Duly, CTRSParker Huston, PhDPatrick C. Walz, MDPatrick Queen, BSN, RNPedro Weisleder, MDPeter Minneci, MDPeter White, PhDPitty JenningsPreeti Jaggi, MDRachael Morocco-Zanotti, DORachel D’Amico, MDRachel Schrader, CPNP-PCRachel Tyson, LSWRajan Thakkar, MDRaymond Troy, MDRebecca Fisher, PTRebecca Hicks, CCLSRebecca Lewis, AuD, CCC-ARebecca Romero ShakReggie Ash Jr.Reno Ravindran, MDRichard Kirschner, MDRichard Wood, MDRobert A. Kowatch, MD, Ph.D.Rochelle Krouse, CTRSRohan Henry, MD, MSRose Ayoob, MDRose Schroedl, PhDRoss Maltz, MDRyan Ingley AT, ATCSamanta Boddapati, PhDSamantha MaloneSammy CygnorSandra C. Kim, MDSara Bentley, MT-BCSara Bode, MDSara Breidigan, MS, AT, ATCSara N. Smith, MSN, APRNSara O’Rourke, MOT, OTR/L, Clinical LeadSara Schroder, MDSarah A. Denny, MDSarah Cline, CRA, RT(R)Sarah Driesbach, CPN, APNSarah GreenbergSarah Hastie, BSN, RNC-NIC Sarah Keim, PhDSarah MyersSarah O’Brien, MDSarah SaxbeSarah Schmidt, LISW-SSarah ScottSarah TraceySarah VerLee, PhDSasigarn Bowden, MDSatya Gedela, MD, MRCP(UK)Scott Coven, DO, MPHScott Hickey, MDSean EingSean Rose, MDSeth Alpert, MDShana Moore, MA, CCC-AShannon Reinhart, LISW-SShari UncapherSharon Wrona, DNP, PNP, PMHSShawn Pitcher, BS, RD, USAWShawNaye Scott-MillerSheila GilesSimon Lee, MDStacy Whiteside APRN, MS, CPNP-AC/PC, CPONStefanie Bester, MDStefanie Hirota, OTR/LStephanie Burkhardt, MPH, CCRCStephanie CannonStephanie Santoro, MDStephanie Vyrostek BSN, RNStephen Hersey, MDSteve Allen, MDSteven C. Matson, MDSteven Ciciora, MDSteven CuffSuellen Sharp, OTR/L, MOTSusan Colace, MDSusan Creary, MDSwaroop Pinto, MDTabatha BallardTabbetha GrecoTabi EvansTabitha Jones-McKnight, DOTahagod Mohamed, MDTamara MappTammi Young-Saleme, PhDTerry Barber, MDTerry Bravender, MD, MPHTerry Laurila, MS, RPhTheresa Miller, BA, RRT, RCP, AE-C, CPFTThomas Pommering, DOThomas SavageTiasha Letostak, PhDTiffanie Ryan, BCBA Tim RobinsonTimothy Cripe, MD, PhDTracey L. Sisk, RN, BSN, MHATracie Rohal RD, LD, CDETracy Mehan, MATravis Gallagher, ATTrevor MillerTyanna Snider, PsyDTyler Congrove, ATVanessa Shanks, MD, FAAPVenkata Rama Jayanthi, MDVidu Garg, MDVidya Raman, MDW. Garrett Hunt, MDWalter Samora, MDWarren D. Lo, MDWendy Anderson, MDWendy Cleveland, MA, LPCC-SWhitney McCormick, CTRSWhitney Raglin Bignall, PhDWilliam Cotton, MDWilliam J. Barson, MDWilliam Ray, PhDWilliam W. Long, MD

Treating Eczema in Toddlers & Infants

Understanding and Treating Eczema in Babies, Toddlers & Older Children

Eczema (or atopic dermatitis) in children can start as early as two months of age. It’s a very common condition, affecting approximately 10% of infants and children. Here are tips about understanding and treating eczema.

Common Scenarios

Your 13-month-old has been off of formula for a month now and enjoys drinking milk out of her sippy cup. You’ve noticed a red, raised rash scattered in different places around her body. She occasionally scratches it, which seems to make it even worse.

Your 4-month-old has had a red, irritated rash on his face for the past two months. Everyone has told you it’s just baby acne. You now start to see the rash breaking out on his arms, legs, and body. It seems to be getting worse. He is exclusively breastfed.

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Your 4-year-old has always had dry skin, but it never seemed to bother him. Lately, however, he has developed dry, scaly patches on his arms, legs, and face.

These are all common scenarios that are typical of eczema.

What is eczema?

Eczema is a skin condition that has two distinct components:

• Dry, easily irritated skin – children with this type of eczema have a genetic tendency toward dry skin. Moisture is very important for our skin. It helps skin stay healthy, prevents irritation, and speeds up healing. Moisture essentially helps our skin function better. With eczema, the skin does not retain moisture very well, thus giving it a dry, slightly rough texture and making it prone to irritation. To further complicate matters, this dry, irritated skin is itchy, causing children to scratch frequently. This further irritates and damages the skin, which leads to worse itching and scratching, and so on.
• Allergies – children with this condition also have some underlying allergies that are manifested in the skin. When exposed to these allergens, the skin over-reacts and breaks out in a rash. The already dry and slightly irritated skin is less able to handle this allergic rash and less able to heal itself quickly.

Thus, children with eczema have an ongoing battle on two fronts – trying to retain moisture in the skin and prevent irritation and itching, and limiting exposure to allergens and skin irritants. This is a battle we plan to help you and your child win against eczema!

Now that we know what causes eczema in babies and toddlers, let’s take a closer look at what symptoms to look for.

What does eczema look like in children?

• Dry skin – your child will have slightly dry skin with a rough texture. You may be able to see and feel tiny white bumps as you run your fingers across the skin.
• Dry patches – you may see scattered, scaly, dry, white patches anywhere on the body.
• Flare-ups – from time to time you will see some areas of the skin become more irritated and flare up due to eczema. These will look like raised, red, slightly oozing patches. Flare-ups generally occur near skin creases – most commonly the inside of the elbows and behind the knees, but also in the neck, wrists and hands, and feet. An eczema rash can also occur on the trunk. One unique aspect of eczema is that it usually does not affect the diaper area.

What causes infant and toddler eczema?

As stated above, eczema is a mixture of dry skin and allergies. The cause is mainly genetic – an inborn tendency toward dry skin and allergies. There is no way to change these genetics. The important issue is not what causes eczema in the first place, but what allergens and skin irritants your child is exposed to that are triggering the flare-ups.

Treating Eczema

There are 5 main aspects of preventing and treating eczema in children:

1. Avoid dry skin

   Moisturize, moisturize, moisturize! This is the single most important step in treating eczema and minimizing your child’s eczema. Do not underestimate this – this is a vital part of toddler and baby eczema treatment. This needs to be part of your daily routine with your child:

   • Luke-warm baths – hot water can dry the skin. Let your child play and soak in the bath. Do not let him soak in soapy water. It used to be felt that frequent bathing made eczema worse. Now we know that luke-warm baths allow water to soak into the skin.
   • Towel off gently by patting the skin. Do not rub dry.
   • Do not use plain soap – soap dries the skin, even liquid baby soap.
   • Use a moisturizing soap with no perfume – unscented Dove works very well. Cetaphil is a cleanser that is also soap-free and good for eczema.
   • Daily moisturizing lotion – this is very important. Two to four times a day, apply a moisturizing lotion or cream to the whole body, especially the affected areas. Some good brands include Aquaphor, Eucerin, or Keri lotion. One good time to apply this is right after the bath – it locks in the moisture.

    

2. Avoid skin irritants

   This is the second most important aspect of eczema prevention.

   • Cotton clothing is best. Avoid wool and synthetic materials; they can be more abrasive and irritating to the skin.
   • Use cotton sheets and soft, cotton blankets.
   • Wash new clothes before wearing them – this will get out any chemicals from the manufacturing process.
   • Do not use any perfumed or scented lotions.
   • Do not use bubble bath.
   • Laundry detergents – use a mild, dye-free detergent such as Dreft, Ivory Snow or All Clear. Liquid detergents rinse out better.
   • Double rinse the wash to get out all the detergent.
   • Shower or bath after your child plays in the grass or engages in sports that make him sweaty.
   • Maintain humidity of 25-40 percent in your home. Buy a humidity gauge. During the dry winter months, use a humidifier in your home. During the humid summer months, the air conditioning can keep the humidity stable.
   • Suntan lotion – use one that doesn’t irritate your child’s skin. PABA free is better.

    

3. Avoid allergic triggers

   • Food allergies – if your child has any food allergies, then they will play a major role in causing eczema. The problem is, you may not know if your child has any food allergies, and if he does, which foods is he allergic to? Thankfully, there are six common foods that make up nearly 90 percent of possible allergic foods. These are milk, egg, soy, peanuts, fish, and wheat. Eliminate all six foods for 2 to 3 weeks. If you see a dramatic reduction in eczema flare-ups, then re-introduce each food one at a time to determine which is causing the allergy.
   • Environmental allergies – these include dust, mold, pets, and seasonal outdoor allergies such as pollens. These environmental allergies are more likely to cause nasal allergies and asthma rather than eczema. However, they can contribute to eczema. Identifying and preventing these allergies is a very complicated process.

    

4. Control the itching

   This is a major problem for children with eczema. They are in a continuous cycle of itching and scratching. The dry, irritated skin itches, so your child scratches. The scratching further irritates the skin, which causes the eczema rash to flare up. This itches even more and your child scratches even more. If you can keep the skin moisturized, decrease the rash, and prevent itching and scratching, then you can avoid this endless cycle.

   • Keep fingernails cut short and very clean – when your child scratches, the bacteria that live under his nails and on his skin get pushed deeper into the rash. This can lead to a skin infection. Shorter nails also will lessen the trauma to the skin.
   • Wear long sleeves and pants, weather permitting – this keeps his skin covered so your child is unable to scratch as much.
   • Medications to reduce itching – oral antihistamines are a very effective way to control the itching caused by eczema. There are two types:
     • Over-the-counter – Benadryl (diphenhydramine) is the standard for itching. Its only drawback is that it causes drowsiness in many people. At nighttime, this can be an advantage since it will help your child sleep through the itching. But during the day, it can interfere will his daily functioning.
     • Non-sedating prescriptions – Zyrtec, Claritin, and Allegra and the three most commonly used. Zyrtec is currently approved for down to age 2 years. The other two are not – so should not be used for infant or toddler eczema treatment. These have two benefits: they are long-acting and last 12 hours, and for most people, they do not cause drowsiness. Thus they are very convenient for use during the day.
     • You can alternate between these two. Use Benadryl at night, and a prescription during the day.
     • When to use these medications – do not just automatically give these to your child every day. When the eczema is under control, the rash is mild, and your child has little or no itching, then give your child a break from the medication. But do not be afraid to use it during flare-ups and for periods of moderate to severe itching. You need to break the itching and scratching cycle before the rash worsens. You can safely use these medications daily for several weeks.

    

5. Topical steroid cortisone cream

   Although this is a medication to help control itching as in the section above, it deserves its own special section. These creams have long been the gold standard. It helps in treating eczema by minimizing the rash and itching. They vary in strength from the extremely mild over-the-counter hydrocortisone cream, to mild, medium, strong, and very strong prescription creams. Follow the instructions below for treating eczema with creams.

   • Preventative treatment – if your child’s eczema is usually well controlled, with very little itching and rash, then you do not need to use cortisone cream for prevention. However, if the eczema is moderate to severe and your child continuously has rash and itching despite all possible measures to minimize it, then you can use this cream on a daily basis to try to improve the condition. Use the mildest form of infant or toddler eczema cream that seems to work for your child.
     • Mild rash – this consists of a few areas of raised, red rash slightly worse than your child’s baseline rash. Treat this with the over-the-counter 1 percent hydrocortisone cream (do not bother with the 0.5 percent – you might as well not use anything if you use this). It will say extra-strength, but it is really very mild. Use the cream twice a day until the rash subsides. Ask your doctor for a mild prescription cortisone cream if the OTC one doesn’t work.
     • Moderate rash – again, what is considered moderate is based upon your child’s baseline rash. These areas are often more red and inflamed, may have some oozing from the rash, and may bleed slightly from scratching. The itching will be worse than usual. Treating eczema in these areas with a mild prescription cortisone cream. You can also ask your doctor for a medium strength eczema cream if the mild one doesn’t work.
     • Severe rash – these areas will be very red and irritated, will ooze, and bleed. These areas will be larger and more widespread than usual. Itching and burning will be troublesome. Treat this with a medium strength prescription cortisone cream. Your doctor may prescribe a strong cream to be used very sparingly for severe areas that don’t improve with a medium strength cream.
     • How long to use eczema cream – only use the prescription cream until the rash subsides. You don’t have to keep using the same strength cream until the rash is totally gone. If you have been treating eczema and you see the rash is somewhat better, then step down to a weaker cream. Use that one until the rash is back to baseline. It is safe to use mild prescription creams for a few weeks.
     • Helpful tips – When treating eczema after a bath, apply the cream to the slightly damp skin. Apply the steroid cream before applying the moisturizer.
     • Side effects of steroid creams. There are two types of side effects:
       • Local side effects in the skin – include thinning of the skin, stretch marks, and infections. Different parts of the body are more susceptible to side effects in the skin. These areas include the face, armpits, and genital areas. It is generally safe to use the mildest creams on these areas for a few weeks, and use the mild to moderate creams for several days, but it is better not to use the strong creams on these areas at all.
       • Internal side effects – a very small percentage of the steroid is absorbed through the skin into the bloodstream. If enough is absorbed, it can affect certain hormone levels which in very rare cases can cause a reduced growth rate. Be aware that this only happens with the overuse of the strong steroid creams. The stronger the cream and the longer it is used, the more chance of side effects. Over the counter cream has virtually zero chance of side effects, and so do the mildest prescription creams. The moderate strength creams have a slight chance of side effects. The strong creams have some chance of side effects, especially the longer they are used. The very strongest creams should not be used to treat eczema in children.

6. “Soak and Seal”

This is a technique we use in our medical practice: because eczema is basically dry skin, apply a light layer of water over eczema, then cover with the lubricant, which then seals the area and allows the water to soak in.

Skin infections

Be aware that children with eczema are more susceptible to bacterial skin infections, especially in areas where the rash is the worst. This infection is called impetigo. Signs that this is occurring are increased redness of the skin around the rash and a honey-colored fluid oozing from the rash or forming a crust over the rash. This is not an emergency and is not a reason to page your doctor after hours. It can wait until the next day to be seen by the doctor.

New innovations in the treatment of eczema in children

Tacrolimus ointment – this is an investigational ointment currently being tested in the U.S. for the treatment of eczema. It suppresses the part of the immune system that is responsible for the eczema rash and itching. This ointment is showing great promise, and will hopefully be available soon. It appears to be just as effective as steroid creams but does not have many of the side effects that the steroids have.

Will my child ever outgrow eczema?

Yes. For most children, eczema improves during childhood. Your child may always have a very slight problem with dry skin and occasional mild rash, but the vast majority of children grow up with very little inconvenience from this condition.

The best foods for healthy skin are:

1. Omega-3 fatty acids, such as flax seeds or flax-seed oil, salmon and tuna fish.
2. The antioxidants vitamin C and vitamin E act like nature’s own protection.
3. Lots of fluids, preferably water, to help keep your baby’s skin well hydrated.

Dr. Sears, or Dr. Bill as his “little patients” call him, has been advising busy parents on how to raise healthier families for over 40 years. He received his medical training at Harvard Medical School’s Children’s Hospital in Boston and The Hospital for Sick Children in Toronto, the world’s largest children’s hospital, where he was associate ward chief of the newborn intensive care unit before serving as the chief of pediatrics at Toronto Western Hospital, a teaching hospital of the University of Toronto. He has served as a professor of pediatrics at the University of Toronto, University of South Carolina, University of Southern California School of Medicine, and University of California: Irvine. As a father of 8 children, he coached Little League sports for 20 years, and together with his wife Martha has written more than 40 best-selling books and countless articles on nutrition, parenting, and healthy aging. He serves as a health consultant for magazines, TV, radio and other media, and his AskDrSears.com website is one of the most popular health and parenting sites. Dr. Sears has appeared on over 100 television programs, including 20/20, Good Morning America, Oprah, Today, The View, and Dr. Phil, and was featured on the cover of TIME Magazine in May 2012. He is noted for his science-made-simple-and-fun approach to family health.

September 10, 2020September 21, 2020Dr. Bill Sears

h2-histamine blockers for chronic spontaneous urticaria

Relevance

Chronic spontaneous urticaria (CSU) is a condition characterized by rashes of red, itchy, flat-raised blisters or urticaria similar in appearance to nettle burn blisters that appear for no specific reason. Other names include: chronic idiopathic or chronic common urticaria (urticaria). “Spontaneity” distinguishes this type of urticaria (urticaria) from “inducible” or “physical” urticaria, for which specific triggers exist, such as cold or pressure.Chronic indicates that the condition has continued for at least six weeks. Hives can cause severe itching, and the appearance of the rash can be unsightly and upsetting. In some cases, hives may be accompanied by a deeper edema known as angioedema (vascular edema), which most often spreads around the eyes and mouth.

Antihistamines, in particular h2 histamine blockers, are the basis for the treatment of urticaria, although they only control the condition, but do not cure it.Many antihistamines are available over the counter, including brand names such as Claritin, Pyriton, Zyrtec, Benadryl, and Fenergan (brand names may vary from country to country).

Review question

Which h2-antihistamines are effective and safe in CSF?

Research characteristics

We included 73 randomized controlled trials, with 9759 participants of all ages, and reviewed the completeness of urticaria (urticaria) suppression.The duration of the intervention was up to two weeks (short-term) or more than two weeks and up to three months (medium-term).

Highlights

We investigated clinical trials in which one therapy was compared with another or against placebo (direct comparisons). We found that overall, cetirizine – 10 mg once daily in a short to medium term course – was effective and completely suppressed urticaria, although not in all participants.Some benefit may be associated with the use of desloratadine 5 mg for at least the medium term and 20 mg for the short term. Levocetirizine 5 mg was effective in completely suppressing urticaria in the medium term, but not in the short term. The higher dose of 20 mg was effective in short-term use, but the 10 mg dose was not effective.

Side effects such as headache or dry mouth are common with most antihistamines.The evidence is less clear for improved quality of life (eg, reduced sleep disturbance due to itching, less stress from urticaria), as most clinical studies have not addressed this issue.

We cannot say if one antihistamine works better than all others, as we did not have direct (drug-to-drug) evidence for every possible comparison of treatment options.

Quality of evidence

The overall quality of the evidence found was low for most of the results.Further well-designed and carefully reported comparative studies are needed if we are to find out how well these drugs work and whether there are any reported adverse effects, especially when used for up to several months.

How to get rid of eczema?

Best Practices Explained

DISCLAIMER

The opinions expressed herein are those of an expert and, like the rest of the contents of the Health Guide, do not replace professional medical advice, diagnosis or treatment.If you have any medical questions or concerns, contact your doctor.

Q: How to get rid of eczema?

A. There is no cure for eczema, but the symptoms can be cured. If you have a mild case of eczema, you can treat it at home. It really is an approach, not one cream or one medicine.

• First, increase the frequency of moisturizing, preferably with a cream and, if possible, ointment. Ointments are usually most delicious in the evening, when you don’t have to worry about splashing on your work clothes during the day.
• Moisturizers are better than lighter lotions, usually rinsed off with alcohol rather than moisturizers. I love Vanicream which is very moisturizing and does not contain fragrances or things like formaldehyde or parabens that are bad for our skin.
• Try to reduce the frequency of bathing. If you can skip a wash for a day or two, that will be helpful. If you are going to swim every day, try to do it for no more than five minutes. Use mild water rather than hot water.Use soap on your hands and in personal areas, but do not apply it all over your body. Maybe only once a week.
• It may be helpful to install a humidifier in the bedroom.
• Wear only soft cotton clothing – no wool or synthetics.

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If eczema does not respond to home treatment, we take it to the next level: cortisone cream in the morning and then ointment in the evening. We can use low, moderate and high potency cortisone creams. There are anti-itch lotions that you can buy without a prescription, such as Sarna; it contains camphor, menthol, which has a soothing effect. Applying cold compresses, such as a few ice cubes in a Ziploc bag and a little water, to any itchy area may help.This is the oldest form of anesthetic, useful for the whole body – it can relieve itching right away.

Some people have more chronic eczema, which usually returns soon after cortisone creams are stopped. In this case, we use immunomodulatory creams such as pimecrolimus (brand name Elidel) or tacrolimus (brand name Protopic). They can be used regularly to reduce skin inflammation. They can be used every day, twice a day, to avoid flare-ups of eczema.This is a big break, especially with kids.

In severe cases, we can switch to systemic steroids such as oral prednisone. Over-the-counter oral allergy medications such as diphenhydramine (brand name Benadryl) will not cure eczema, but they can relieve itching, causing drowsiness. In fact, we do not have effective itching pills yet, although they are currently being tested. Allergy shots can help people with their allergies, but in the dermatological literature, the link between eczema and allergies is less than 10%.

Dermatitis and eczema remedies to cleanse the skin

Perhaps the first question you ask yourself after the doctor makes a diagnosis is, “Why me? Why exactly should I suffer from itching and dryness, from eczema? Why should I have dermatitis – red and inflamed skin? ”

Your doctor will probably be better able to answer these questions. But, no matter how difficult it may be for you, remember: you are not alone. The latest government statistics indicate that about 9 million Americans suffer from some form of dermatitis every year.How many people itch!

The following tips are intended to help those diagnosed with eczema or dermatitis control the itching and dryness that accompany these conditions.

1.4

Experts say the best home treatment for itching eczema and dermatitis is to moisturize and moisturize dry, blotchy skin well. For this reason, many of the remedies listed in the Dry Skin and Winter Itch section can help you with these conditions.

Beware of dry air.Dermatitis is aggravated in dry air, especially in winter when heaters are in use.

“Dry air heating dries the skin more than any other heating,” explains Howard Donski, MD, resident dermatologist at Toronto General Hospital. – Since dry air

Do you have a nickel rash?

“Nickel dermatitis is probably the most common type of contact dermatitis,” says Howard Donski, MD. “But often people do not even suspect what the matter is: they believe that gold is to blame for everything.”
Nickel dermatitis is 10 times more common in women than in men and is often triggered by ear piercing. The strange thing is that the ears are pierced, and the rash appears in completely different places when a person comes into contact with metals containing nickel. Suddenly, bracelets, necklaces and other jewelry that a person has worn for several years causes contact rashes.

If this is similar to what is happening to you, the following tips may help you:

• Buy earrings with stainless steel clasp.Until the lobes heal (about 3 weeks), earrings with a steel clasp should be inserted into the ears;
• Do not sweat as sweat plays an important role in nickel dermatitis: it leaches nickel from nickel-plated jewelry;
• Stay in the shade if you are wearing such jewelry, or do not wear them at all in the heat.

the spirit aggravates the itching of eczema and dermatitis, the main concern of people suffering from these diseases, and their families, should be to keep the air in the apartment moist.If you can counter dry air heating with a good humidifier, that will solve the problem. ”

But experts warn that a humidifier alone is not enough. “People think that once they install a humidifier, their problem will be solved,” explains Hillard H. Perelstein, MD, private physician and assistant professor of dermatology at Mount Sinai School of Medicine at City University of New York. “But humidifiers are not like air conditioners: you really need a large unit.Of course, if you sleep next to him, everything will be fine. Put it next to the bed. ”

Bathe in room temperature water. The old prejudice that people with dermatitis should not take a bath is now being scrutinized. While some doctors think bathing too often makes the condition worse, others believe that bathing regularly reduces the chance of infection and helps soften the skin.

Basically, our experts belong to the second group. “Swim, but bathe in room temperature water,” LR Donski insists.”Avoid both too hot and too cold.”

Buy rich creams. Regular use of soap should not be avoided when bathing, if you then apply a moisturizer to the skin to keep it from dryness. “You can’t bathe too often if you don’t cover your skin with grease after a bath,” warns Dr. Pereleptein. “Fat retains water, and dry skin is the result of losing water, not oil.”

Preferred post-bath emollients (or fats as dermatologists call them) are special juts or creams that are identified as care products i.i body after shower.

Take an oatmeal bath. For an extra “soothing” effect, Dr. Donski recommends adding Avino Colloidal Oats to your bath water and even using oatmeal instead of soap. For a bath, pour 2 cups of colloidal oatmeal (available from pharmacies) into room temperature water. The term “colloidal” means that the oats have been crushed into a fine powder that will remain suspended in water. To use a hundred like soap, wrap the powder in a handkerchief and tie it, soak it in water, wring it out and use the handkerchief like a regular washcloth.
Avoid antiperspirant products. Metal salts such as aluminum chloride, aluminum sulfate and zirconium hydrochloride are active ingredients in antiperspirants and are known to cause irritation in those with sensitive skin. “It is usually the antiperspirant that is irritating, not the deodorant,” says Dr. Donski. “I recommend using a product called Aquaeous Zephyran, which can be bought at any pharmacy.” But if you are going to continue using over-the-counter sweat repellents, look for anti-irritating ingredients such as allantoinate, zinc oxide, magnesia, aluminum hydroxide, or tritanolamine.

Try over-the-counter products. Topical creams, ointments, and topical lotions containing cortisone are often used to relieve the itching and inflammation of dermatitis and eczema. Hydrocortisone is the mildest in the family of cortisones, a steroid hormone, and is available over the counter as an irritant soothing agent.

“A 0.05% hydrocortisone cream can be bought without a prescription and it works,” says Dr. Perelyptein. “You have to start somehow, and if you go to the pharmacy and buy some hydrocortisone cream, it won’t hurt you.”However, stronger cortisone creams

can have serious side effects and should not be used unless directed by a doctor.

Wear cotton. “Cotton clothing that makes contact with the skin is much better than wool or polyester, especially wool,” said dermatologist John F. Romano, MD, an instructor at New York Hospital at Cornwall University Medical Center. Avoid wearing synthetic or itchy fabrics, as well as tight-fitting, ill-fitting clothing.They not only seem to stick to the body, but also provoke itching.

Refrain from artificial nails. A recent study by the Cleveland Clinical Foundation found that acrylic manicure products are a frequent and clear cause of dermatitis. These acrylics are found in artificial nails, nail extensions, or false nails and can irritate the eyes, nose, or respiratory tract in addition to allergic contact dermatitis.

Once these funds were only in salons, but now they can even be written out at home.“And even if most people don’t have problems with artificial nails,” says Dr. Donski, “the problem is that the first fixatives contained formaldehyde, and some still do today. Contact with this substance can cause problems, as, indeed, with other polymers that make up artificial nails. ”

If you suspect you are allergic to such substances, avoid contact with them. This is the only way to be saved.

4gt; Apply emollient compresses.Cold, wet dressings can soothe and relieve itching caused by contact dermatitis. “I recommend trying cold milk instead of water,” says Dr. Romano. “It turns out it softens much better.”

Here are his recommendations: “Pour milk into a glass with ice and set aside for a few minutes. Then moisten a gauze cloth or a thin piece of cotton wool with milk and apply to the irritated skin area for 2-3 minutes. Wet the tissue again and apply again, continuing the procedure for 10 minutes. “
Dr. Romano does not recommend this treatment in cases of generalized eczema or dermatitis. Sometimes the eczema can be so severe that it forms “oozing”. This condition is known as weeping eczema, and some doctors believe it responds well to compresses that need to be done several times a day. If the condition does not improve, consult your doctor as soon as possible.

Refrigerate with calamine. “Calamine Lotion is good for many types of inflammation that get wet and need to be treated.
sew, says Dr. Romano.”You can also buy menthol or phenol calamine lotion from pharmacies, which is even better for itching than just calamine lotion.”

Analyze your diet. “Food allergies can play an important role in atopic dermatitis in children,” says Dr. Pereleptein. “Most often they occur before the age of 6, and you can improve the condition of your child’s skin by making changes to their diet.”

Traditionally, eggs, orange juice, and milk are thought to worsen eczema in children.But Dr. Perelenthein says, “I certainly wouldn’t put the blame on them entirely.” This means that parents should consult a doctor before eliminating anything from the diet, just in case. Such diet exceptions seem to work best in children under 2 years of age. “We found that food plays a minimal role for most people over the age of 6,” says Dr. Perelstein.

For adults, Dr. Perelyntein believes that dietary manipulation is mostly in their hands: “If you think that there is a food that is bad for your skin, do not eat it and see what happens.If your problem is resolved, then you may have a food allergy. ”

Avoid sudden fluctuations in air temperature. “If you have eczema,” says Dr. Donski, “then sudden changes in temperature can be a problem. Leaving a warm room in the cold winter air, or even an air-conditioned room with a hot shower, can cause itching. You can protect yourself from chilling by wearing several layers of cotton clothing. And, of course, people with eczema should refrain from hot baths and showers.A little precaution will help reduce the itching-provoking effects of temperature changes. ”

Use white paper. To avoid itching from contact dermatitis, “white toilet paper is best,” advises Dr. Donski. “Paints are also irritating.”

Be careful with baby lotions. “Sometimes baby lotions are not the best remedy for childhood eczema,” notes Dr. Romano. “They have a high percentage of water content, and this can further dry out and irritate the skin during evaporation.”Certain fragrances and active ingredients in baby lotions (lanolin and mineral oil) are common causes of skin allergies. Instead, you need Creams and Main. Something like a cream “Eucerin”, “Aquaphor” or Vaseline “Dermatological Formula”.

f Urine therapy. “Emollients containing urine are very good for relieving itching from eczema or dermatitis,” says Dr. Perelyptein. – Urine causes peeling, and this is a good remedy. We usually apply it when the skin is slightly thickened from friction and scratching. “
• I (§and Foods containing urine that you should try are

these are “Karmol 10” or “Karmol 20”, “Ultra Mide 25”. You can even recommend products containing lactic acid (lacticair 1 and 2%, aqualacthen or lacgudrin).

Use antihistamines for atopic eczema. Antihistamines block the release of histamine from cells, thereby reducing classic allergy symptoms such as headache, wet nose and itching. For this reason, “anti-histamines like Benadryl are very good for eczema,” says Dr. Romano.Antihistamines reduce itching by preventing histamine from reaching sensitive skin cells and causing swelling. A word of caution: Sometimes you have to take large vines of antihistamines for relief. They cause drowsiness, which can cause problems with driving a car or working on a dangerous machine.

Wash once, rinse – 2. When washing laundry for people with eczema and dermatitis, “it is not what powder is used, but how many times the laundry has been rinsed,” says Dr. Romano.- You must be sure that the detergent is completely rinsed out. When washing, do not add too much powder and be sure to rinse the laundry twice (in the washing machine) to wash off all the soap. ”

Get to know your optometrist. A 20-year survey of 492 people at the Mayo Clinic in Rochester, Minnesota found that 13% of those with atopic dermatitis developed cataracts. “Cataracts are more common among people with atopic dermatitis,” says Dr. Perelstein.”Atopics should visit an ophthalmologist more often than others.”
90,000 Eczema (atopic dermatitis): a glossary of formal and informal terms used to describe tests, treatments, patients and over

October 1, 2019

Chances, you or someone you know are affected

eczema

Withdrawal About 1 in 12 people in the United States are typically affected by atopic dermatitis, the most common form of eczema.

to the National Eczema Association (NEA)

Refusal

According to FamilyDoctor.org.

atopic dermatitis is a chronic inflammatory skin condition that

NEA Notes.

associated with an intact immune system. Eczema can lead to significant discomfort for those who have it. It can start in early childhood, although people of all ages are amazed. This may disappear as the child grows older or persists into adulthood.

Symptoms of eczema

Include red or pink dry, itchy, irritated, scaly skin that can look around clear liquid when scratched.The National Eczema Society notes that babies tend to develop it on their face and scalp, although it can appear anywhere on the body, especially in older children and children.

Allergens

such as a pet; chemical irritants, including aromatic soaps or laundry detergents;

dry skin

; stress; hormonal changes; or infections can cause a flare-up of eczema.

Scientists do not know the exact cause of atopic dermatitis, but the condition occurs in families where people either have atopic dermatitis, asthma, or hay fever.

According to the American Academy of Dermatology (AAD)

Refusal The disease is not contagious.

RELATED:

No, eczema is not contagious, but here’s how you can spread additional infections

For a diagnosis, see a Dermatologist, who is a doctor who specializes in skin, hair, and nails. As Alissa Danielle, a Dermatologist in Charlotte, North Carolina explains, explains the doctor, the doctor will take your medical history and check you “sometimes, if the patient history results and exams are not entirely clear, the skin

biopsy

can be done, she says, who

NYU Langone Health Echoes

Disclaimer Tests for a blood or skin patch may be done to rule out other conditions, according to FamilyDoctor.org.

Treatment options for atopic dermatitis

include topical or oral medications, heavy use of moisturizers, and

diet

and the way of life is changing. Dealing with the health of the skin barrier and reducing inflammation are major challenges, says Dr. Daniel.

Treatment may include:

Topical corticosteroid creams or ointments

Including

hydrocortisone

,

Triamcinolone

, or

CLOBEX (cobetasol propionate 0.05 percent)

they apply to

rash

To help reduce inflammation and itching.

Antimicrobial therapy

“Bleach or bath vinegar and topical antimicrobials can help keep bacterial, viral and yeast colonized in the skin, which also reduces inflammation,” says Daniel.

Moisturizers and emollients

To keep your skin soft and flexible, it is preferable to choose fragrance-free products without a lot of irritating additives. Daniel adds, “Gentle cleansers and room vases can be used to help moisturize the skin.”

RELATED:

Best soothing creams and moisturizers to help tame eczema

Avoiding flashing triggers

“Some patients have problems with food sensitivities and other allergic triggers,” says Daniel. “Removing these specific foods and allergens from the environment can be beneficial.”

Additional treatments may include:

Topical non-steroidal medications

These include CRISABOROLE, PIMECROLIMUS and

Tacrolimus.
Refusal

Oral antihistamines


Hydroxyzine

and

Benadryl

Among other things, it can be used to deal with itching.

Dupixent (Dupilumab)


Dupilumab

is an injectable drug for moderate to severe cases that tackle the overreaction of the immune system to the triggers of eczema.

Of course, there is a lot more to learn in the eczema guide.“I always recommend that patients be inquisitive, but not believe everything they read or hear. Certain “natural” treatment options also carry risks, and if the provider is not trained in how to recognize and manage these risks, there may be negative results from Daniel’s Warning.

90,000 Piribenzamine – Chemist’s Handbook 21

Chemistry and Chemical Technology

Articles
Drawings
Tables
About the site
English

Of particular importance as an antihistamine is one of the substituted aminopyridines known as pyribenzamine 134], which, along with benadryl, has been successfully used to relieve the symptoms of many allergic diseases such as hay fever, allergic eczema and, to a lesser extent, bronchial asthma.Pyribenzamine X can be prepared in various ways, with 2-aminopyridine being the starting material in all methods. The most satisfactory and the only method adopted in production can be represented by the following scheme [c.433]

Most antihistamines are derivatives of di-methylethylamine, for example, diphenhydramine and pyribenzamine [c.387]

Pyribenzamine causes side reactions in fewer patients than benadryl, and the type of these reactions is somewhat different [43].Dyspeptic disorders occurred in 19 out of 200 patients who were exposed to it [c.159]

See pages where the term Piribenzamine is mentioned:

[c.609]

[c.433]

[c.433]

[c.387]

[c.324]

[c.94]

[c.199]

[c.401]

[c.269]

See chapters in:

Heterocyclic compounds T.1 -> Piribenzamine

Heterocyclic Compounds, Volume 1 -> Pyribenzamine

Heterocyclic compounds Vol.1 (1953) – [

c.433

]

Heterocyclic Compounds, Volume 1 (1953) – [

c.433

]

Organic analysis (1981) – [

c.269

]

© 2020 chem21.info Advertising on the site

90,000 Treatment of eczema in babies and children

Last year, 3-year-old Anthony Keir was covered with a red scaly rash that prevented him from scratching all night. “I was with him every two hours – sometimes he scratched so hard that there was blood on his sheets, and we were both exhausted and grumbled the next day,” his mother, Angela, recalls. She had to keep him at home on hot summer days and he couldn’t even go to the pool to cool off because the chlorine burned his irritated skin.“For several months, I felt like taking care of his skin was a 24-7 job,” Queer says.

Anthony has eczema, also known as atopic dermatitis, a condition that causes itchy, inflamed skin and often begins in infancy. An estimated 17 percent of children suffer from eczema, and about a third of them experience severe symptoms like Anthony’s. “We’re seeing more eczema in children than ever before – the incidence has more than doubled since the 1970s,” says parent advisor Amy Paller, MD, chair of the Department of Dermatology at the School of Medicine.Feinberg at Northwestern University in Chicago. And because many parents unnecessarily worry about the safety of medications that relieve itching, their children don’t always get the relief they desperately need.

What causes eczema in children?

Eczema is more than just sensitive skin. “Usually the skin is supposed to act as a barrier against environmental irritants like dust, pollen and animal dander, but when a child has eczema, his skin acts like a sieve that allows the irritants to enter his body,” explains Adnan Nasir.MD, dermatologist at the University of North Carolina at Chapel Hill and co-author of Eczema Free for Life magazine. “These foreign substances are causing his immune system to go into attack mode, causing an itchy rash.” In fact, scientists have pinpointed why some children are more susceptible: they have a genetic condition that prevents them from making filaggrin, a protein that normally creates a protective layer on the skin’s surface.

Although the disease runs in families, experts say one of the reasons for the rise in eczema is the same reason for the rise in allergies: “Children in Western societies are not exposed to as many germs as 50 years ago,” says Julie Schaffer, Dr. Medicine, Director of Pediatric Dermatology at New York University.”If a child’s immune system is not busy building resistance to childhood infections, it may be more likely to respond when it is exposed to harmless foreign substances.” Unsurprisingly, up to 80 percent of children with eczema also suffer from other allergic conditions, such as asthma or hay fever.

General signs and symptoms of eczema

Eczema usually begins on the head, forehead, ears, neck, cheeks, or in the scrotum behind the elbows or knees.However, the early signs of this condition in a child can be as subtle as fussiness.

“Technically, eczema is just a rash that results from scratching, but babies don’t yet know how to use their hands to scratch itchy skin, so they can get eczema on their face and scalp from rubbing their head against bedding or even theirs. parents, “says Dr. Nasir. If you notice that your child is moving a lot, see your pediatrician. If he rules out other conditions, such as colic, consult a dermatologist who can examine your child’s skin for subtle signs of eczema.Older children and children usually have more classic symptoms: dry, flaky, red skin. They are also better able to describe itching. It’s important to get a diagnosis well in advance because your child may fall into a vicious cycle of itching and scratching that leaves her skin raw and sore.

Eczema Risks

Last summer, Cindy’s sons Melvin, Kendall, 12, and Kobe, 4, did not make it to the beach. They did not play in their neighbors’ yards and could not go to camp with their friends.Boys have severe eczema that is aggravated by sweating and external allergens such as grass. “We had Kendall’s birthday party outside in September,” says Melvin from Lakewood, California. “Halfway through, he started to itch so badly that he had to go inside and watch the rest of his party from the kitchen window. He was devastated. ”

Stories like this clearly show that the effects of eczema are more than the skin. One study found that children who had the disease for more than six months rated their quality of life lower than children with epilepsy or asthma.“Children with eczema usually have to learn to live with an uncomfortable itching sensation,” says Sarah Chamlin, MD, assistant professor of pediatrics and dermatology at Children’s Memorial Hospital in Chicago. “Their parents are trying to keep them from scratching and this can be a power struggle. And since children also have trouble sleeping, they are often irritable and unable to concentrate at school. ” Unfortunately, anxiety can also worsen symptoms.

Eczema creams and medicines for children

Whether your child has mild redness or a scaly rash from head to toe, their doctor can prescribe a variety of safe and effective medications.

These over-the-counter and prescription drugs reduce inflammation associated with eczema. “Parents often panic because they associate the word steroids with performance-enhancing steroids and muscle building, but these anabolic steroids are completely different from the creams we prescribe for eczema,” says Helen T. Sheen, MD. head of pediatric and adolescent dermatology. at Hackensack University Medical Center in New Jersey.The creams mimic cortisol and hydrocortisone, two steroid hormones your body naturally produces to control inflammation. In fact, the biggest problem doctors often see with topical corticosteroids is that parents are reluctant to apply them to their child’s skin when eczema flares up. “As a result, the eczema heals and worsens, so the baby eventually needs even stronger corticosteroids to control his symptoms,” says Dr. Shaffer.When used continuously over long periods of time, topical corticosteroids can cause side effects such as thinning of the skin and stretch marks. However, short-term daily use (up to one month) or long-term intermittent use (two days per week) were not associated with these complications.

These new topical anti-inflammatory drugs, Elidel and Protopic, were approved over five years ago for children over 2 years of age. Since they do not have the potential side effect of skin thinning associated with corticosteroids, they are especially beneficial for fragile areas such as the eyelids, armpits, and groin.However, many parents and doctors stopped giving these topical medications to children when the FDA issued a black box warning last year, citing evidence that the medications increased the risk of lymphoma in animals. The American Academy of Dermatology and the American Academy of Allergy, Asthma, and Immunology state that the drugs do not cause immunosuppression or an increased risk of cancer in humans. “The amount given to the animals was 47 times the maximum recommended dose for humans,” says Dr. Paller.”But it looks like a lot of pediatricians were intimidated by the use of these valuable drugs.”

OTC drugs like Benadryl can help relieve itching due to their sedative effects, Dr. Paller says. “If you give your child an antihistamine before he goes to bed, he will probably sleep better.” However, if it does itch, it may still start to itch later in the night.

Nondrug Eczema Treatment for Children

While medications play an important role in relieving symptoms, there are other important ways to prevent flare-ups.

“They replace missing lipids and protect the skin from external irritants,” explains Dr. Shin. Apply it every time your child gets out of the bath and after she goes swimming. Moisturizers can bite children with eczema, so you’ll have to experiment with different brands. Best over-the-counter choice: A thick ointment such as petroleum jelly or aquaphor. If your child complains about feeling too oily, try an OTC cream like TriCeram, which contains a natural oil found in the skin called ceramide.In the past few years, the FDA has also approved new prescription moisturizers like Atopiclair, which are made from fatty acids that form a strong skin barrier.

“Many parents mistakenly skip their baby’s bath because they are concerned that the water will dry out his skin,” says Dr. Nasir. However, bathing (for at least 10 minutes) actually keeps the skin hydrated and flushes away germs that cause infections. Ideally, your child should take a bath and wash their hair right before bed to get rid of any allergens or irritants that have accumulated on their skin or hair during the day.Bathing your child with oatmeal like Aveeno Bath can also be soothing.

90,000 Dyshidrotic eczema – symptoms and treatment

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Dyshidrotic eczema is an acute or chronic skin disease of the hands and feet, belonging to the group of pruritic dermatoses. This pathology is characterized by damage to the fingers, palms, soles with the formation of many delimited superficial cavities deep in the epidermis, which is accompanied by persistent itching.

The causes of the disease are not exactly known. It has been proven that with dyshidrotic eczema there is no dysfunction of the sweat glands. The provoking factors are stress, high ambient temperature, humid climate. The overwhelming majority of patients have a history of various allergic reactions and diseases.

Symptoms of dyshidrotic eczema

The preferred age of patients is from 15 to 40 years. Men and women get sick equally often. The pathological process begins suddenly.The chronic course is characterized by periodic exacerbations that occur at intervals of several weeks or even months. Patients complain of persistent itching in lesions, which usually begin on the lateral surfaces of the fingers. Further, there is the appearance of a rash on the palms and soles and the back of the fingers.
Rash with dyshidrotic eczema at an early stage is a small, deeply located vesicles, resembling granules in appearance. The diameter of the elements is not more than 1 mm.They are more often located in groups. In some cases, blisters may appear.

At a late stage, the vesicles merge with each other, gradually they open up with the formation of erosion. When rubbing the affected skin surfaces, papules and peeling are formed. When combing the elements – lichenization and cracks, which is accompanied by pain. As a rule, a secondary infection joins. Clinically, this is represented by the formation of pustules and crusts. Complications can be lymphangitis and lymphadenitis.This form often leads to purulent inflammation of the subcutaneous tissue.

Treatment of dyshidrotic eczema

The severity of the disease and other factors influence the choice of treatment option. You may also need to try more than one option before you can find the right one for your particular case.

For mild dyshidrotic eczema, your doctor may prescribe antihistamines such as claritin or benadryl to relieve symptoms.

In the acute stage of the disease, wet dressings with antiseptics and Burov’s liquid are used. In the presence of large bubbles, it is possible to pierce and empty them, while the bubble cap is not removed. In the presence of infection, antibiotic therapy is performed. Topical application of corticosteroids is possible. Local PUVA therapy (psoralens for external use together with UV radiation) gives a good effect.

Soaking hands and feet in cool water and applying wet cold compresses two to four times a day for 15 minutes can help reduce the discomfort associated with itchy skin.

The doctor may also recommend applying an ointment or moisturizer after using compresses. A moisturizer helps with dryness and therefore reduces itching, you can use petroleum jelly, Lubriderm and Eucerin creams, mineral oil, witch hazel.