Skin-Care Tips

‘I’m a Dermatologist Who Regularly Treats Eczema—Here Are 5 Things I Wish Every Patient Knew’

Photo: Stocksy / Lucas Ottone
If you're one of the 31.6 million people who's dealt with eczema at some point in their lives, you know firsthand how uncomfortable and irritating it can be. And while it can be easy to spot—dry red irritated skin accompanied by itching and flaking is usually a tell-tale sign—it's not always so easy to deal with.

Considering it's one of the most common skin conditions out there, though (second only to acne), it's thankfully something dermatologists are well-versed in treating. Hadley King, MD, a board-certified dermatologist based in New York City, regularly sees eczema patients, and says there are five things she makes sure that each and every one of them are aware of.

1. Know you're in it for the long haul

Eczema is a sensitive skin condition that makes your complexion more prone to irritation and dryness. When eczema is triggered—which can happen as a result of internal factors, like stress, or external ones, like cold dry air—the skin reacts by overproducing cells. This is what leads to those flaky, inflamed, pink and red dry patches. While eczema can show up during adulthood, most people who deal with the condition first notice it when they're under 18 (it tends to appear during infancy or early childhood, and some research suggests that there's a genetic predisposition associated with it). Though symptoms can improve with age, there's no way to fully get rid of it. "There is no cure for eczema, but there are great strategies and medications for helping to control it," says Dr. King.

2. Not all moisturizers are created equally

Because eczema is characterized by a weakened skin barrier—and because cold, dry air can exacerbate the situation—properly moisturizing is key for managing the condition. "For all ages, moisturizing and supporting the skin barrier are the mainstays of maintenance," says Dr. King. But not all moisturizers will do the trick. Dr. King says you need to use moisturizers that contain "humectants to hydrate, emollients to support the skin barrier, and occlusives to lock in the moisture, several times daily."

Humectants

"Humectants, like hyaluronic acid and glycerin, are mostly low-molecular-weight substances that bind water into the stratum corneum," says Dr. King. "They need to be used along with the other components in order to retain the water content."

Emollients

"Emollients are saturated and unsaturated variable-length hydrocarbons which help in skin barrier function, membrane fluidity, and cell signaling leading to an overall improvement in skin texture and appearance," says Dr. King. "They're often used in combination with emulsifiers. Examples include cholesterol, squalene, fatty acids, fatty alcohols, and ceramides."

Occlusives

"Occlusives are oils and waxes which form an inert layer on the skin and physically block transepidermal water loss," says Dr. King. "Examples include petrolatum, beeswax, mineral oil, silicones, lanolin, and zinc oxide."

3. Your shower habits can make a difference

While long, hot showers may help to temporarily relieve some of the itching associated with eczema, the practice can actually make your symptoms worse. That's because hot water can strip the skin, leaving your already-weakened barrier even more prone to irritation. With that in mind, "showers should be brief—seven minutes or less, use lukewarm rather than hot, and occur no more than once per day," says Dr. King. Additionally, she says to look for gentle cleansers "that are free of harsh detergents that will strip the natural oils from the skin, and that contain moisturizing ingredients."

4. A humidifier is a worthy investment

To keep eczema flare ups at bay, you'll want to avoid cold, dry air as best as possible—and having a humidifier at home can help. Dr. King suggests keeping one in your bedroom (we do, after all, spend at least one-third of our days in bed), which will keep the air moist and prevent dehydration in the skin.

5. Staying in contact with your doctor is key

Sometimes, over-the-counter moisturizers and lifestyle tricks aren't enough to manage eczema. When that's the case, you need to consult your doctor to get the correct medication. "When necessary, topical corticosteroids are also helpful, and non-steroidal anti-inflammatory topical medications may also provide benefit," says Dr. King. Plus, "any infections that develop should be treated, and in more severe cases, there are also systemic medications that can be helpful."

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