By Cynthia Bailey MD.
Dermatologist's Advice and Tips for Eczema
This term is most commonly used to describe atopic eczema, an inherited skin problem that describes the classic case of those born with “sensitive skin”. People with atopic eczema (dermatitis) have dry skin that loses moisture more easily than normal skin, and is more easily irritated by harsh products. Their skin immune system is hypersensitive and allergies to ingredients such as fragrances and preservatives are more common. When eczema develops, it is a rash characterized by redness, scale, and sometimes weeping, crusting, and small fluid-filled blisters.
The best hypoallergenic, hydrating skin care routine is extremely important for anyone with eczema.
That includes gentle soaps and cleansers used with cooler water temperature to help avoid stripping skin oils and irritating sensitive skin. Ingredients that calm inflammation, such as green tea antioxidants, are helpful. It’s important to lock in skin hydration after bathing by applying moisturizer within 3 minutes after toweling dry. Hypoallergenic and deeply hydrating moisturizers are really important to control eczema. Sun protection is always important, and sunscreens should be both non-irritating and hypoallergenic.
Know that the term “eczema” is actually much broader than atopic eczema; it actually describes a type of change in the skin called spongiosis, and can be seen in allergic dermatitis, dandruff, and other more complicated rashes.
What are the main types of eczema?
Atopic dermatitis, which is usually is hereditary and can involve all of the skin of the body. It often starts in the folds of the elbows and behind the knees. Areas of skin with atopic eczema are prone to a skin infection called impetigo. In this type of eczema, skin structure is weaker than normal. Skin moisture is lost easily and skin irritation happens more readily. Allergens also seep into skin faster than with normal skin. In addition, atopic eczema prone skin has an immune system that is hyperactive, leading to allergic reactions to many things such as wool, perfumes, laundry soap, ingredients in skin care products etc. People with atopic dermatitis need to use hypoallergenic skin care products to prevent developing allergic reactions in the future.
Scalp and face eczema due to seborrheic dermatitis. Scalp skin and the seborrheic areas of the face can appear dry, red and itchy. Skin with this type of eczema is sensitive and easily irritated by harsh personal care products, weather etc.
Dry skin eczema, also called nummular or asteatotic eczema, often starts on the arms and legs. It gets worse with age. Hands are also very prone to this type of eczema, as is facial skin when exposed to cold or windy weather.
Allergic contact dermatitis is eczema due to something your skin touched that it was allergic to, such as poison oak or ivy, or an allergen such as fragrance, essential oils, metal etc
Irritant dermatitis is caused when your skin’s barrier breaks down due to direct contact with something harsh such as harsh solvents, dish soap, acne treatment ingredients, etc.
Eyelid eczema (dermatitis) is due to contact of your delicate eyelid skin with an allergen or irritating substance such as harsh soaps, acne medicine ingredients, airborne chemicals or allergens, harsh hair care products that wash over your face, allergens carried to eyelids from your hands, etc. These taunting allergens and irritant substances cause a rash on delicate eyelid skin more readily on any of the thicker skin covering the rest of your body.
Dyshydrotic hand eczema is a type of eczema where intensely itchy blisters develop on the sides of fingers, toes, palms and soles. The cause is unknown. These blisters can lead to painful cracks in this very thick skin.
Stasis dermatitis, is a type of eczema occurring on the lower legs due to poor circulation of the leg veins. It can be a chronic condition and the eczema can lead to serious skin infection called cellulitis.
All types of eczema involve damaged skin barrier. The rash is visual evidence of breaks in the skin barrier. Eczema leads to hypersensitive skin that is easily irritated.
Skin care treatment that heals eczema must include a hypoallergenic and hydrating skin care routine
This is important to support skin barrier repair. It includes:
- Using only gentle soaps and cleansers on eczematous skin and be certain to rinse off all of the cleanser well.
- Bathing and washing skin with cooler water temperature. Cooler water helps avoid stripping your natural skin oils. It also helps reduce inflammation (have you noticed how red skin gets on contact with hot water – that increased circulation brings the building blocks of inflammation aka eczema!)
- Applying hypoallergenic and deeply hydrating moisturizers. This is really important. For best results, lock in skin hydration after bathing by applying moisturizer within the magic 3 minutes after toweling dry.
What are the best skin cleansers for eczema?
Natural soaps made without botanical essential oil scents are a great choice. Gentle pH cleansers and bar soaps are another great choice for skin cleansing. I list my favorite below.
What are the best skin moisturizers for eczema?
Again, hypoallergenic moisturizers that are free of fragrance and harsh preservatives are best for eczema prone skin. Light weight products are often not moisturizing enough. Look for products with oils, ceramides and glycerin.
Ingredients that calm inflammation to help eczema heal include green tea antioxidants.
Green tea can be found in skin care products. The most powerful product is my Green Tea Antioxidant Skin Therapy which I have found helpful for some types of eczema, especially facial eczema from seborrhea. Other helpful ingredients include oats.
Sun protection for eczema
Sun protection is always important for healthy skin. Sunscreens for eczema should be both non-irritating and hypoallergenic. Mineral zinc oxide based sunscreen products are the best choice for eczema prone skin.
People with eczema need to avoid common allergens beyond those in your personal care products
Home cleaning products are an important source of allergen exposure. For all types of eczema except stasis dermatitis, home cleaners need to be hypoallergenic and non-irritating. I have developed my All Purpose 100% Natural Liquid Cleaner and Natural Spray Cleaner especially for my eczema prone patients. Remember, eyelid dermatitis can be caused by airborne spray cleaner droplets, hand dermatitis is worsened by allergens and irritants in home cleaning products and atopic eczema prone skin readily develops allergic reactions to taunting home cleaning product ingredients! Yes, even your home cleaning products are important to your skin’s health when eczema is a skin problem.
Find hypoallergenic home cleaners and personal care products below that are ideal for people suffering from eczema.
I have created a range of products to fit most product preferences and skin care habits. Whether it's your entire body skin, your face, or just your hands that suffer from eczema, I've got the building blocks of a skin care routine to help heal your eczema and keep your skin healthy and comfortable.
All of my skin cleansers are hypoallergenic. Choose from naturally made soaps rich in hydrating glycerin, such as my All Natural Foaming Hand Soap and Naturally Best Bar Soap. (Please note that 'naturally made soaps' are not pH balanced.) I also have a classic dermatologic cleanser for sensitive skin, called SYNDETS (synthetic detergents). They are pH balanced and include Vanicream Cleansing Bar Soap. If you like to use a facial toner, you can follow your facial cleansing with a hydrating toner, such as my Naturally Hydrating Pore Refining Toner.
I created my Naturally Eczema Free skin care kit to give you safe product alternatives for the most common skin care products that cause allergic contact eczema.For hand eczema, there's Dry Skin Hand Cream, and for those suffering from
severely chapped hands, I recommend the Dry Hand Repair Kit to provide your hand skin with intensive repair therapy.
If you have eczema, you need smart skin care choices screened and created by a dermatologist who knows the nuances and pitfalls of your eczema-prone skin. I've worked hard to curate my product line for people like my family, my patients, and you - we are folks who need the absolute best eczema treatment for our sensitive skin.
If you would like more specific skin care tips for eczema please see:
Verallo-Rowell VM1, Dillague KM, Syah-Tjundawan BS., Novel antibacterial and emollient effects of coconut and virgin olive oils in adult atopic dermatitis. Dermatitis. 2008 Nov-Dec;19(6):308-15.
Joi A. Nichols and Santosh K. Katiyar, Skin photoprotection by natural polyphenols: Anti-inflammatory, anti-oxidant and DNA repair mechanisms, Arch Dermatol Res. 2010 March ; 302(2): 71. doi:10.1007/s00403-009-1001-3.
Boozalis E, Patel S, “Allergen of the Year” alkyl glucoside is an ingredient in top-selling sunscreens and facial moisturizers, Journal of American Dermatology (2017), Volume 78, Issue 4, 809 - 810 doi: 10.1016/ j.jaad.2017.10.013.