American Medical Association Family Medical Guide - American Medical Association [756]
Diagnosis
If you have a mild form of dermatitis and know the cause, use the self-help measures at right. If you have a severe case of dermatitis or the self-help measures do not relieve your symptoms, see your doctor. He or she may refer you to an allergist or a dermatologist (a doctor who specializes in disorders of the skin), who may recommend skin and blood tests (see pages 912 and 913) to help determine the cause.
Self-Help for Dry Skin and Dermatitis
Skin can become dry for a number of reasons, such as overwashing or exposure to chemicals. Skin drying and irritation can usually be prevented and treated with the following measures:
• If possible, avoid contact with the substance that is causing your dermatitis.
• Don’t rub or scratch the affected areas. Fill plastic bags with water and freeze them, then apply the frozen bags to the affected areas to relieve the itching.
• Ask your doctor to recommend an over-the-counter corticosteroid cream or ointment (to reduce inflammation and promote healing), a pain reliever, or an antihistamine (to reduce itching, swelling, and redness).
• Don’t wash too often. Use a mild, superfatted soap and apply it with your hands or a clean sponge (not a washcloth or loofah, which are rough on the skin). Don’t use bubble baths or bath oils. Try to keep showers and tub baths short (no longer than 5 minutes), and use cool or lukewarm (not hot) water. Pat (don’t rub) your skin dry.
• Avoid saunas and steam baths.
• Protect your skin by using a moisturizer, especially right after bathing or showering.
• If dermatitis is on your hands, apply an unscented barrier hand cream frequently. Wear white cotton gloves under rubber gloves when working with a possible irritant.
• Don’t use perfumes, scented sprays, or talcum powder on your skin; these products can irritate the skin and worsen dermatitis.
• Don’t wear tight or poorly fitting clothes. Avoid rough, scratchy, or wool clothing, linens, blankets, rugs, or upholstery.
• Use mild laundry detergents, and rinse clothes in clear water twice. Don’t use fabric softeners.
• Avoid excessive sweating. Dress lightly in cotton clothing.
• Keep the temperature of your home cool and stable. Use a humidifier to keep the humidity level constant.
• Avoid caffeine and alcohol; they can make itching feel worse.
Treatment
In addition to the self-help measures described on the previous page, your doctor may recommend a liquid cleanser (a substitute for both soap and water) that cleans and lubricates the skin. He or she may prescribe a more concentrated topical corticosteroid medication to speed up the healing process and an antihistamine to take before bedtime to reduce itching at night to help you sleep. Tacrolimus is a topical prescription ointment used to treat mild to moderate dermatitis that doesn’t have the possible adverse side effects of topical corticosteroid preparations. Use only the creams or ointments that your doctor prescribes; using anything else may reduce the amount of natural oil produced by your skin. If you have a bacterial skin infection, your doctor will prescribe an antibiotic.
For mild cases of infantile eczema, try to prevent your baby from becoming too hot. Don’t overdress him or her. Dress your child in cotton clothes that are washed and rinsed well. Do not use moisturizers on your child’s skin that haven’t been prescribed or recommended by his or her pediatrician. Your child’s doctor may prescribe an antihistamine to prevent the release of substances called histamines that produce allergic symptoms such as itching. Severe infantile eczema is often treated with topical corticosteroid medications to relieve the inflammation. Your child’s doctor may recommend eliminating foods from your child’s diet that