Your Everyday Guide to Living Well With Eczema
Share
Exercising With Atopic Dermatitis
You can and should exercise if you have atopic dermatitis, says Jeff Yu, MD, a dermatologist at Massachusetts General Hospital in Boston. “Exercise is important for everyone. Unfortunately, some patients with eczema are irritated by sweat and heat. I would encourage exercising in controlled climates indoors if you are intolerant to heat.”
“Swimming is also a great form of exercise that engages many muscle groups,” Dr. Yu says. “The chlorinated water can be helpful in decreasing inflammation in the skin. An important note is to rinse off all the chlorine from the pool water and moisturize immediately after.”
- Hydrate before, during, and after exercise.
- Choose light, breathable fabrics to reduce irritation to your skin.
- Take a break during exercise to rehydrate and cool down if you’re sensing a flare-up.
- Moisturize before and after you exercise. Before swimming, use a thicker application of emollient to act as a barrier.
- Bring your own shower gels and other shower products.
Managing Your Medications for Atopic Dermatitis
- Topical JAK inhibitors, such as Opzelura (ruxolitinib) cream, block enzymes that contribute to skin inflammation and itch in mild or moderate atopic dermatitis.
- Topical calcineurin inhibitors (TCIs) are nonsteroidal medications that help prevent symptoms such as redness, itch, and inflammation. Available TCIs include tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel).
- Topical PDE4 inhibitors can help prevent inflammation. Crisaborole (Eucrisa) is an FDA-approved topical PDE4 inhibitor for atopic dermatitis.
- Topical corticosteroid creams or ointments (available in varying strengths), such as hydrocortisone or clobetasol topical lotion, are applied to the irritated area in order to reduce inflammation and itching.
- Biologics, such as dupilumab (Dupixent) and tralokinumab-ldrm (Adbry), are injectable medications for moderate or severe atopic dermatitis that target molecules in the body that trigger inflammation.
- Oral immunomodulators, such as the JAK1 inhibitors abrocitinib (Cibinqo) and upadacitinib (Rinvoq), help rebalance the immune system to reduce inflammation in moderate or severe atopic dermatitis.
- Oral steroids such as prednisone may be prescribed in severe cases of atopic dermatitis to control inflammation.
- Phototherapy uses ultraviolet (UV) light to reduce inflammation.
- Systemic immunosuppressants, including azathioprine, cyclosporine, methotrexate, and mycophenolate mofetil, may be used “off-label” to treat atopic dermatitis, meaning they’re not approved by the FDA for this medical purpose.
- Over-the-counter medications for atopic dermatitis include antihistamines to address itching, and acetaminophen or naproxen for burning, pain, and inflammation.
Whichever course of treatment you and your doctor settle on, it’s important to take your medications on time, even if that means setting a reminder on your phone.
Complementary and Integrative Therapies for Atopic Dermatitis
Advice for complementary and integrative treatments for atopic dermatitis abounds, but there is limited medical evidence for their efficacy, Yu cautions.
Complementary and integrative therapies should be used in concert with therapies that have more substantial medical evidence and safety, and not as a replacement for them, Yu advises. “Just because something is natural doesn’t make it safe, or effective.”
Home Environment and Atopic Dermatitis
An important step in managing atopic dermatitis is minimizing the triggers and irritants in your environment that can cause flare-ups or make them worse.
Common triggers to avoid include fragrances — aerosolized especially — which can serve as an irritant on the skin or induce allergic contact dermatitis in patients with eczema. These include perfumes, colognes, and essential oil diffusers, says Yu. “I would make sure to avoid cigarette smoke in the home, as this can contribute to worsening eczema. Many people with eczema are at risk of developing asthma, and smoking can exacerbate asthma to a significant degree, especially in children.”
Desai recommends using 100 percent cotton towels and sheets, and washing them in fragrance-free fabric softeners and laundry detergents. “Also, if someone has pets in their home then they need to make sure that the pets are clean. They also need to make sure that they are not allergic to those pets.”
Personal Care With Atopic Dermatitis
“Moisturizers are the most important skin-care products for individuals with eczema,” says Yu. “The thicker the moisturizer, the better. Ointments such as petrolatum are the thickest and do the most to help moisturize the skin, while lotions and gels contain the most alcohol and do not moisturize as well.”
Also important in managing the disease is vetting personal-care product ingredients. “Potential allergens in personal-care products may play a significant role in eczema,” says Yu. “Preservatives are included in all products with a shelf life (regardless how natural or organic the label says it is).”
Both the NEA and the Asthma and Allergy Foundation of America (AAFA) have directories of products they certify to be eczema- and allergy-friendly.
Traveling With Atopic Dermatitis
Proper planning can ease the risks of traveling when you have atopic dermatitis. “Some hotels may have special accommodations available for patients with eczema,” says Yu. “I would also recommend contacting the hotel ahead of time to see if they can launder the sheets in fragrance-free detergent and avoid dryer sheets.” Naturally, if you have an allergy to feathers and down, then you’ll want to request bedding that is free of these materials.
“Sometimes I’ll even tell [patients] to take their own towel to make sure what they’re using is not abrasive to the skin,” says Desai. “Take your moisturizers and any creams with you. And if you need a doctor’s note to travel with those items through TSA at the airport, then ask for one. Also, I recommend that you not use hotel toiletries.” Those items may contain fragrances or other ingredients that can trigger a flare-up. Stick with your own toiletries that you know are safe.
