Atopic Dermatitis

Managing overview

It's important to remember that while atopic dermatitis is a difficult disease, it is also a manageable one. With proper care, patients can lead fulfilling lives and participate fully in work and family activities. To do this, it helps to have an action plan. This section has details on developing such a plan, including:

• Controlling scratching
• Tips on clothing and laundry
• Tips on temperature
• Recognizing signs of infection
• When to consult a health care provider

Controlling scratching

Scratching is a natural response to the itching of the disease, but it only inflames the rash, making it itch even more. Further, scratching can break the skin's surface, making it prone to infections.

To control scratching:

• Wear light cotton gloves or even socks on the hands, particularly at night. Nighttime is when people unconsciously scratch themselves.
• Apply moisturizer when you feel itchy, instead of scratching or rubbing.
• Keep fingernails trimmed short and cut smoothly to prevent damage should you scratch.
• Keep hands busy.

Tips on clothing and laundry

Be careful about the clothes you wear and how you wash them. Care in these areas can help patients avoid irritants that trigger atopic dermatitis flares.

• Wash new clothes before wearing them. Formaldehyde and other irritating chemicals often are present in new clothing.
• Wear open-weave, loose-fitting clothing that lets air circulate freely over the skin.
• Wear cotton or cotton-blend clothing, which may be less irritating than other fabrics. If wool irritates your skin, avoid it.
• Remove labels if they bother you. If seams cause itching, try wearing clothes inside out while at home.
• Use fragrance-free, dye-free, liquid detergents. Use a second rinse cycle to remove any residual detergent.

Tips on temperature

Extremes of temperature and humidity can be a problem for people with this condition. Sweating caused by overheating and high humidity can irritate the skin. Low humidity causes water to be lost from the skin. This can lead to dryness and skin irritation. Actions you can take:

• Try to keep your surroundings at a comfortable temperature and humidity.
• Wear loose-fitting, open-weave clothing during hot weather and while exercising.
• If you swim for exercise, be sure you shower or bathe when you get out of the pool. Use a mild cleanser to remove chemicals, and then apply a moisturizer.

Recognizing signs of infection

Skin infections often are a problem for people with atopic dermatitis because the condition has damaged their skin barrier. Infections can become quite serious if they are not treated promptly, so it is important to recognize the signs:

• Increased redness
• Pus-filled bumps or oozing fluid
• Honey-colored crusts or scabs
• Cold sores or fever blisters

If you see any of these signs, contact a healthcare provider immediately. He or she can provide appropriate medication or other treatment.

When to consult a healthcare provider

Though the goal of managing atopic dermatitis is self-care, you should consult your healthcare provider if:

• You spot signs of infection.
• The severity of the rash or itching changes markedly.

Atopic dermatitis is categorized as mild, moderate, or severe. Patients usually can place themselves in one of these categories depending on how they feel. A change from one of these categories to another is reason to consult a healthcare provider. He or she can suggest changes in medications or in methods, such as "soak and seal," for bringing symptoms under control.