Advice for learning to live better with eczema.

Eczema is a skin inflammation characterised by the formation of red patches on the skin, accompanied by an intense itching sensation. There is not one but several types of eczema. The most common is atopic eczema or atopic dermatitis. This is a chronic inflammatory skin disease. This dermatosis develops in individuals with a genetic predisposition to atopy. Atopic eczema primarily affects young children. It can disappear during puberty or, less commonly, in adulthood.

Please note : the termatopy refers to an individual's tendency to develop anallergic reaction to environmental elements (animal hair, dust, pollen, etc.), which do not cause problems for the rest of the population.

Individuals affected suffer from red patches that itch intensely and sometimes ooze, along with extremely dry skin (xerosis). Due to the chronic itching that these individuals endure, their skin thickens, a condition known as lichenification . The skin no longer performs its role as a barrier against infections, leading to an increased risk of bacterial and viral infections.

Eczema is a challenging condition to manage on a daily basis due to the symptoms it causes (itching and skin dryness). Beyond the physical and sleep-related repercussions, eczema is a disease with a significant psychological impact. Certain advice can help to better cope with this condition on a daily basis:

• Use emollients daily.

  Eczema arises from a malfunction of the skin barrier caused by a lack of sebum, lipid, and cell adhesion molecule production. Indeed, as this barrier is no longer impermeable, it allows water to evaporate and external elements to penetrate the epidermis.

  To improve the condition of atopic skin, emollients are key elements. These are emulsions with a predominantly oily phase (oil in water emulsion). The supply of fatty substances helps to compensate for the lack of lipid production in atopic skin.

  Dermatologist Dr. LEVY GAREL explains the importance of emollients: "In the management of atopic eczema, the role of emollients is very significant. By restoring the skin barrier, they limit the occurrence of flare-ups. The application of emollient on atopic skin should be done at least once a day."

  Thus, the use of an emollient is essential for atopic skin. This is applied once to several times a day depending on the patient's needs.

• Use suitable hygiene products.

  The shower can be a challenging experience for individuals suffering from eczema. Indeed, prolonged contact with water can weaken the epidermis. Therefore, it is essential to adopt a gentle routine to provide comfort to the skin.

  Firstly, we favour warm showers over baths in order to reduce the duration of water contact with the skin. The water temperature should not be hot, as this dries out the skin and increases inflammation. Regarding your hygiene care, turn to gentle superfatted soaps, without irritating surfactants, soap-free and with a neutral pH.

  For atopic skin, the ideal is a shower oil. This type of product gently cleanses the skin while soothing irritations and restoring the skin barrier. Thanks to the re-lipidising and moisturising agents, the skin is nourished and protected. After showering, remember to apply your emollient to provide your skin with maximum comfort and restore its hydrolipidic film.

• Avoid exposure to irritating agents.

  As a reminder, atopic skin is skin that exhibits allergic reactions to environmental elements. Therefore, irritants should be avoided as much as possible.

  Regarding cosmetics, choose products with the simplest formulation that are suitable for atopic skin. The irritating cosmetics and those containing potentially allergenic substances (essential oils, certain preservatives...) should be avoided.

  The choice of clothing is also very important! Certain fabrics such as synthetic wool can irritate the skin. Therefore, it is preferable to choose cotton clothing.

  Please note : it is also advisable to wear loose clothing to avoid friction on the skin, which can cause irritation.

• Avoid scratching as much as possible.

  Scratching is an automatic and natural need. It's a normal response to itchiness. However, scratching and scraping one's skin exacerbates eczema lesions. Moreover, the sensations of itchiness impair quality of life by disrupting sleep and causing irritability. There are anti-scratch solutions available.

Eczema often equates to challenging nights. Indeed, at night, the sensation of itching intensifies, and the risk of scratching increases. Keep a soothing cream or thermal water close to hand. You can also wear cotton gloves to prevent scratching yourself. Keep your nails short and maintain good hand hygiene to limit the risk of infections.

• Reap the benefits of the sun.

  Just as in psoriasis, the sun has shown numerous benefits for atopic skin. Several studies have demonstrated the effectiveness of phototherapy using UVB in children suffering from moderate to severe eczema. This allows for a significant reduction in their lesions, up to about 60%. If you suffer from atopic eczema, exposure to the sun could improve your skin lesions. However, it is necessary to adhere to sun protection rules to avoid the harmful effects of UV rays.

• TAYLOR A. E. M. & al. Narrowband ultraviolet B phototherapy in children with moderate-to-severe eczema: a comparative cohort study. The British Journal of Dermatology (2014).

• SALAH E. M. & al. The impact of vitamin D supplementation as an adjuvant therapy on clinical outcomes in patients with severe atopic dermatitis: A randomized controlled trial. Pharmacology Research and Perspectives (2020).