How to wash in case of atopic eczema?

Theatopic eczema or atopic dermatitis is a chronic inflammatory skin disease. Non-contagious, it is characterised by red patches that appear in flare-ups and are accompanied by itching. These flare-ups vary in duration and leave the skin very dry, this is referred to as xerosis. Following scratching of the skin, the latter thickens, this is known as lichenification.

According to several studies, 50 to 70% of children affected by eczema have a first-degree relative (father, mother, brother or sister) who has also been affected. Those suffering from it secrete large amounts of immunoglobulin E (IgE), antibodies, in response to environmental antigens (also called allergens). Moreover, it is often noticed in these individuals abnormalities affecting the gene coding for filaggrin, as well as other molecules necessary for the proper functioning of the stratum corneum.

This atopy is caused by a malfunction of the skin barrier, due to a lack of sebum, lipids, and cell adhesion molecules production, which can no longer fulfil its protective role. Environmental allergens can therefore easily penetrate the epidermis and cause a misdirected inflammatory response.

As previously discussed, in the case of atopic eczema, the individual's immune system secretes high quantities of IgE antibodies in response to allergens. Atopic skin is dry and the skin barrier does not function properly. Thus, allergenic molecules can easily penetrate the epidermis and come into contact with the skin's immune defence cells. To avoid exacerbating skin reactions, certain hygiene practices can be adopted.

• Preferably use a superfatted soap-free cleansing bar.

  To avoid itching, opt for a gentle, non-irritating cleansing care, preferably free from fragrance and allergens. There are soothing and non-lipid stripping shower care products, specifically formulated for individuals with atopic or sensitive skin. If in doubt, seek advice from your dermatologist who can guide you towards a suitable product.

• Limit the duration of showers.

  Water has a drying effect on the skin. However, individuals suffering from atopic eczema naturally have dry and sensitive skin. To avoid further weakening it, try to limit the time you spend in the shower.

• Avoid baths.

  When one has atopic skin, it is recommended to favour showers over baths, in order to limit the skin dryness caused by prolonged contact with water.

• Do not use excessively hot water.

  We recommend that you shower in lukewarm water if you suffer from eczema. Indeed, excessively hot temperatures disrupt the hydrolipidic film present on the skin, which further weakens the skin barrier.

• Gently wipe one's skin.

  Friction is a movement that can irritate sensitive skin and cause itching. When you dry yourself, do not rub your skin with your towel, but rather perform light patting. Also, favour towels that are soft and fluffy.

• Apply a nourishing cream after showering.

  To restore the skin barrier, the application of a emollient balm after showering is essential. This treatment helps to compensate for the skin's lack of lipids and prevents the evaporation of water and the passage of allergens, which are the cause of the inflammatory reaction. Emollient balms are treatments designed to nourish, soften and soothe the skin. They help to counteract the drying effect of showers.

• GOLDENBERG G. & al. Eczema. The Mount Sinai Journal of Medicine (2011).

• YEUNG J. & al. Diagnosis and treatment of pruritus. The College of Family Physicians of Canada (2017).