Persistent Itchy Skin: and Treating Eczema-Related Wounds

Red, itchy lesions that have not healed for a long time?

Hello, doctor.
I have had atopic dermatitis since childhood, but it hasn't been severe except for my neck, which is mostly just red with a few areas being more swollen.
Recently, my finger joints became suddenly very itchy, and I scratched them, resulting in a slightly deep wound that shows a pinkish area and oozes a little fluid.
If I don't scratch it, it becomes red and swollen with a layer of dry, hard skin on top, but it can be very itchy at times.
I'm not sure what it is.
A bit earlier, the joint on the back of my other hand also became suddenly itchy, and I scratched it, resulting in a similar wound.
Initially, I applied ointment and antiseptic solution myself, but it didn't improve.
I went to a dermatology clinic, and the doctor told me to apply Gentamicin (as Sulfate) from a local biotech company, and not to remove the yellow crust that formed.
However, it still hasn't healed, so I went to see a surgeon.
The surgeon said the wound was not infected, removed the crust, and advised me to clean it daily with saline solution.
He prescribed tetracycline eye ointment and told me it would take two months to heal.
From the time I got the wound until I saw two doctors, at least three months have passed.
I noticed that applying the ointment sometimes helps, but at times it still becomes red and swollen.
At night, it tends to itch more, and occasionally, I scratch it in my sleep, which causes it to become red and swollen again, and sometimes the ointment oozes fluid.
I have a compulsive behavior where I want to tear at uneven areas to make them flat, and the persistent wound makes me feel very anxious.
When it itches, I can't help but scratch a little.
Could you please advise me on how to improve the condition of these wounds? Do I need to see another specialist? Is it common for a scratch from itching to result in a split wound? Thank you, doctor.

Niming, 20~29 year old female. Ask Date: 2018/01/10

Dr. Wu Yuxin reply Dermatology

Based on your description, your issue is "persistent itching," so the most important thing is to reduce the severity of the itch and minimize the chances of scratching.
Active treatment in dermatology is crucial.

Reply Date: 2018/01/10

More Info

Eczema, also known as atopic dermatitis, is a chronic skin condition characterized by dry, itchy, and inflamed skin. It can manifest in various ways, including persistent itching, redness, and the formation of wounds due to scratching. Your description of the itchy skin on your fingers and the resulting wounds aligns with common symptoms of eczema. The fact that you have a history of atopic dermatitis suggests that your current symptoms may indeed be related to this condition.

When it comes to treating eczema-related wounds, the primary goal is to manage the underlying eczema while promoting healing of the affected skin. Here are some recommendations based on your situation:
1. Moisturization: Keeping the skin well-hydrated is crucial. Use a thick, fragrance-free moisturizer regularly, especially after bathing. This helps to lock in moisture and prevent the skin from becoming too dry, which can exacerbate itching and irritation.

2. Topical Steroids: For areas that are particularly inflamed or itchy, topical corticosteroids can be effective in reducing inflammation and relieving symptoms. However, they should be used judiciously and under the guidance of a healthcare professional to avoid potential side effects, especially with prolonged use.

3. Avoid Scratching: It’s important to resist the urge to scratch, as this can lead to further damage and potential infection. Keeping your nails short and wearing gloves at night can help minimize scratching during sleep.

4. Wound Care: For the wounds you have developed from scratching, it’s essential to keep them clean and protected. You can gently cleanse the area with saline solution and apply a thin layer of an antibiotic ointment, such as bacitracin or a similar product, to prevent infection. If the wound is oozing, it may be beneficial to cover it with a sterile bandage to protect it from further irritation.

5. Consultation with Specialists: Given the persistence of your symptoms and the slow healing of your wounds, it may be beneficial to consult a dermatologist who specializes in eczema and skin conditions. They can provide a more tailored treatment plan, which may include stronger topical treatments or systemic medications if necessary.

6. Behavioral Strategies: If you find yourself engaging in compulsive behaviors related to your skin condition, such as picking at the wounds, it may be helpful to speak with a mental health professional. They can assist you in developing coping strategies to manage anxiety and reduce the urge to scratch or pick at your skin.

7. Identifying Triggers: Eczema can be exacerbated by various environmental factors, including allergens, irritants, and stress. Keeping a diary of your symptoms and potential triggers can help you identify patterns and make necessary lifestyle adjustments.

8. Lifestyle Modifications: Consider implementing changes in your daily routine that may help reduce flare-ups. This includes wearing breathable fabrics, avoiding harsh soaps and detergents, and managing stress through relaxation techniques or exercise.

In summary, while eczema can lead to persistent itching and skin damage, a combination of proper skin care, medical treatment, and behavioral strategies can significantly improve your condition. If your symptoms continue to worsen or do not improve with home care, seeking further evaluation from a dermatologist is advisable. They can provide a comprehensive approach to managing your eczema and promoting healing of your skin.

Similar Q&A

Effective Treatments for Persistent Eczema: Beyond Topical Creams

I have been experiencing eczema on my buttocks intermittently and have sought medical attention several times. However, the treatment has mostly consisted of topical ointments. The doctor also suggested considering injections, but I am hesitant due to concerns about potential sid...

Dr. Hong Zhengsheng reply Dermatology
Hello, Kiwi: [Finding a trusted dermatologist for consultation] is the best advice for you. I apologize, but based on your written description, it is currently impossible to determine your exact condition. Answers found online can only speculate based on the description and exper...

Understanding Eczema: Diagnosis and Treatment for Children’s Skin Issues

Dear Doctor, I am very troubled by my child's skin issues, and my child feels embarrassed when interacting with peers. Is the diagnosis eczema and atopic dermatitis? The eczema on the fingers and the atopic dermatitis lesions have been recurring in ten different areas of th...

Dr. Zhang Zhibo reply Dermatology
Hello: "Eczema" broadly refers to dermatitis, characterized by symptoms such as redness, swelling, and itching. "Atopic dermatitis" is actually a chronic, recurrent allergic inflammatory skin disease. There are certain diagnostic criteria that must meet at lea...

Managing Persistent Skin Conditions: Seeking Effective Treatment Solutions

Hello, my husband suddenly developed several skin conditions that have persisted for 8 to 9 months. He has hand dyshidrotic eczema (which is not itchy), folliculitis on his body, eczema, and seborrheic dermatitis on his scalp. This has been troubling us for quite some time, and d...

Dr. Zhong Yitun reply Dermatology
The patient's skin condition includes eczema, folliculitis, and seborrheic dermatitis on the scalp, which suddenly appeared about 8-9 months ago. It is necessary to determine whether this is caused by external stimuli or allergies, which requires an examination by a dermatol...

Chronic Eczema: Understanding Persistent Itching and Treatment Challenges

I have been experiencing itching on my neck and buttocks for many years without knowing the cause. Sometimes the itching becomes unbearable, and scratching leads to broken skin, which is even more uncomfortable. However, during the winter months, the symptoms seem to improve or e...

Dr. Jiang Zheen reply Dermatology
Eczema can be classified into exogenous and endogenous types. Exogenous eczema is caused by substances in the external environment that the skin may come into contact with, while endogenous eczema is related to an individual's inherent constitution and allergic predispositio...