Managing Severe Eczema: Tips for Daily Care and Treatment

Severe eczema

Hello doctor, I started having a rash on my face at the beginning of July.
I thought it was a flare-up of my rosacea, so I continued using topical medication.
However, specific areas of the red rash did not go away.
On July 8th, I visited a dermatologist who diagnosed me with eczema and prescribed oral medication and a topical steroid.
That night, because of work, I applied a primer, and when I removed my makeup later, I noticed it had turned into a small, red, flat, dry patch resembling psoriasis.
The next day, I wore makeup to work again, and after removing it, I found that the red patches on my face, resembling psoriasis, had started to spread.
So, the following afternoon, I went to see another dermatologist who said I had severe eczema.
They prescribed me more medication and instructed me to apply topical steroids in the morning and evening.
However, as of today, July 13th, there has been no improvement at all.
What should I pay attention to in my daily skincare routine? I only wash my face with water, gently pat it dry with tissue, and then apply the medication without using any moisturizer.
If I want to apply a moisturizing lotion, such as Vaseline, should I do it before or after applying the medication?

Xiao Wen, 20~29 year old female. Ask Date: 2015/07/13

Dr. Wu Yuxin reply Dermatology

Without actually seeing the lesion, I cannot confirm anything and cannot provide much advice.
It is recommended to wear less makeup and use fewer makeup removal products.
In principle, skincare products should be applied first, followed by the ointment.

Reply Date: 2015/07/13

More Info

Managing severe eczema can be challenging, especially when symptoms persist despite treatment. Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition characterized by dry, itchy, and inflamed skin. It can be exacerbated by various factors, including environmental irritants, allergens, stress, and even certain skincare products. Here are some tips for daily care and treatment that may help you manage your condition more effectively.

Daily Care Tips
1. Gentle Cleansing: Since you mentioned using only water to wash your face, it's essential to ensure that the cleanser you choose is gentle and free from harsh chemicals or fragrances. Look for a mild, soap-free cleanser that is specifically formulated for sensitive skin or eczema-prone skin.

2. Moisturizing: Moisturizing is crucial for managing eczema. It helps to restore the skin barrier and prevent moisture loss. You should apply a moisturizer immediately after cleansing while your skin is still damp. This helps to lock in moisture. Products like petroleum jelly (Vaseline) or thick creams are often recommended because they provide a protective barrier. If you are using topical steroids, apply them first, and then follow with a moisturizer to help seal in the medication.

3. Topical Steroids: When using topical steroids, it's essential to follow your dermatologist's instructions regarding application frequency and duration. Apply the steroid cream to the affected areas as directed, and then apply your moisturizer afterward. This can help reduce inflammation while also keeping the skin hydrated.

4. Avoid Irritants: Identify and avoid potential irritants that may trigger your eczema flare-ups. This includes certain fabrics (like wool), harsh soaps, and skincare products with alcohol or fragrances. Opt for hypoallergenic products whenever possible.

5. Temperature Control: Hot water can exacerbate eczema, so use lukewarm water for washing and bathing. Also, try to keep your living environment cool and humid, as dry air can worsen skin dryness.

6. Sun Protection: If you are using topical steroids, your skin may be more sensitive to sunlight. Use a broad-spectrum sunscreen with an SPF of at least 30, even on cloudy days, and reapply it every two hours if you are outdoors.

7. Diet and Hydration: While there is no specific diet for eczema, maintaining a balanced diet and staying hydrated can support overall skin health. Some people find that certain foods can trigger their eczema, so keeping a food diary may help identify any potential dietary triggers.

8. Stress Management: Stress can exacerbate eczema symptoms. Incorporating relaxation techniques such as yoga, meditation, or deep-breathing exercises into your daily routine may help manage stress levels.

When to Seek Further Help
If your eczema does not improve with the current treatment regimen, or if it worsens, it is essential to follow up with your dermatologist. They may consider alternative treatments, such as phototherapy or systemic medications, depending on the severity of your condition.

Conclusion
Managing severe eczema requires a comprehensive approach that includes proper skincare, lifestyle adjustments, and ongoing communication with your healthcare provider. By following these tips and being mindful of your skin's needs, you can help reduce flare-ups and improve your skin's overall health. Remember, consistency is key, and it may take time to see significant improvements. If you have any concerns or questions about your treatment plan, do not hesitate to reach out to your dermatologist for personalized advice.

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