Eczema--Continue

• Don't scratch, no matter how aggravating the itching becomes. Scratching can worsen the rash and cause an infection. Instead, put an ointment in the refrigerator to chill before applying, for extra analgesic effect.
• Bathe in lukewarm (not hot) water laced with bath oil, baking soda or a commercial oatmeal bath preparation. Use fragrance-free, nondrying soaps, such as Dove or Alpha keri, cleansers such as Cetaphil or baby shampoo. Pat rather than rub your body dry.
• Keep your skin moist. Dry skin is vulnerable, so routinely apply a nonirrating emollient moisturiser. Use it within three minutes of a bath or shower, and immediately after washing your hands. Good choices include petroleum jelly and sorbolene cream.
• Stop using all cosmetics and creams if a rash appears on your face. After your rash clears up, add them back one at a time, with a week between additions until you identify the troublemaker.
• Wear loose clothing. Fabrics that 'breathe' (cotton and other  natural fibres) are less likely to irritate than woollens and acrylics.
• Control your surroundings. Your skin prefers the thermostat at 20 degrees C with a comfortable level of humidity. This may mean using a humidifier in winter and a dehumidifier in summer.
• Try to minimise stress, a common eczema trigger. Practise deep breathing, walking or dancing. Consider seeing a counsellor or joining a stress management course. 

Medications
The severity of an outbreak will determine what kind of medication you'll need. In general, oozing spots dictate the use of a liquid or lotion, with rough, dry patches requiring an ointment or cream. Mild cases can be treated with a topical over-the-counter 1 percent hydrocortisone cream (such as Sigmacort) applied no more than twice a day after washing. If your eczema is more intractable, you may need a prescription topical corticosteroid. There are dozen of brands in a whole spectrum of strengths. Your doctor will decide which is right for your condition. You may also be told to apply a moisturiser on top of it. Powerful prescription oral corticosteroids (prednisone, methylprednisolone) are used only for severe cases. Wet dressings may be required to improve hydration and allow greater penetration of the  corticosteroid, especially when the itch is difficult to control.
   You may be able to control your itching--one of eczema's most annoying symptoms--with over-the-counter oral antihistamines such as promethazine (Phenergan) or dexchlorpheniramine (Polaramine). These help quell the urge to scratch, but also cause drowsiness. Ask your doctor if cetirizine (Zyrtec), a new, nondrowsy histamine blocker, might work for you instead. If your skin is not acutely inflamed, your doctor may prescribe a shampoo or ointment containing coal tar, which will reduce itching and inflammation.
  A promising development in the treatment of moderate to more severe eczema is the advent of nonsteriodal topical immunomodulators. These agents, not yet available in Austrialia, remain with the skin and do not get into the bloodstream. Consequently they do not have the systemic problems which may be associated with high-dose topical steroids and they seem safe for long-term intermittent use.

Natural Methods
Getting certain key nutrients through foods and/or from a daily vitamin/mineral supplement can have numerous benefits. Foods that are rich in vitamin A, beta-carotene and essential fatty acids may help to combat skin dryness. And foods that are high in zinc, the antioxidant vitamins C and E and the flavonoid quercetin may help stifle inflammation. Try applying a camomile cream or ointment. Camomile contains azulene, which is a natural anti-inflammatory that may relieve eczema on its own or can be applied over a cortisone cream.

NOTHING TO SNEEZE AT

If you have atopic eczema, you belong to a large, diverse family; those with hay fever (allergic rhinitis), asthma and other kinds of allergies. It's common for eczema sufferers to come from clans where wheezing and sneezing is the norm, and sometimes to be doubly afflicted. Furthermore, many children with eczema may grow out of their itchy skin condition, only to develop hay fever or asthma later.
  The mechanism that causes such allergic reactions appears to be generic; your body is programmed to react adversely to an antibody called immunoglobulin E, or IgE. This substance adheres to mast cells, which cause the swelling, redness and itching of an allergic reaction. It's no surprise that allergy and eczema sufferers usually  have high levels of IgE in their bloodstream.

Procedures
Phototherapy using ultraviolet (UV) light may be a treatment option if you have atopic dermatitis. In this procedure, you expose your skin to UVlamps at a wavelength prescribed by your doctor. You may also find that PUVA therapy, which combines an agent that boosts the therapeutic effect of light (psoralen) with ultraviolet A (UVA) light, is of benefit. Ask your doctor if either of these might be an effective part of your treatment plan.