Eczema
Eczema
Eczema
Eczema
Eczema Education Series
www.eczemahelp.ca
EDUCATION
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EDUCATION EDUCATION
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EDUCATION TRIGGER CHART
Deoderants
Perfumes
Cosmetics
Shampoo/hair
products
Bubble bath/
bath oils/scented
bath salts
Wool/other
fabrics
Latex/rubber/
plastic
Tobacco smoke
Plants
Cleaning
products
Foods (eggs,
milk, wheat,
citrus foods, soy,
seafood, etc.)
Sweating
Change in
weather
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EDUCATION HYDRATING THE SKIN
Psychological Impact of Eczema Does drinking lots of water help to hydrate the
Eczema can be a significant burden and have skin?
a psychological impact on sufferers and their It is a common myth that drinking an
families, and can contribute to feelings of adequate amount of water during the
embarrassment, social withdrawal, depression, day will hydrate the skin. It is in fact the
and anxiety. The condition can have a negative bathing and moisturizing technique that
impact on mood and daily living, as it can be a hydrates the skin. Decades ago, doctors
chronically painful and uncomfortable condition.
Sleep disruption is very common, which also often recommended that eczema sufferers
impacts psychological well-being. Speak with limit baths and showers; however, experts
your or your child’s care provider about any now recommend bathing as an important
concerns related to psychological well-being. part of controlling eczema.
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HYDRATING THE SKIN HYDRATING THE SKIN
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HYDRATING THE SKIN HYDRATING THE SKIN
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MEDICAL MANAGEMENT MEDICAL MANAGEMENT
Topical Topical prescription treatment for Mild to moderate burning sensation may occur.
Immunomodulators inflammation and itching. Can be used
(e.g. Elidel® and for short or repeated periods of time.
Protopic®)
Topical PDE4 Inhibitors Eucrisa™ (crisaborole) is a topical PDE4 The only reported side effect was pain from stinging and
(e.g. Eucrisa™) inhibitor for eczema that is approved burning of the skin where the ointment is applied. This is the
by Health Canada for the treatment only side effect noted in the product monograph and occurred
of mild-to-moderate atopic dermatitis in less than 4% of clinical study participants.
(eczema) in patients two years of age
and older. Clinical trial data for Eucrisa™
(crisaborole) shows a reduction in the
symptoms of atopic dermatitis such as
itching, redness, weepy rash, raw lesions
and skin thickening.
Topical Antibiotics with The topical antibiotic Fucidin® combined Long-term use may cause bacteria to become resistant to
Topical Corticosteroids with topical corticosteroids is used the antibiotic.
(e.g. Fucidin® H, to treat inflammation and bacterial
Fucibet®) infection. Recommended when bacteria
is suspected to be contributing to
the eczema flare. Preferred when the
infection is on small areas of the skin.
Fucidin® H is Fucidin® combined with a
mild topical corticosteroid, and Fucibet®
is Fucidin® combined with a mid-potency
topical corticosteroid.
Skin Barrier Repair A skin barrier repair emulsion which is After application a temporary tingling sensation may occur.
Emulsion (e.g. EpiCeram®) applied to patches of active eczema, as
directed by your physician.
ADDITIONAL TREATMENTS
Type of Treatment Uses Drawbacks/Concerns
Biologic Drugs Biologic drugs are injectable The most common side effects of dupilumab are
(e.g. Dupixent™) treatments indicated for moderate conjunctivitis (commonly called pink eye) and redness and
or severe atopic dermatitis other symptoms at the site of the injection. Speak to your
not responding to topical doctor about the safety of this and all medications
medication. Biologic drugs work to to manage atopic dermatitis (eczema).
stop the process of inflammation that
occurs with atopic dermatitis. Speak
to your doctor about whether this
treatment is suitable for you.
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MEDICAL MANAGEMENT MEDICAL MANAGEMENT
Phototherapy Reduce symptoms of eczema. Prolonged exposure to UVB light can cause sunburn, skin
damage, eye damage, skin cancer, dry skin, freckling, and
premature aging of the skin. This is recommended as a
second-line treatment and is only used under the guidance
of a physician.
Oral corticosteroids Only used in the most severe cases, to There are long-term side effects with prolonged use,
(e.g. prednisone) control wide spread inflammation on the and because eczema is a chronic condition, this is not a
skin. permanent solution for severe chronic eczema.
Antihistamines Sometimes used to relieve itching and Antihistamines are not recommended as part of regular
aid in sleep. treatment. They can cause drowsiness, although this
is often what helps with reducing itch. Skin that is
well hydrated through bathing and moisturizing should
become less itchy, and therefore reduce the need for
antihistamines. Use of antihistamines for children 6 years
of age and under is not recommended. Antihistamine use
should be discussed with a health care provider.
ADJUNCTIVE THERAPIES
Type of Treatment Uses Drawbacks/Concerns
Bathing & Moisturizing To increase hydration of the skin, reduce Risk of injury from slipping if oils or additives are used in
itching, reduce inflammation, and the bath.
prolong time between flare-ups.
Cold Compresses To relieve itching and burning associated While this only offers temporary relief, it can be very
with inflammation. When skin is helpful during a flare, or an intense period of itchy skin.
inflamed cold compresses or a cold
pack may be helpful to soothe and cool
the skin, and help to relieve itching.
Soft cotton fabric can be soaked in
cool water and applied to the skin for
5-10 minutes (wring out excess water
before applying to the skin). Follow the
compress with a moisturizer. Note that
cold packs or ice packs should not be
applied directly to bare skin.
Wet Wraps Relieve itching and help hydrate the Maceration, or damage to the skin, may occur. Do this
skin. treatment only under the advice of your health care
provider.
Homopathic Remedies, Itching, redness, inflammation. Little and/or no data or research supports the effects
Naturopathic Remedies, or the safety of these treatments. Be advised that there
Alternative Therapies may be side effects and drug interactions from these
treatments. Patients and parents of patients should have
a clear understanding of the expectations of what these
treatments are meant to do.
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MEDICAL MANAGEMENT
Bleach Baths
Bleach baths are sometimes recommended by
health care providers to help manage eczema in
patients who experience frequent infection.
• For smaller bathtubs, a good rule of thumb Note that bleach baths are not for everyone
is to use 1 teaspoon (5 ml) of regular with eczema, and should only be used under
bleach for every 5 litres of water. Always
the care of your doctor. Consult your physician
exercise caution when handling bleach,
and remember to protect clothing, bath regarding bleach baths to see if these
mats, towels, etc., as they may become treatments are appropriate for you or your child.
bleached from the solution.
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Eczema Tips and Facts What does the Eczema
• Often kids will outgrow eczema. Society of Canada do?
• Eczema is not contagious. You cannot “catch” • Supports and educates patients and
it from a school playmate.
caregivers living with eczema
• Keeping your skin moist and well hydrated (e.g. • Provides eczema information at
applying moisturizer several times throughout
the day) is the best defence against recurrent www.eczemahelp.ca
flares.
• Provides accredited and certified
• Use a cool-mist humidifier in the house or in medical education to health care
the bedroom of the eczema sufferer, especially providers across Canada
during the dry winter months. Clean as
directed to prevent potential mold growth. • Participates in media to raise
awareness about eczema
• Avoid overheating and sweating when possible,
as it increases itchiness, and can worsen • Created a Seal of Acceptance program
eczema. for products which are suitable for use
by people with eczema
• Cotton clothing is often best tolerated by
people with eczema. • Funds and contributes to eczema
research
• Avoid harsh soaps, and try to select products
that are formulated for eczema and/or
sensitive skin. • Advocates for eczema sufferers for
better care and treatments
• Many sunscreen products contain irritating
ingredients. Look for sunscreens that are • Hosts the Eczema Care Network,
formulated for sensitive skin, or look for a directory of dermatologists and
formulations with physical sunblocks (e.g.,
titanium dioxide or zinc oxide). specialists across Canada who are
dedicated to helping patients suffering
• Other sun protection strategies should always with eczema
be used, when possible. These strategies
include avoidance of peak sun exposure time
(typically mid morning to late afternoon); use
of a wide brimmed hat; use of loose and light
protective clothing.
• Keep nails trimmed short and filed smooth.
This will help to reduce damage done to the
skin from scratching.
• Ensure that you use your prescription products
as recommended by your doctor. Eczema
sufferers often use too little, rather than
too much, of their topical treatments, which
reduces the effectiveness of the medication.
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About the Eczema Society
The Eczema Society of Canada is a registered
Canadian charity dedicated to eczema education,
support, awareness, and research.
www.eczemahelp.ca