Eczema! Is my skin too wet or is my skin too dry? Let the doctor answer it!

Author: Dermatologist? Dr. You Yisheng

"The doctor said I have eczema, but my hands are extremely dry. How could it be eczema?"

" My hands are often wet, even so wet that they cause blisters. The doctor also said it is eczema. How could it be? ”

Is eczema caused by too wet skin or too dry skin? In fact, both of these are correct and neither is correct.

Everything is right, but also wrong? Please speak Chinese!

In fact, the skin with eczema can appear wet or dry; what needs to be remembered more is that the skin with eczema is afraid of being wet or dry.

Let’s look at two actual cases!

The first case is a typical hand eczema, which in vernacular is called rich hands. You can see red and swollen skin, dry and peeling. This is caused by frequent contact with detergents. Local eczema. The second case is hand blisters, or palmar vesicular eczema. You can see many small blisters scattered on the palms and fingers. This is in the acute stage of eczema because there is a gap between the epidermis and the dermis. Tissue fluid accumulates and separates, forming what appears to be blisters. (Sweat herpes has nothing to do with sweating) The skin of eczema can indeed appear dry or wet, so the skin of eczema is neither too dry nor too wet, but sensitive and fragile, so it is afraid of dryness in winter. , Afraid of sweating and getting wet in summer.

Why can a disease have completely different manifestations?

This starts with the performance of tissue sections. Skin with eczema, under a microscope, shows the infiltration of many inflammatory cells in the epidermis, and the epidermis becomes many small bubbles, which we call Spongiosis: When these small bubbles gather together, they form large bubbles. The large bubbles separate the epidermis from the dermis, so small blisters appear on the surface. This is acute eczema.

When eczema attacks again and again and the skin experiences repeated inflammation, the epidermis will thicken. The stratum corneum, which should have normal metabolism, accelerates metabolism due to inflammation, resulting in a lot of cells that have no time to fall off. Half of the cutin is stuck to the skin and half is lifted up. Clinically, it is what we see as "peeling" or "desquamation." Externally, we can see thick, red skin, combined with scaling; this It's subacute eczema.

When eczema attacks many, many times, the skin begins to react accordingly. In order to resist these repeated inflammations, the skin begins to proliferate and thicken. The external manifestations are thickening of the skin, When it dries out or even forms cracks, this is chronic eczema.

To use an analogy, the same person will have significantly different appearances when he is a baby, a teenager, and an old person, but he is still the same person! This can explain the above question. The same disease can have three different changes: acute, subacute, and chronic, but in essence, it is still the same disease.

Are the treatments for all three stages of eczema the same?

If you look at the drugs used alone, the treatments for eczema in the three stages are indeed similar. The only differences are the expectations for the course of the disease and how to prevent recurrence.

Acute eczema, depending on the cause, may cause an immediate allergic reaction just because of contact with the inducing substance. This one-time attack only needs to treat the immediate changes and can be treated as It is incidental event handling.

For subacute eczema, patients usually have a predisposition to eczema, so the chance of recurrence is high. In addition to treating the current lesions, patients must also cooperate with regular work and rest, active moisturizing, and avoidance of excessive cleaning. , in order to achieve effective control.

Chronic eczema, just by hearing the name, you will know that the course of the disease is ups and downs, and it is not easy to recover. The skin often appears rough and thick. At this time, it is very important in treatment to break the vicious cycle of chronic eczema: Don’t Grasp! Don't catch it! Don't catch it! Scratching the skin will cause more inflammation and thickening.

It’s easier said than done! What should I do if I feel itchy?

The pain is bearable, but the itching is unbearable. Eczema is very itchy. How can I relieve the itching without scratching?

Some people will say, I know I can’t scratch it, so I use pats, scrape it with the back of a knife, and rinse it with hot water to relieve the itching. This is actually wrong! Patting, scraping, or scalding with hot water will irritate the skin and dilate the blood vessels underneath, which will also worsen the inflammation of eczema and cause subsequent skin thickening.

Could it be that when eczema itches, you can only use thoughts and prayers? In addition to using thoughts and prayers, there is another good method: pour cold water, or use a cold wet towel to apply cold compress. After cold compress, the blood vessels of the skin will contract, and the itching feeling will be reduced.

After cooling down, patients with eczema should pay more attention to moisturizing and apply moisturizing lotion, cream, or ointment. These external moisturizers can not only protect the skin, but also provide local cooling.

Eczema cannot just rely on taking medicines

Compared with normal skin, eczema skin lacks epidermal barrier, so it is easily affected by the external environment. In summer, when you sweat a lot, , if the waste materials in sweat are not removed in time, they will irritate the skin with eczema and cause inflammation; in winter, the weather is dry and cold, and when the cold wind blows, the moisture content of the epidermis decreases, and the protection is even less effective, which can also cause inflammation.

Therefore, for eczema skin, taking medicine and applying ointments in the acute stage can only treat it, but cannot prevent the recurrence of the disease; more importantly, patients must understand their own skin and do not go to the oven or sauna; do not touch* ** Sexual substances such as dishwashing detergent, washing powder, bleach, and organic solvents; do not eat ** foods such as spicy hotpot and ginger duck; try to have a regular work and rest schedule, do not stay up late or suffer from insomnia; at the same time, apply moisturizer frequently to provide Protection can effectively reduce recurrence.

Sweat should not stay, moisturize three times a day

For skin care with eczema, please remember the twelve-word secret "Sweat should not stay, moisturize three times a day"

Sweat will irritate the skin, so once you sweat, in addition to drying it with a towel as soon as possible, rinse the affected area with clean water several times a day, then gently press it dry with a towel, and then add moisturizer to completely reduce the damage caused by sweat to the skin. influence. Clothes made of moisture-wicking materials have become very popular in recent years. Although it feels like the sweat dries quickly, the sweat actually dries on the skin and is not absorbed by the clothes. Therefore, the waste materials in the sweat still stay on the skin, just the same. Will damage the skin.

For patients with eczema, I would advise patients to choose pure cotton for close-fitting clothing. Although pure cotton clothing will be wet and uncomfortable after absorbing sweat, at least the clothes will absorb the sweat. Change it when it gets wet. While changing it, you can gently wipe the skin with a wet towel, which can also reduce the damage caused by sweat residue.

Moisturize three times a day, once after bathing, before going to bed, and before going out.

After taking a shower, the skin has the highest moisture content. This supplemental moisturizer can lock moisture on the surface of the skin, forming a protective barrier to isolate external bacteria.

When sleeping, if you cover yourself with a quilt, your body temperature will rise, and the rate of evaporation of water will also be accelerated; when water evaporates and the skin barrier disappears, it will easily itch, so eczema often breaks out in the middle of the night, for this reason; while sleeping Apply moisturizer before use to give the skin of the affected area an extra layer of protection, which can reduce water evaporation and prevent unconsciousness in the middle of the night. Keep scratching.

Outdoor wind, sun, rain, as well as road dust and air pollution, will damage the skin and make eczema worse. Therefore, before going out to fight, please help Skin Ready Armor: Moisturizer provides an extra layer of protection to delay recurrence.

Skin with eczema is afraid of getting wet or dry. Please remember the twelve-word secret and take good care of your skin.

I followed everything the doctor said, but why does it still keep relapsing?

Hands are one of the organs we use the most throughout the day, so hand eczema is often particularly difficult to treat.

In the outpatient clinic, I often hear patients ask me: "Doctor, I apply medicine carefully and use lotion all the time, but after stopping the medicine for a few days, the disease relapses. What is the reason?"

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Some recurring hand eczema is actually closely related to occupation! Moms who love cleanliness are always washing and scrubbing all day long; friends in the catering industry and bakers are exposed to oils, food ingredients, and detergents repeatedly; friends in beauty salons are exposed to water and organic solvents all day long. These are all occupations where hand eczema is common.

But if you don’t have a job, you won’t have food to eat, so what should you do?

At this time, I will emphasize to them the important order of wearing gloves!

Wear two layers of gloves, one layer of cloth and one layer of plastic, with the cloth on the inside and the plastic on the outside. Cloth gloves can absorb sweat, absorb foreign substances that accidentally penetrate into the gloves, and provide a buffer for the skin of the hands. More importantly, once the cloth gloves become wet, they must be replaced. A pair of wet gloves cannot remain stuck to the hands. Keep working.

When changing gloves, please rinse your hands with clean water to rinse away sweat, bacteria, and detergent. After replenishing moisturizer, put on dry cloth gloves or plastic gloves. Keep working.

Use gloves to effectively isolate harmful substances that you will come into contact with in the environment and at work to reduce the chance of recurrence. If you really cooperate with wearing two layers of gloves and applying moisturizer frequently, your hands will Local eczema usually resolves without medication.

For extremely stubborn hand eczema, dermatologists have a unique trick

Dermatologists have two tricks, which are also very effective for hand eczema that is extensively thickened and has large areas of scaling. , both of which must be performed under the supervision and guidance of a dermatologist, and are shared with everyone here.

Tip 1: Light treatment

For stubborn chronic hand eczema, because the skin has been in a state of repeated inflammation, if the inflammatory reaction can be effectively reduced, topical ointments will get twice the result with half the effort and speed up the treatment. Speed, single wavelength UV light irradiation can provide this advantage.

Phototherapy has a wide range of applications in skin diseases. Psoriasis, atopic dermatitis, eczema, sweat herpes, vitiligo, and uremic pruritus are all effective indications that have been used for many years. Phototherapy has been used for many years. There are not many side effects, and the dosage required for hand eczema is not high. Under the supervision of a dermatologist, it is a safe and effective method. (Dermatology phototherapy, answers to frequently asked questions at once)

Tip 2: Wet compress therapy

Wet compress therapy involves applying nourishing lotion and inflammation-controlling ointment together on the skin. The affected area is then sealed to double the absorption effect. For stubborn hand eczema, under the guidance of a dermatologist, the ratio of topical ointment and lotion is gradually adjusted, and the treatment period is set according to the course of the disease. Eczema is also an effective treatment.

(Wet compress therapy is safe and effective, please do this with me!)

Eczema is not an incurable disease. With good care and proper control, life with eczema can also be colorful!