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An Overview of Eczema and Treatment Options
Happy 6 Months, Team!
Disclaimer: I am not a doctor, just a cartoon deer on the internet with a background in chemistry and a hyperfixation on skin. This is not medical advice.
This is a bonus free post on my six month anniversary of becoming Fawn! I’m so glad you guys are here. From the bottom of my heart, thank you!
Now, in the last six months, I’ve talked to a number of clients dealing with eczema and psoriasis. It’s not a fun condition to deal with. An eczema flare-up will leave you itching with irritated skin, dryness, and scaly/rough patches.
While it’s hard to pinpoint actual cause, there is evidence that common household items like soaps or metals can be responsible for trigger an allergic reaction in the form of eczema. If you suffer from eczema, consider searching through the products you commonly use in your house and kitchen to see if the ingredient lists contain formaldehyde, isothiazolinone, cocamidopropyl betaine, or paraphenylene-diamine. Further, as the dermatitis showing up on your skin is an inflammatory response, you may want to consider an elimination diet to test how dairy, gluten, and vegetables may be contributing to your eczema.
Buuuut by now y’all know that I’m more interested in topical solutions than just discussing root cause. Some ideas I have for treating eczema over the counter involve a solid moisturizing routine, topical steroids, chemical exfoliation, and retinoids.
Developing a consistent moisturizing routine will alleviate some issues with light to moderate eczema by replenishing your skin with lipids. This is my preferred moisturizer. If you prefer something formulated without parabens, this is a good option. Both of these formulations are gentle and devoid of common irritants.
The best way to incorporate this into your routine is to moisturize right after you finish your shower. When your skin is wet, the top layer of your skin increases in volume and thus becomes more permeable. Increased uptake of the moisturizer into your epidermis will understandably improve its effectiveness. I call this The Corneocyte Phenomenon, and you can read this to understand more.
2. Topical steroids
Because eczema is an inflammatory immune response, logic would dictate the use of steroid treatment to inhibit the JAK1 and JAK2 pathways. This is just a fancy way of saying we’re trying to decrease inflammation in the body in an analogous method to taking ibuprofen to kill a fever, for example. A topical steroid you can get over the counter would be 1% hydrocortisone ointment. You can apply the ointment to the inflamed patches of skin and top with a moisturizer.
For particularly severe cases of eczema, you can consider visiting a dermatologist for a prescription for immunosuppressive oral steroids.
3. Alpha Hydroxy Acids
I love AHAs! Y’all know I talk about them all the time in the context of anti-aging, but we can apply their function to eczema as well. AHAs work by dissolving the lipids that hold the top layer of our skin together, allowing it to be sloughed off. In the context of eczema, I’m most familiar with using lactic acid, which looks like this:
Lactic acid is a fairly small molecule so it will penetrate the epidermis well. However, if the eczema presents on your face, you may be uncomfortable using lactic acid due to the strength and chance for irritation. A more gentle acid you could consider would be mandelic acid, which looks like this:
Because mandelic acid is bigger than lactic acid, uptake into the epidermis will decrease making it somewhat less effective, but more importantly, less irritating. You can think of it like washing your potatoes in a colander - the water runs through the holes in the colander because it’s smaller than your potatoes, right? Same concept applies. Here are two affordable ($8) serums you can try:
I would recommend applying at night before going to bed with a moisturizer layered on top. Then, make sure to rinse off the morning. Fair warning - AHAs can increase your skin’s sensitivity to the sun, so you may burn more easily. Thus, you should consider wearing SPF.
Okay, I lied when I said I loved AHAs. My true love is for retinoids. If you’ve been following me on Twitter for long enough, you already know this. Retinoids are incredible! Upon metabolism and conversion to retinoid acid, they bind to our retinoid receptors to upregulate cell turnover and stimulate collagen and elastin production, thereby thickening our dermis. These two mechanisms make retinoids good solutions for treating acne and aging. There is emerging evidence that retinoids in the form of tazarotene and toctino (oral) can be used in the treatment of eczema and psoriasis. In the United States, these medications are prescription-only, so you should visit a dermatologist. Even if you know you can just get it online (looking at you, gym bros), I’d strongly recommend visiting a provider before using something strong like a retinoid to treat your eczema (…then buy it online cause it’ll be way cheaper).
You can also learn more about retinoids and their usage in treating aging here.
So there you have it - an understanding of what eczema is, what could be causing it, and some treatment options. If you decide to try any of these ideas, please take progress pictures for me! You’re welcome to DM them to me on Twitter here.
That’s all for now! Happy Skincare!
Note: you can now book consultations with me! Check it out here or DM me on Twitter to book with ETH.