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Eczema

Eczema is frequently called atopic dermatitis because it was noted to occur in individuals with allergic symptoms, e.g., allergic rhinitis (hay fever) and asthma. The term atopic simply means allergic. Even though eczema was considered to be an allergic problem, allergy seems to be less likely as our understanding of the disease increases. Physicians know that eczema is a very complex disease and contains allergic as well as non-allergic elements in different individuals. As a result, the treatment of every individual may vary.

While the causes of eczema continue to be investigated, certain things are known about the disease. The skin is much more easily irritated than normal skin. Dryness of the skin is a primary component and results in significant itching. Eczema is known as “the itch that rashes”. Itching is made worse by irritants on the skin. Winter months are particularly bothersome because of the dry winter air. Flares in the summer months can occur after exercise because sweat is a significant irritant. Citrus or some vegetables, e.g., tomato, can act as a primary irritant when they touch the skin. Stress in some individuals can affect the skin. While emotional factors may play a role in flaring eczema, they are not considered a primary source of causing the onset of eczema, if it is not already present.

Eczema occurs in about 3% of the population. In about 80% of those individuals, the onset occurs in the first year of life. One-half are free of disease by age 2 years, about one-fourth by the end of adolescence, and the remaining one-fourth will continue to have eczema into adult life. Some individuals do not have the onset of symptoms until adolescence or adulthood.

Treatment is multifaceted and includes lifestyle modification as well as various types of medication. A portion of treatment will be listed in the accompanying tables. Adequate attention to clothing, diet manipulation, and attention to the emotional well-being of the affected patient are very important. It is preferable for a patient with eczema to wear clothing which will not irritate the skin; soft cotton material would be best. The room temperature should be kept moderate with controlled humidity (between 35-50%). Overheating and perspiration should be avoided.

Some investigators believe there is a genetic tendency for eczema with approximately 50% of eczema patients ultimately developing allergic rhinitis and/or asthma. This is compared to about 20% without the presence of eczema. While allergy skin testing and allergy injection treatment are usually helpful in cases of allergic rhinitis and/or asthma, it is generally agreed that this is often not the case with eczema. In some individuals, starting allergy shots for allergic rhinitis and/or asthma may actually result in significant flaring of the eczema.

Prevention

  • Trim fingernails short
  • Cotton gloves at night if needed to decrease scratching
  • Clothing should be double rinsed after washing to remove all residual detergent (irritants)
  • Avoid excessive room temperatures
  • Wear light, non-occlusive clothing (e.g., cotton instead of polyester)
  • Keep the bedroom moderate (cool) and avoid excessive bed clothing
  • Allergen contact or ingestion avoidance (e.g., foods, pets, dust mite) can reduce stimulation of the skin

Treatment

  • Bathing for moisturization, e.g., soaking in tepid water for 30-45 minutes at least once daily and if possible 2-3 times.
  • Within 2 minutes after getting out of the tub, a lubricating cream or ointment should be applied to help hold the moisture in the skin. Examples include Aquaphor, Curel, Moisturel, Eucerin, Keri, Lubriderm, Acid Mantle, Unibase, Vanicream, petrolatum, and chilled Noxzema,etc. Newer medications include Triceram/Certopic, Impruv, Mimyx, Nourica Repair, Cerave, Atopiclair, and Hylira. Some of the newer medications are by prescription only. None of the medications in the above list contain steroids.
  • In general, lotions should be avoided since they contain alcohol which may sting and provide limited moisture.
  • If marked irritation or weeping areas are present, wet wraps with a drying solution (e.g., Burrow’s solution, one tablet mixed in one quart of water is available by prescription) will avoid the stinging or burning sensation that can occur with bathing.
  • Addition of oil or similar substances to the bath water generally has little effect on increasing moisturization.
  • Pat dry with a soft towel; do not “rub” dry since this will remove natural, protective oils from the skin.
  • Showers do not add moisture to the skin and actually remove the protective oils from the skin resulting in increased dryness.
  • Topical steroids are the mainstay of therapy for more severe eczema. Ointments or creams are generally used.
  • Nonsteroidal medications that help the immune system in the skin may be necessary either in addition to or in place of topical steroids if the topical steroids are not adequate for relief. Examples of the nonsteroidal medications are Elidel and Protopic.
  • Antibiotics, topical and/or oral, may be needed if the lesions become infected. An alternative to antibiotics is the use of Clorox baths. One-quarter to one-half cup of Clorox in a full bath provides antibacterial activity that will treat all known bacterial infections. No resistant bacteria to Clorox are known.

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Oklahoma Allergy & Asthma Clinic Warns High Heat May Trigger Asthma Flare-Ups

Doctors urge residents to take precautions as extreme summer temperatures hit Oklahoma

With dangerous heat and humidity gripping Oklahoma and much of the Southern United States, the Oklahoma Allergy & Asthma Clinic is urging individuals with asthma and respiratory conditions to take extra precautions. According to clinic physicians, extreme heat can significantly worsen asthma symptoms and contribute to a rise in asthma related medical emergencies during the summer months.

“Oklahomans with asthma need to take summer heat seriously,” said Dr. Dean Atkinson, a board-certified allergist at the Oklahoma Allergy & Asthma Clinic. “High temperatures and humidity can combine with high pollen and high mold levels to create a perfect storm for asthma attacks.”

Excessive heat, often accompanied by high ozone levels, humidity, and stagnant air, poses multiple threats to individuals with asthma. According to the Centers for Disease Control and Prevention (CDC) and the American Lung Association, heat increases inflammation in the airways, while humidity can trap allergens like mold spores, dust mites, and pollen—making it harder to breathe and easier to trigger flare-ups.

“We see a clear uptick in asthma flare-ups during Oklahoma’s high heat index days,” added Atkinson. “Staying cool and following an asthma action plan are critical steps for staying safe.”

In Oklahoma, where summer temperatures often reach triple digits, local air quality can deteriorate rapidly. The Oklahoma region continues to experience “HIGH ALLERGY ALERT DAYS” and “Ozone Alert Days,” with elevated pollen, mold, and pollution levels that can exacerbate asthma symptoms, especially for children, seniors, and individuals with chronic lung disease.

TIPS TO HELP YOU BREATHE EASIER WHEN THE HEAT IS ON

To help residents protect their respiratory health, physicians at the Oklahoma Allergy & Asthma Clinic recommend the following five strategies during extreme heat:

1. Stay indoors in air-conditioned spaces, especially during peak heat and ozone hours (typically mid-afternoon).

2. Stay hydrated to help maintain healthy airway function.

3. Check the Daily Pollen and Mold Report and the Air Quality Index (AQI) and avoid strenuous outdoor activity on high alert days.

4. Follow your asthma action plan and keep quick-relief inhalers accessible at all times.

5. Minimize exposure to additional triggers, such as cigarette smoke, cleaning chemicals, and other pollutants.

“Children are especially vulnerable to the effects of extreme heat and poor air quality. Their lungs are still developing, and they tend to be more active outdoors, which increases their exposure to asthma triggers during high heat index days.” says Dr. Maya Gharfeh, another board-certified allergist at the Oklahoma Allergy & Asthma Clinic

The Oklahoma Allergy & Asthma Clinic encourages all asthma patients to review their action plans and speak with their healthcare providers about how to adjust medications or activity levels during extreme weather.

For more information about asthma care, pollen counts, and summer safety tips, visit www.oklahomaallergy.com or follow the clinic on social media.

About Oklahoma Allergy & Asthma Clinic

Founded in 1925, Oklahoma Allergy & Asthma clinic has a 100-year history of patient-focused, state-of-the-art allergy and asthma care. Today, the clinic is home to 13 allergy and asthma specialists, caring for tens of thousands of patients a year with a focus on evidence-based treatment, research, and patient education. To learn more, visit OklahomaAllergy.com.

The post Oklahoma Allergy & Asthma Clinic Warns High Heat May Trigger Asthma Flare-Ups appeared first on Oklahoma Allergy and Asthma Clinic.

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