How to wash in case of atopic eczema?

Theatopic eczema or atopic dermatitis is a chronic inflammatory skin disease. Non-contagious, it is characterized by red patches that appear in flare-ups and are accompanied by itching. These flare-ups vary in duration and leave the skin very dry, this is referred to as xerosis. As a result of scratching the skin, it thickens, this is known as lichenification.

According to several studies, 50 to 70% of children affected by eczema have a first-degree relative (father, mother, brother, or sister) who has also been affected. Those suffering from it secrete large amounts of immunoglobulin E (IgE), antibodies, in response to environmental antigens (also called allergens). Moreover, it is often observed in these individuals abnormalities affecting the gene coding for filaggrin, as well as other molecules necessary for the proper functioning of the stratum corneum.

This atopy is caused by a malfunction of the skin barrier, due to a lack of sebum, lipids, and cell adhesion molecules production, which can no longer fulfill its protective role. Environmental allergens can therefore easily penetrate the epidermis and cause a misdirected inflammatory response.

As previously discussed, in the case of atopic eczema, the individual's immune system secretes high amounts of IgE antibodies in response to allergens. Atopic skin is dry and the skin barrier does not function properly. Thus, allergenic molecules easily penetrate the epidermis and come into contact with the skin's immune defense cells. To avoid exacerbating skin reactions, certain hygiene practices can be adopted.

• Preferably use a superfatted soap-free cleansing bar.

  To avoid itching, opt for a gentle, non-irritating cleanser that ideally contains no fragrance or allergens. There are soothing, non-drying shower treatments specifically formulated for individuals with atopic or sensitive skin. If in doubt, consult your dermatologist who can guide you towards an appropriate product.

• Limit the duration of showers.

  Water has a drying effect on the skin. However, individuals suffering from atopic eczema naturally have dry and sensitive skin. To avoid further weakening it, try to limit the time you spend in the shower.

• Avoid taking baths.

  When one has atopic skin, it is recommended to favor showers over baths, in order to limit the skin dryness caused by prolonged contact with water.

• Do not use excessively hot water.

  We recommend that you shower in lukewarm water if you suffer from eczema. Indeed, excessively hot temperatures disrupt the hydrolipidic film present on the skin, which further weakens the skin barrier.

• Gently wipe your skin.

  Friction is a movement that can irritate sensitive skin and cause itching. When you dry yourself, do not rub your skin with your towel, but rather perform light patting. Also, prioritize towels that are soft and fluffy.

• Apply a nourishing cream after showering.

  To restore the skin barrier, the application of a emollient balm after showering is essential. This treatment helps to compensate for the skin's lack of lipids and prevents the evaporation of water and the passage of allergens, which are the cause of the inflammatory reaction. Emollient balms are treatments designed to nourish, soften, and soothe the skin. They help to counteract the drying effect of showers.

• GOLDENBERG G. & al. Eczema. The Mount Sinai Journal of Medicine (2011).

• YEUNG J. & al. Diagnosis and treatment of pruritus. The College of Family Physicians of Canada (2017).