I was compensated by Med-IQ through an educational grant from Pfizer, Inc. to write about the signs, symptoms, and treatments available for eczema/atopic dermatitis in communities of color. All opinions are my own.
I previously wrote about what it’s like traveling with a child with eczema and the extra precautions we take. We don’t experience true winter in Miami but our family loves a good winter getaway. Each year we take a ski trip and while we have a lot of fun, eczema often worsens in the winter which can lead to my daughter having more flare ups. This is due in part to the dry, cold air in colder climates and the fact that Vitamin D from the sun helps with the symptoms of eczema but people go outside less in the winter in certain parts of the world.
There are many ways to treat eczema and atopic dermatitis and reduce the discomfort in kids, even during the winter. Jeanette Kaplun of Hispana Global recently did a Facebook Live with Dr. Alexis where they covered treatment of eczema specifically for people of color. The live is still available to watch here but below are some steps you can take.
Initial Steps to Take That Don’t Include Medication
Since our daughter is so young we try to avoid medication as much as possible. Our initial step in combating her eczema flare ups was to start gentle skin care treatments. This meant using soaps and cleansers that are oil-based, do not contain preservatives, and moisturize the skin. For many people, moisturizing the skin can be enough, but the best products can be expensive. We use an ointment like petroleum jelly, Aquaphor® or Hydrolatum® and which has helped.
In addition to switching up your child’s skin care routine, identifying and avoiding possible irritants and allergens that can trigger flares is a great initial step before using medication. Lots of things can trigger flare ups including fragrances, wool, coarse fabrics, certain foods such as dairy products, or transitions/extremes in humidity/temperature. We learned that cheese is a big trigger for my daughter and while she loves it, we’ve had to find alternatives. A healthcare provider can help identify triggers by doing an allergy test.
Additional Steps to Take That Include Medication
When changing your child’s skin care routine or identifying triggers still isn’t enough, it may be time to consider medication. For children that suffer from mild or moderate atopic dermatitis, topical therapies can help greatly. This includes:
- Short-term use of topical corticosteroids, as long-term use is not recommended due to an increased risk of side effects such as skin thinning, striae (aka stretch marks), rosacea, and other problems.
- Corticosteroid-sparing therapies can be used longer term and are recommended for sensitive body sites such as the face or diaper area. These include crisaborole (Eucrisa®), topical calcineurin inhibitors such as tacrolimus ointment (Protopic®) and pimecrolimus cream (Elidel®), or generic options.
What to Do If Topical Options Aren’t Working
Unfortunately, if your child has more than a mild case of eczema the topical options may not be effective. In this case more intense treatments may be necessary to see improvements Some options are:
- Systemic therapies
- Nonspecific immunosuppressants such as systemic corticosteroids and other immunosuppressing therapies may be prescribed; however, their use may be limited due to side effects, potential for rebound flares, or the need for laboratory work.
- New systemic agents are emerging that target the underlying causes of atopic dermatitis, including the factors that cause itch and inflammation. Currently, one injectable biologic is FDA approved for use in patients aged 6 years and older, and other targeted agents that can be taken orally are currently in development.
- Systemic therapies may also be augmented by topical medications.
- Because atopic dermatitis is a chronic condition, a formal written plan or “Eczema Action Plan” can help patients follow their recommended management plan.
- Remember if your or your child’s symptoms aren’t improving but you’re not following your plan to a T it will be harder fora doctor to determine another treatment option as they can’t pinpoint their needs.
Understanding When It’s Time to Make a Change in Treatment
As parents we all take extreme pride is taking care of our kids. It can be heartbreaking to see them suffer with medical conditions like eczema and atopic dermatitis. As a parent I know I try my best to avoid having them constantly test out new treatments because it can be annoying for them but it’s important to understand when it’s time to make a change in treatment.
- If treatments are not working despite following the management plan, a treatment change may be needed; it is important to seek care from a skin care provider.
- If needed, consider seeking help from a dermatologist, pediatric dermatologist, or eczema specialist who may be more comfortable moving up the treatment ladder.
Impact of COVID-19 pandemic and value of telemedicine
Covid-19 has had an impact on many who suffer from eczema due to the increased use of harsh hand sanitizers and increased hand-washing. These can further irritate skin and eczema rashes meaning it’s even more important to follow your treatment plan.
- For patients of color, eczema can lead to light or dark color spots, or hypopigmentation. By continuing your treatment plan during the pandemic, you can maintain better control of their disease, minimize the hypopigmentation, and reduce the risk of flares.
- I know many people don’t feel comfortable leaving their homes so be sure to take advantage of telemedicine. It’s an effective, alternative way to ensure easy and timely visits.
- To optimize a telemedicine visit, follow these tips:
- Before making an appointment, check with your insurance provider to make sure they cover telemedicine visits.
- Take photos of the condition before the visit and send the images to the doctor in advance because high-resolution images are better quality than video.
- Collect any medicines in advance of the appointment and have them nearby.
- Come prepared to discuss any family history of allergies and asthma.
- Find a quiet area and make sure there is internet access.
- Because lighting is very important for dermatology visits, patients should place the light in front of them and face the window; windows should not be behind them.
- Patients should know their cleansing and moisturizing routines.
- To find a doctor who treats skin of color, patients can check out the Skin of Color Society or American Academy of Dermatology website and search for areas of specialization, including skin of color.
How Can You Help?
Med-IQ is conducting an anonymous survey and would appreciate your input. The survey will take less than 10 minutes to complete. Survey responses are shared only in aggregate. Your responses to these survey questions will provide Med-IQ with important information about your experiences with atopic dermatitis, which will help us develop future educational initiatives. Once you’ve completed the survey, you will have the option of providing your email address to be entered into a drawing administered by SOMA Strategies to win 1 of 10 $100 VISA gift cards. If you choose to enter, your email address will be used only to randomly draw the winners and notify them of their prize and to send a follow-up survey as part of this same initiative. You can take the survey here.
Additional Resources
- National Eczema Association
- Eczema treatments: https://nationaleczema.org/eczema/treatment/
- Eczema in skin of color: https://nationaleczema.org/eczema-in-skin-of-color/
- Telemedicine and Teledermatology
- Preparing for a telemedicine visit:
- Photographing your skin for a teledermatology appointment:
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