Dermatitis Winter Skin Guidelines

The low humidity common in many parts of the United States during winter can cause dry, irritated skin. When skin becomes dry and irritated, eczema can flare. Here are some tips to help skin feel more comfortable during winter or anytime the air is dry:

1. Use a humidifier. With the heat on and the windows closed, the air inside can become very dry in the winter, making the dryness and itching of eczema even worse. Use a humidifier to place moisture in the air. If you don’t want to invest in an expensive humidifying system, smaller, relatively inexpensive humidifiers can be obtained at a local drug store. Placing two or three of these around your home will help to humidify the dry air. This can keep skin from drying and becoming cracked and itchy.

2. Switch to an oil-based moisturizer and moisturize frequently. The more oil a moisturizer contains the more effectively it protects against moisture loss. Moisturizers that come in ointment form contain the most oil because an ointment, by definition, consists of 80% oil and 20% water. This water-in-oil emulsion forms a protective layer on the skin and makes it more “moisturizing” than creams and lotions. Ointments are especially beneficial when humidity is low. Ointments should not be used on areas of the body that tend to get hot and sweaty.

3. Before Going Outside in Winter:
Apply a heavy layer of moisturizing broad-spectrum sunscreen with an SPF of 15 or higher to the face, hands, and any other skin that may be exposed. This will act as a barrier to help protect against the harsh elements and is especially important if you will be outside for any length of time. Sunscreen is important in winter as the sun’s reflective powers are great year round - 17% on the sand and 80% on the snow. Today, several products are available that combine oily, moisturizing cream with sunscreen. If you are unsure of which product to use, ask a dermatologist.

Grab those gloves. Protecting hands from the cold air and low humidity plays an important role in preventing flare-ups. Make sure the gloves are made from material that does not irritate your skin. Some patients find that wearing a cotton mitten next to the skin and a woolen mitten over the cotton one, keeps hands warm and dry.

4. Dress in layers. The most common triggers of the scratch/itch cycle are sweating and overheating. Wearing layers allows you to remove clothing as needed to prevent overheating. Be sure to wear loose-fitting cotton fabrics next to your skin.

5. Shed wet clothes and shoes immediately. These can irritate the skin and cause a flare-up.

An educational insight from the American Academy of Dermatology.

Novartis Tries to Re-assure Elidel Users

Novartis AG said Monday that data from a long-term study of adult and pediatric patients with atopic dermatitis showed that the company's Elidel cream provided sustained control of symptoms associated with eczema. Richard Langley, Assistant Professor, Director of Research, Division of Dermatology, Dalhousie University, Canada, said, "This study provides encouraging news because one of the most unsettling aspects of eczema is the unpredictability of the condition.

What this study shows is that using Elidel to treat a flare-up at the onset of such symptoms as tingling or itching may enable patients to control flares and better manage their condition long-term." The objective of the multinational study was to evaluate the long-term safety and effectiveness of Elidel in pediatric and adult patients with eczema of any severity, who had previously completed a six-month 947-patient core study.

The extension study included 368 of those patients who remained in the study and were treated for up to 18 months. During the extension phase of the study, Elidel was incorporated as needed into patients' daily treatment routines - any time signs or symptoms returned, patients resumed twice-daily treatment, in effort to prevent progression.

In the core study, 79.6 percent of patients who had used Elidel twice daily experienced relief from the itching associated with mild to moderate eczema. These results were sustained for an additional six months in 75.3 percent of the patients who continued to be monitored in the extension study.

Novartis said also said that importantly, the quantity of Elidel used during the course of the study decreased from 3.3 grams per day at the end of the core study to 2.5 grams per day six months later, particularly in those patients who had the most severe eczema at the start of the study. The company said more than 75 percent of patients continued to rate their disease control as either "complete" or "good" at the end of the extension study. There were no unexpected safety findings.

The most common adverse events, occurring in 5 percent of patients or more, were infections, respiratory disorders, application-site conditions and headache. The overall incidence of viral infections was less than 1 percent, and treatment-related herpes simplex occurred in 4 patients or 1.1 percent of the study group.

Novartis noted that the incidence of adverse events decreased from the end of the core study to the end of the extension study. Currently, eczema affects up to 17 percent of the U.S. population.

Eczema is a term used to describe patchy, red, dry itchy and scaly skin, which, when severe, can bleed and/or crust over. Novartis' Elidel uses pimecrolimus, which is derived from a natural substance produced by the fungus Streptomyces hygroscopicus var. ascomyceticus, to selectively block the production and release of cytokines from T-cells. These cytokines in the skin cause the inflammation, redness and itching associated with eczema.

FDA Expresses Concerns over Elidel and Protopic

Government scientists, concerned that two prescription creams used widely for a common skin condition may increase the risk of certain cancers, especially among children, will propose adding strong new warnings to the product labels. A handful of cases of cancer have been reported among adults and children using the creams, sold under brand names Elidel and Protopic, and animal and laboratory studies suggest the drugs could be to blame, according to a new Food and Drug Administration analysis."The evidence raises serious safety concerns in children regarding the potential for carcinogenicity in humans treated with these agents,"wrote Jean Temeck of the FDA's division of pediatric drug development in a recommendation posted late yesterday on the agency's Web site.

Treating Atopic Dermatitis

There is no known cure for atopic dermatitis, but it can be controlled with proper treatment. The first step in treatment is to avoid the offending allergens or irritants that are known to trigger the onset of symptoms.
The use of harsh soaps and detergents should be avoided. Soaps and detergents should be mild and free of perfumes. When laundering, rinse the clothing twice to remove any soap residues.
As with any rash, it is best to avoid scratching when the skin itches. Scratching can break the skin open and increase the chance of infection. Cool compresses or ice can be used to relieve the itching.
There are many ways to combat dry, irritated skin. The skin is dry because it fails to retain water, not because it lacks enough oil. The best way to hydrate the skin again is to bathe or soak the affected area in tepid, not hot, water for 15-20 minutes. Pat the skin dry and then apply an emollient to trap the moisture in the skin. The water soak should happen a least once daily, but for best results do it twice daily, followed by the emollient. The emollient can be applied several more times a day for optimum results.
To help alleviate inflammation and promote healing, a doctor may prescribe a topical steroid. A topical steroid should be applied immediately after bathing. It should not be used more than twice a day.
Since itchy skin is the most aggravating symptom of this disorder, an antihistamine may need to be used to relieve the itching sensation.
For additional information on atopic dermatitis, please refer to the collected Internet links.