Eczema, also known as atopic dermatitis, is a common noncontagious inflammatory skin condition characterized by dryness, itching, redness, oozing, and scaly rashes. Proper skin care, particularly gentle cleansing, plays a significant role in managing eczema symptoms and maintaining the skin barrier.
Understanding Eczema and Skin Cleansing
Eczema compromises the skin’s natural barrier, designed to retain moisture and protect against irritants and allergens. This barrier can be “leaky” or dysfunctional, making the skin more susceptible to dryness, irritation, and inflammation. An impaired barrier allows allergens and irritants to penetrate, triggering immune responses that cause inflammation.
Traditional soaps and harsh cleansers strip the skin of natural oils, exacerbating dryness and worsening eczema symptoms by disrupting the skin barrier and removing essential lipids. Eczema-friendly cleansing aims to clean skin effectively without causing further damage to the barrier or inducing irritation. This approach helps to support the skin’s natural defenses and reduce the frequency and severity of flare-ups.
Key Ingredients to Look For
Selecting cleansers with specific beneficial ingredients helps manage eczema symptoms. Emollients, such as petrolatum, mineral oil, and shea butter, are fatty substances that soften and smooth the skin by forming a protective layer. This layer traps moisture, which is especially important for eczema-prone skin that struggles to retain hydration.
Humectants, like glycerin and hyaluronic acid, attract water to the skin’s surface, helping to keep the skin hydrated. These ingredients enhance the skin’s ability to hold onto moisture, which can alleviate dryness and improve comfort.
Ceramides are lipids that constitute a significant portion of the skin’s natural barrier, holding skin cells together. Individuals with eczema often have a deficiency of ceramides, and products containing them can help repair and strengthen the skin barrier, sealing in moisture and blocking out irritants.
Colloidal oatmeal, finely ground oats, is recognized for its soothing and protective properties. It contains compounds like avenanthramides that have antioxidant and anti-inflammatory effects, helping to reduce itchiness, redness, and irritation. It also forms a protective coating on the skin, aiding in moisture retention and shielding against irritants.
Niacinamide, a form of vitamin B3, can help strengthen the skin’s lipid barrier by promoting ceramide production and reduce inflammation and redness. It contributes to overall skin health by boosting hydration and helping to calm irritated skin.
Ingredients to Strictly Avoid
Certain ingredients commonly found in cleansers can irritate sensitive, eczema-prone skin and should be avoided. Fragrances, whether synthetic or derived from natural essential oils, are frequent triggers for allergic reactions and can exacerbate eczema flares. “Fragrance-free” is a more reliable label than “unscented,” as the latter might contain masking fragrances. Dyes or synthetic colors, often listed as “FD&C” or “D&C” followed by a number, are used for visual appeal but can irritate sensitive skin and trigger eczema.
Sulfates, such as sodium lauryl sulfate (SLS) and sodium laureth sulfate (SLES), are foaming agents that can strip the skin of its natural oils, disrupting the skin barrier and leading to dryness and irritation. SLS, in particular, is known to be harsher and can penetrate the skin more easily, increasing irritation risk. Parabens (e.g., methylparaben, propylparaben) are preservatives used to extend product shelf life but can irritate sensitive skin. Phthalates, often found in fragranced products, are also best avoided due to potential irritation.
Simple alcohols (e.g., ethanol, isopropyl alcohol) can be very drying and irritating to eczema-prone skin by stripping away natural oils and disrupting the skin barrier. While some fatty alcohols are non-irritating, it is generally safer to choose alcohol-free formulations. Harsh exfoliants, including physical scrubs or chemical exfoliants like salicylic acid or glycolic acid, can further disrupt the compromised skin barrier and increase irritation, redness, and dryness.
Choosing and Using the Right Cleanser
Liquid or cream cleansers are generally preferred over traditional bar soaps for eczema, as they often contain more moisturizing ingredients and are less likely to strip the skin. Look for products specifically labeled “for eczema-prone skin” or those with a pH balance close to the skin’s natural slightly acidic pH, which helps maintain barrier function.
Bathing practices significantly impact eczema management. Use lukewarm water instead of hot, as hot water can strip the skin of its natural oils and exacerbate dryness. Keep showers or baths short, ideally around 5 to 10 minutes, to minimize water loss from the skin.
Apply cleanser gently with hands, avoiding harsh scrubbing or abrasive materials.
After cleansing, gently pat skin dry with a soft towel, leaving it slightly damp to retain moisture. Applying moisturizer immediately after bathing, ideally within three minutes, is crucial to seal in hydration and reinforce the skin barrier. This “soak and seal” method is a fundamental practice for managing eczema, helping to prevent water loss and reduce flare-ups.