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Protect Your Skin from Infections

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With the onset of the winter season large number of patients suffering from skin infection are visiting the OPD (Outdoor Patients  Department) of the Hospital these days.

CLICK & SEE THE PICTURES

According to Sushil Chandra, head of Skin department (HOD) at Ganesh Shankar Vidyarthi Memorial (GSVM) Medical College, “The cases of scabies, eczema and other fungal infections are on the rise due to changing weather. Approximately 25 per cent of the patients coming here are suffering from seasonal skin allergy.”

Scabies is a common skin infection that causes small itchy blisters due to tiny mites. The rash appears on head, face, neck and palms. Itching is the most common symptom which tends to become worse during night. Continuous scratching leads to bacterial infections and sometimes pus formation also,” he sad.

“The infection is contagious and is usually transmitted through skin-to-skin contact. The infection spreads more easily in crowded places,” he added.

About eczema, Dr S K Arora, professor in Skin department at GSVM College said that it normally occurs due to dryness. He said, “With the onset of winter season, blood supply to the skin decreases which affects the secretion of sebum (a kind of oil which keeps skin moist) from sebaceous glands. A cycle of itching and scratching begins which prolongs the xerotic eczema.”

About the preventive measures, Dr Arora said, “Scratching makes the skin infection worse. It can also lead to further bacterial infection if you break the skin. It is therefore, better to keep the nails short so that there are less chances of harming yourself accidentally by scratching with dirty fingernails. One should also use moisturiser and coconut oil regularly to keep the skin moist. Drink a lot of water to keep the body moisturised from within and take a bath daily.”

Source:The Times Of India

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News on Health & Science

‘Bleach Bath’ Benefit for Eczema

Adding bleach to the bath may be an effective treatment for chronic eczema, US researchers say.
……………
In a study of 31 children, there was significant improvement in eczema in those who had diluted bleach baths compared with normal baths.

The Pediatrics study also showed improvements were only on parts of the body submerged in the bath.

The Pediatrics study also showed improvements were only on parts of the body submerged in the bath.

UK experts stressed the treatment could be extremely dangerous and should only be done under the care of a specialist.

Children with bad eczema suffer from chronic skin infections, most commonly caused by Staphylococcus aureus, which worsen the eczema that can be difficult to treat.

Some children get resistant MRSA infections.

“Bleach used incorrectly could cause enormous harm to a child with atopic eczema while in the hands of an expert it can, as this trial indicates lead to benefit” SAYS  Professor Mike Cork, Sheffield Children’s Hospital

Studies have shown a direct correlation between the number of bacteria on the skin and the severity of the eczema.

It has been shown that bacteria cause inflammation and further weaken the skin barrier.

In the study, researchers randomly assigned patients who had infection with Staphylococcus aureus to baths with half a cup of sodium hypochlorite per full tub or normal water baths for five to 10 minutes twice a week for three months.

They also prescribed a topical antibiotic ointment or dummy ointment for them to put into their nose – a key site for growth of the bacteria.

Eczema severity in patients reduced five times as much as those on placebo.

But there was no improvement in eczema on the head and neck – areas not submerged in the bath.

Rapid improvement :-

“We’ve long struggled with staphylococcal infections in patients with eczema,” said study leader Dr Amy Paller, from Northwestern University in Chicago.

She added they saw such rapid improvement in the children having bleach baths that they stopped the study early.

“The eczema kept getting better and better with the bleach baths and these baths prevented it from flaring again, which is an ongoing problem for these kids.

“We presume the bleach has antibacterial properties and decreased the number of bacteria on the skin, which is one of the drivers of flares.”

Professor Mike Cork, head of dermatology research and a consultant at Sheffield Children’s Hospital, said antiseptic baths had been used as a treatment for eczema for quite a while but the trial was important because it highlights the benefits from reducing bacteria.

“But people should not start putting bleach in their children’s bath.

“Bleach used incorrectly could cause enormous harm to a child with atopic eczema while, in the hands of an expert, it can as this trial indicates lead to benefit.”

He added the trial highlighted the need for children with uncontrolled eczema to be referred to a specialist for treatment.

Sources: BBC News :27th.April.’09

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Ailmemts & Remedies

Seborrhea Dermatitis

An infant with Cradle CapImage via Wikipedia

Definition: Seborrhea (say: seb-uh-ree-uh) is a common skin problem. It causes a red, itchy rash and white scales. When it affects the scalp, it is called “dandruff.” It can be on parts of the face as well, including the folds around the nose and behind the ears, the forehead, and the eyebrows and eyelids. On the body, seborrhea often occurs in the middle part of the chest, around the navel and in the skin folds under the arm, below the breasts and in the groin and buttocks area.

Seborrhoeic eczema (also Seborrheic dermatitis AmE, seborrhea) is a skin disorder affecting the scalp, face, and trunk causing scaly, flaky, itchy, red skin. It particularly affects the sebum-gland rich areas of skin.

click to see the pictures…..(01)...…(1)..……..(2).…..…(3)....………………….

Who gets seborrhea?
Infants may get seborrhea. It’s known as “cradle cap.” Cradle cap goes away after about 6 months. It may also affect the diaper area and look like a diaper rash.

Seborrhea also affects adults and elderly persons, and is more common in men than in women. Seborrhea occurs more frequently in persons with oily skin.

It affects 3 percent of the general population. It occurs more commonly in older people who are bedridden or have neurologic conditions such as Parkinson’s disease. Seborrhea also affects almost 85 percent of people with AIDS.

Causes:The cause of seborrheic dermatitis is not fully understood, although many factors have been implicated.. It is likely that a number of factors, such as hormones and stress, can cause it.
The widely present yeast, Malassezia furfur (formerly known as Pityrosporum ovale), is involved, as well as genetic, environmental, hormonal, and immune-system factors. A theory that seborrhoeic dermatitis is an inflammatory response to the yeast has not been proven. Those afflicted with seborrhoeic dermatitis have an unfavourable epidermic response to the infection, with the skin becoming inflamed and flaking.

Acute form of seborrhoeic dermatitis on scalpIn children, excessive vitamin A intake can cause seborrhoeic dermatitis. Lack of biotin, pyridoxine (vitamin B6) and riboflavin (vitamin B2) may also be a cause.

It is a chronic inflammatory skin disorder that affects the areas of the head and trunk that have sebaceous glands. A type of yeast that has an affinity for these glands called Pityrosporum ovale may be the cause, but this has not been proven yet. It is believed that the build-up of yeast in these glands irritates the skin causing redness and flaking.

Seborrhea is more common in men than women and affects 3 percent of the general population. It occurs more commonly in older people who are bedridden or have neurologic conditions such as Parkinson’s disease. Seborrhea also affects almost 85 percent of people with AIDS.

Diagnosis:

Clinical Manifestations
Seborrheic dermatitis typically affects areas of the skin where sebaceous glands appear in high frequency and are most active. The distribution is classically symmetric, and common sites of involvement are the hairy areas of the head, including the scalp , the scalp margin , eyebrows, eyelashes, mustache and beard. Other common sites are the forehead , the nasolabial folds , the external ear canals and the postauricular creases. Seborrhea of the trunk may appear in the presternal area and in the body folds, including the axillae, navel, groin, and in the inframammary and anogenital areas. Figure 7 illustrates the typically symmetric distribution of seborrheic dermatitis.

More severe seborrheic dermatitis is characterized by erythematous plaques frequently associated with powdery or greasy scale in the scalp (Figure 8), behind the ears (Figure 9) and elsewhere in the distribution described above. Besides an itchy scalp, patients may complain of a burning sensation in facial areas affected by seborrhea. Seborrhea frequently becomes apparent when men grow mustaches or beards and disappears when the facial hair is removed. If left untreated, the scale may become thick, yellow and greasy and, occasionally, secondary bacterial infection may occur.

Seborrheic dermatitis is more common in men than in women, probably because sebaceous gland activity is under androgen control. Seborrhea usually first appears in persons in their teens and twenties and generally follows a waxing/waning course throughout adulthood.

UV-A and UV-B light inhibit the growth of P. ovale,9 and many patients report improvement in seborrhea during summer.

Treatment:
Soaps and detergents such as sodium laureth sulfate may precipitate a flare-up, as they strip moisture from the top layers of the skin, and the drying property of these can cause flare-ups and may worsen the condition. Accordingly a suitable alternative should be used instead.

Among dermatologist recommended treatments are shampoos containing coal tar, ciclopiroxolamine, ketoconazole, selenium sulfide, or zinc pyrithione. For severe disease, keratolytics such as salicylic acid or coal tar preparations may be used to remove dense scale. Topical terbinafine solution (1%) has also been shown to be effective in the treatment of scalp seborrhoea, as may lotions containing alpha hydroxy acids or corticosteroids (such as fluocinolone acetonide). Pimecrolimus topical lotion is also sometimes prescribed.

Chronic treatment with topical corticosteroids may lead to permanent skin changes, such as atrophy and telangiectasia.

UV-A and UV-B light inhibit the growth of M. furfur, although caution should be taken to avoid sun damage.

According to the American Academy of Family Physicians(AAFP), one treatment that has proven successful, especially when steroid topicals and shampoos aren’t working, and the patient continues to suffer from rapid hair loss and rashes, has been low doses(10mg-30mg daily) of the perscription drug Accutane,(Isotretinoin). The exact mechanism isn’t known, but it is thought to work by reducing sebum, which plays an important role in seborrhoeic dermatitis. Patients should be evaluated monthly, while examing the proper liver functions when putting a patient on accutane therapy. Special screening should be in place for women patients, because of the risk of birth defects. This therapy can last, when the condition is chronic and the isotretinoin does is low, for years. But, patients should be given a one to two month break off this particular therapy every 6 months to see if the condition still is affecting the patient

Adults who have seborrhea usually experience a waxing and waning course. In other words it can’t be “cured”. The good news is with proper maintenance, seborrhea can be controlled. Furthermore, most of the treatments can be found over-the-counter.

Treatment will help keep seborrhea under control. It’s important to keep your body clean.

Dandruff Shampoo
If you have dandruff, use medicated shampoos.

When using dandruff shampoo, first wet your hair. Rub some shampoo into your scalp and hair. Leave the shampoo on your scalp and hair for at least 5 minutes. Then rinse it out. Use the dandruff shampoo every day until your dandruff goes away. Then use the medicated shampoo 2 or 3 times a week to keep dandruff away. Having dandruff does not mean that your scalp is too dry! Dandruff comes because you need to wash your hair more often.

Medicated Shampoos should always be used.For black persons, daily shampooing may not be needed. Ask your doctor about a special steroid preparation in oil that can be used on the scalp like a pomade. Or you can use a steroid-containing shampoo.

Adults who have seborrhea usually experience a waxing and waning course. In other words it can’t be “cured”. The good news is with proper maintenance, seborrhea can be controlled. Furthermore, most of the treatments can be found over-the-counter.

Proper hygiene plays an important role in treatment. Frequent washing with soap gets rid of the oils in the affected areas and improves symptoms. Sunlight inhibits the growth of the yeast; therefore exposure of affected areas to sun is helpful, although caution should be exercised to avoid sun damage. The main medical treatments are antifungal shampoos and topical.

Cradle Cap:
Cradle cap in infants also gets better with daily shampooing. First try a mild, nonmedicated baby shampoo. If that doesn’t work, try an a dandruff shampoo. If the patch of cradle cap is large and thick, first try softening it by rubbing on warm mineral oil. Next, gently brush with a baby hairbrush. Then use shampoo.

Seborrhea Shampoos
There are several good antifungal shampoos on the market that can be purchased without a prescription. The main shampoos are selenium sulfide found in Selsun, pyrithione zinc found inHead & Shouldersulders and Sebulon, coal tar found in Sebutone and Tegrin, and finally ketoconazole found in Nizoral.

All of these shampoos have a medicated smell. The way to use them is to shampoo and leave on for at least 10 minutes then rinse off. The shampoos can be used on the face and other parts of the body as a lotion with the same instructions as long as precaution is used around the eyes. Do this daily until the redness and flaking is controlled then use 2-3 times a week as needed to keep symptoms from returning.

Topical Steroids For Seborrhea
Topical steroids reduce the inflammatory response and help control itching. You can buy hydrocortisone cream 1% over-the-counter, and it’s safe to use on the face. Apply twice a day to the affected area until the redness resolves. Save the hydrocortisone for flare-ups and use the antifungal shampoo for maintenance because long-term steroid use can cause side effects like acne and thinning of the skin.

Herbal Treatment:The World Health Organization mentions Aloe vera gel as a yet to be scientifically proven traditional medicine treatment for Seborrhoeic dermatitis.

*Arctium lappa (Burdock) oil
*Chelidonium majus (Celandine)
*Glycyrrhiza glabra (Licorice)
*Melaleuca (Tea tree) species
*Plantago (Plantain) species
*Symphytum officinale (Comfrey)
*Zingiber officinale (Ginger) root juice
*Ledebouriella Seseloides (Fang Feng)
*Smilax China (Smilax china)
*Trichosanthes Kirilowii (Snakegourd)
*Glycyrrhiza Uralensis
*Coptis Chinensis (Chinese goldthread)
*Phellodendron Amurense (Huang Bai)
*Sophora Flavescens
*Centella Asiatica (Gotu Kola)
*Evening primrose,
*dandelion root
*red clover Norwegian kelp
* berberine (from barberry, Oregon grape root or goldenseal).

Quik Tip: Evening primrose – anti-inflammatory herb of the first magnitude; it helps your

body balance itself hormonally, too.

Click to learn more about Seborrheic Dermatitis

 

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Seborrheic_dermatitis
http://www.herbnews.org/seborrheadone.htm
http://dermatology.about.com/cs/seborrhea/a/sebderm.htm
http://www.aafp.org/afp/20000501/2703.html

http://en.wikipedia.org/wiki/Taraxacum

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Dyshidrosis

Definition:
Dyshidrosis, also termed Dyshidrotic Eczema, Pompholyx and Dyshidrotic Dermatitis, is a skin condition that is characterized by small blisters on the hands or feet. It is an acute, chronic, or recurrent dermatosis of the fingers, palms, and soles, characterized by a sudden onset of many deep-seated pruritic, clear vesicles; later, scaling, fissures and lichenification occur. Recurrence is common and for many can be chronic. Incidence/Prevalence is said to be 20/100,000 in the USA, however, many cases of eczema are diagnosed as garden-variety atopic eczema without further investigation, so it is possible this figure is misleading.
It is a non-contagious skin problem that is thought to be perhaps a reaction to some environmental irritant; it may also be an autoimmune disease. It is common, slightly more women get it than men, and has been one of the earliest known skin problems. It is rare in children under 10.

This condition is not contagious to others, but due to its unsightly nature can cause significant distress in regards to social interactions with others.

The name comes from the word “dyshidrotic,” meaning “bad sweating,” which was once believed to be the cause. Sometimes called pompholyx (Greek for “bubble”) which is generally reserved for the cases with blisters; in some countries, pompholyx refers to hand dyshidrosis.

……You may click to see the picture.

Symptoms:
Small blisters with the following characteristics:

*Blisters are very small (1 mm or less in diameter). They appear on the tips and sides of the fingers, toes, palms, and soles.

*Blisters are opaque and deep-seated; they are either flush with the skin or slightly elevated and do not break easily.
*Eventually, small blisters come together and form large blisters.

*Blisters may itch, cause pain, or produce no symptoms at all. They worsen after contact with soap, water, or irritating substances.

*Scratching blisters breaks them, releasing the fluid inside, causing the skin to crust and eventually crack. This cracking is painful as well as unsightly and often takes weeks, or even months to heal. The skin is dry and scaly during this period.

*Fluid from the blisters is serum that accumulates between the irritated skin cells. It is not sweat as was previously thought.

*In some cases, as the blistering takes place in the palms or finger. Lymph node swelling may accompany the outbreak. This is characterised by tingling feeling in the forearm and bumps present in the arm pits.

*Nails on affected fingers, or toes, may take on a pitted appearance.

Causes:
Causes of dyshidrosis are unknown. However, a number of triggers to the condition exist:

*Dyshidrosis has been historically linked to excessive sweating during periods of anxiety, stress, and frustration, however, many cases present that have no history of excessive sweating, and the hypothesis of dyshidrosis as a sweating disorder is largely rejected. Some patients reject this link to stress, though as a trigger of vesicular eruption it cannot be overlooked, as with other types of eczema.

*Vesicular eruption of the hands may also be caused by a local infection, with fungal infections being the most common. Sunlight is thought to bring on attacks, some patients link outbreaks to prolonged exposure to strong sunlight from late spring through to early autumn. Others have also noted outbreaks occurring in conjunction with exposure to chlorinated pool water or highly treated city tap waters.

*Soaps, detergents, fragrances and contact with fruit juices or fresh meat also can trigger outbreaks of dyshidrosis, as with other types of eczema.

*Systemic nickel allergies may be related such as foods high nickel content – cocoa, chocolate, whole grains, & nuts.

*Keeping skin damp will trigger or worsen an outbreak. For this reason, people with dyshidrosis should wear gloves, socks, and shoes made of materials which “breathe well”, such as cotton or silk. Certain fabrics may greatly irritate the condition, including wool, nylon and many synthetic fabrics.

*Inherited, not contagious. Often, patients will present with other types of dermatitis, such as seborrheic dermatitis or atopic eczema. For this reason, among others, dyshidrosis is often dismissed as atopic eczema or contact dermatitis.

*Can be the secondary effect of problems in the gut. Some sufferers claim diet can ease symptoms (relieving internal condition of IBS or intestinal yeast infection). Also Inflammatory bowel diseases of Ulcerative colitis and Crohn’s disease.

*Bandages, plasters or other types of skin-tapes may be irritating to dyshidrosis and should be avoided. As the skin needs to breathe, anything that encourages maceration of the palms should be avoided. If the ‘wounds’ are raw enough to warrant covering, pure cotton gloves or gauze should be used. Liquid Band-Aid brand bandage may be tolerated and helpful, refer to the Treatment section, below.

*Latex and vinyl gloves may increase irritation.

*Multiple Chemical Sensitivity

*Allergic reaction to Potassium Dichromate (leather preservative)

*Dyshidrosis can sometimes even be caused by dust mite allergies, with sufferers having to wash and change bedding weekly, sometimes even every 2 days or even every day, to combat symptoms.

*Balsam of Peru is a common irritant among sufferers of hand eczema, more commonly, people with dyshidrotic eczema.

Treatment:
There are many treatments available for dyshidrosis, however, few of them have been developed or tested specifically on the condition.

*Topical steroids – while useful, can be dangerous long-term due to the skin-thinning side-effects, which are particularly troublesome in the context of hand dyshidrosis, due to the amount of toxins and bacteria the hands typically come in contact with.

*Nutritional deficiencies may be related, so addressing diet and vitamin intake is helpful

*Hydrogen Peroxide – posited as a key alleviating treatment (not a cure) on a popular website, it is used in dilutions between 3% and 27% strength, but side-effects of its use include burning and itching, and there is argument as to whether it only attacks the ‘sick cells’.

*Potassium permanganate dilute solution soaks – also popular, and used to ‘dry out’ the vesicles, but can also be very painful and cause significant burning.

*Domeboro (OTC) helps alleviate itching in the short term.

*Emollients during the drying/scaling phase of the condition, to prevent cracking and itching. While petroleum jelly may work well as a barrier cream, it does not absorb into the skin and or allow it to breathe, so may actually be less helpful.

*Salt soaks

*White vinegar soaks

*Avoidance of known triggers – dyshidrosis sufferers may need to abstain from washing their own hair or bodies, or wearing gloves when they do so, however waterproof gloves are often potential irritants.

*Zinc oxide ointment

*Nickel-free diets

*When in the scaling phase of the condition, the scales may cause deep cracks and fissures in the skin. Filing (as with an emery board) may help to minimize this.

*Stress management counseling

*Light treatment: UVA-1, PUVA, Grenz rays, Low Level Light Therapy using a Red + NIR (LED) combination

*Ciclosporin a strong immunosuppressant drug used to combat dyshidrosis caused by ulcerative colitis

*Efalizumab (Raptiva) a medication used to treat psoriasis

*Tacrolimus and Pimecrolimus, potent immunomodulators often used to prevent organ rejection in topical, ointment form, may be used in severe cases.

*Unbleached cotton gloves may be used to cover the hands to prevent scratching and vulnerability of the skin to bacteria

*Plantain (Plantago major) infused in olive or other oil can be soothing.

*Band-Aid brand liquid bandage regularly applied during the (often painful) peeling stage allows the skin to breathe while protecting it from further irritation. Some suffers have found that with regular application the skin will close and reform within 1 to 2 days. Protection is sufficient that the user can (gently) wash their hands with no irritation, however additional application after each hand wash is suggested. It does not cure the condition and only aids healing during the peeling stage. Other spray-on or brush-on liquid bandaids can contain irritating ingredients and have not been found to be helpful, some will aggravate the condition significantly.

*Avoid metal computer keyboards and track pads which contain nickel.

Many sufferers of dyshidrosis will find that treatments that were previously suitable for them no longer work or have induced sensitive reactions, which is common in most types of eczema.

*It may be prudent to wear light cotton gloves while reading newspapers, books and magazines. The inks and paper may irritate the condition.
*Avoid Purell and other hand sanitizing products which contain alcohol. These may aggravate the condition.

*Wash affected hands and feet with cool water and apply a moisturizer as soon as possible.

*On the other hand, hot water usually kills the itch.

*Avoid moisturizers that contain water (cremes and lotions). Stick with ointments.

*Valium in small doses during flare ups
Click to learn more about Dyshidrosis and it’s proper treatment

ABC Homeopathy Forum for Dyshidrosis

Allergy testing:
Allergy testing is a contested subject among eczema communities. Some dermatologists posit that if a sufferer is allergic to a substance, then a general allergy test on the forearm will suffice, yet others believe that in conditions like dyshidrosis, the suspect substances need to be applied to the affected area to induce a reaction. -Often seen in people who are already suseptible to allergies and/or asthma.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.
Resources:
http://en.wikipedia.org/wiki/Dyshidrosis
http://www.geocities.com/vyera/dyshidrosis/main.html

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Ailmemts & Remedies

Eczema

 

Eczema is a noncontagious inflammation of the skin, characterized chiefly by redness, itching, and the outbreak of lesions that may discharge serous matter and become encrusted and scaly.
The main feature of eczema is red, inflamed, itchy skin that is often covered with small, fluid-filled blisters. in long-standing eczema, the affected skin may become thickened as a result of persistent scratching. eczema tends to recur intermittently throughout life.


What are the types?

There are several different types of eczema. Some are triggered by particular factors, but others, such as nummular eczema, occur for no known reason.

Atopic eczema:
This is the most common form of eczema. it usually appears first in infancy and may continue to flare up during adolescence and adulthood. the cause of the condition is not known, but people who have an inherited tendency to allergies, including asthma, are more susceptible to it. Click to learn more

Contact dermatitis

Direct contact with an irritant substance, or an allergic reaction to a substance, can result in a type of eczema known as contact dermatitis. it can occur at any age. Click to learn more

Seborrheic dermatitis:
This form of eczema affects both infants and adults. the precise cause of seborrheic dermatitis is unknown, although the condition is often associated with a yeastlike organism on the skin. Click to learn more

Nummular eczema:

Otherwise known as discoid eczema, this form of the condition is much more common in men than women. In nummular eczema, itchy, coin-shaped patches develop on the arms or legs, and the affected areas of skin may ooze and become scaly or blistered. the cause is not known. Click to learn more

Asteatotic eczema:

Most common in elderly people, this is caused by drying of the skin that occurs with aging. the scaly rash is random and cracked. Click to learn more

Dyshidrotic eczema:
This type of eczema occurs when the skin is thickest, such as on the fingers, the palms of the hands, and the soles of the feet. Numerous itchy blisters develop, sometimes joining to form large, oozing areas. the cause is not known. Click to learn more.

What is the treatment?
Try to keep your skin moist with emollients, take short, luke-warm showers or baths, and use mild soaps. Topical corticosteroids help reduce inflammation and itching. Avoid contact with substances that may irritate the skin. If contact dermatitis occurs, patch testing can be done to identify a triggering substance. most forms of eczema can be controlled successfully.

Click to learn more ……………………………….(1)

Alternative Treatment………………………………………….…(1).………...(2)

The Truth About Eczema

Diet and Eczemas

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.

Resources:

http://www.charak.com/DiseasePage.asp?thx=1&id=148

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