Eczema allergies

[Pearl1957]

I finf this site very difficult to use. I am confused if creams i am using i am allergic as so many ingredients to know which one is causing a flair.any advice would help

[lovesradio]

Hi Pearl I am in the same boat. My skin was great when I was away last July cycling in the Scottish islands. Since I came back it has been pretty awful and I can't pin it on anything in particular though do wonder if Fairy non-bio washing powder has changed formulation? Can anyone answer this?
Fiona

[Dr Chris Rutkowski]

Dear Pearl 1957, do you mean that your creams (when applied) make your eczema worse?

[Pearl1957]

Dear Dr Chris Rutkowski
I dont know what causes the flair ups as have used cetraben or aveeno or more recently QV and none really help and can all sting on my face. I stopped using anything around my neck as was looking worse there after using them.

[Dr Faheem Latheef]

Dear Pearl, sorry to hear about the problems you are having with the creams you are using for your eczema which appear to be flaring things up. There may be a number of reasons for why this may happen.

Firstly it is worth knowing that creams are water based and just like you may have seen your shower getting mouldy (because the water is getting contaminated/infected by fungus/mould or bacteria) the manufacturers try to prevent this from happening in creams by using preservatives or biocides. These preservatives can often irritate eczema and can be perceived as stinging when applied to the skin. This one of the reasons why Dermatologists tend to recommend ointments (vaseline type greasy products) as these are oil based and do not contain water and therefore no preservatives. Patients however sometimes feel creams are more cosmetically acceptable as they soak in more readily and don't leave you with a shiny appearance but they do come at a risk of getting such reactions to the preservatives. Therefore it might be worth switching to ointment based moisturisers for your eczema such as hydromol ointment, diprobase ointment, or epaderm ointment. "Emollient packs" with samples of various ointments are usually available from your local dermatology department so you can find one that suits your skin and that you like and will be able to use daily.

We also occasionally find that patients may have become allergic to the preservatives in creams as certain preservatives such as cetostearyl alcohol are found in nearly all cream based products and this is something that could be picked up on a patch test by a Dermatologist with an interest in allergic skin disease.

Finally another common reason for irritation when applying creams is that they can sometimes be applied quite vigorously, being rubbed up and down and this can often irritate the hair follicles causing something called folliculitis which presents with irritation and red spots at the base of the hairs. This can be avoided by being less vigorous in the application and trying to apply the cream "along the grain" of the direction of hair growth.

I hope this has been of some help but if your eczema is not as well controlled as you would like and you suspect a possible allergy to products I would suggest being referred to a Dermatologist for review and further management.

[Dr Chris Rutkowski]

Dr Latheef's reply covers it all but I would also add that sometimes poorly controlled/active eczema might seem to worsen when creams are applied; however once it settles (perhaps with some topical steroid treatment ) creams become better tolerated ( and 'sting' less)
The best solution would be to experiment with a few creams and use the one that irritates your skin the least.

[Pearl1957]

I stopped using steroid creams years ago as made the eczema come back more frequently and also a rosacea sufferer so my face often flushes when i put any cream on so will just have to put up with it. Impossible to get an appointment with a dermatologist for months on end so gave up.

[Dr Faheem Latheef]

Having eczema and rosacea can be a difficult combination as steroids for the eczema tend to make rosacea worse. However there is a non-steroid alternative treatment cream called Protopic (Tacrolimus) which can help treat your eczema but avoid the rosacea flaring up and doesn't come with the side effects of steroids. It can sting and burn and feel a bit warm for the first few days of use but this then settles down. I understand the difficulties you are having getting referred to a Consultant Dermatologist as there is a significant shortage in the UK but I would encourage you to speak to your GP again about possibly getting referred to a local Community Dermatology service where the waiting time is usually less and where they should be able to prescribe Protopic for you if appropriate. Wish you all the best.