II. Management: General Measures

  1. Avoid Provocative Factors
    1. Excessive bathing (see below)
    2. Rough clothing (see Pruritus Management)
    3. Excessive sweating
  2. Wear comfortable clothing
    1. See Pruritus Management
  3. Skin barrier protection (Skin Lubricants)
    1. See bathing below
    2. Apply immediately after patting dry from bathing
    3. Skin Lubricant lotions (e.g. Lubriderm)
      1. Apply lotion frequently throughout the day
      2. Avoid lotions with Alcohol (drying)
    4. Skin Lubricant creams or oils (Eucerin or Vaseline)
      1. Bedtime application
      2. Severe cases

III. Management: "Do not bath, Soak!"

  1. Add Bath Emollients (Bath Oils)
  2. Limit soap use (Causes skin drying)
    1. Use a Mild Soap for general skin areas 2 times weekly
      1. See Mild Soaps
      2. Examples: Unscented Dove or Cetaphil Skin Cleanser
    2. Daily use of soap only in groin or axilla
    3. Spare legs, arms, and torso
  3. Decrease bath frequency, length, and Temperature
    1. Limit bathing to a brief, tepid bath
  4. Immediately after bath:
    1. Briefly pat dry
    2. Apply skin barrier protection (Skin Lubricant)

IV. Management: Topical Agents

  1. Alpha-Hydroxy acid Moisturizers (e.g. Eucerin Plus)
    1. Apply after warm water soaks
  2. Topical Corticosteroid ointment (triamcinolone for 4-5 days)
    1. Indications: Visible pink or red dermatitis

V. Management: Dyshidrotic Eczema of hands

  1. Apply Moisturizing Lotions to hands 10-20 times daily
  2. Apply petroleum jelly at bedtime under over-glove
    1. Cotton liner with Vinyl over-glove for hand washing
    2. Allerderm (Hypoallergenic glove supplier)
  3. Moderate to severe exacerbations
    1. Continue protocol above
    2. Add 2 weeks of a moderate to high potency Topical Corticosteroid
      1. If need to repeat Corticosteroids, give at least 1 week break before reusing

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