Tuesday, May 10, 2005
An Effective Treatment Starts With the Cause
To find an effective treatment, you must first identify the cause or aggravating factors in your eczema outbreaks. The steps taken to identify the cause of dermatitis are akin to a detective story, in which a few clues may lead to a suspected allergen or irritant. Try to remember anything that changed prior to the reaction. Was there any change in clothing, detergents, personal care items, behaviors, habits, or foods? A specific area of the body may point to a possible offender. For instance, if dermatitis is confined to the eyelids, the culprit may be a recent change in makeup procedures. The preservatives, vehicles, or colorants in eye makeup or eyelid cleansing products should be reviewed. Hair care products, eyelash curlers, or other facial cosmetics may also be the cause.If an allergy to a ring has developed, often, there will be a ring of dermatitis under the ring. If the ring is a gold alloy, allergy to nickel in the ring is possible, but the probable cause is a detergent or other product to which the hands are exposed. An allergen or irritant residue can remain under the ring, where dermatitis eventually develops. To reduce this problem it is best to remove the ring until the hands are thoroughly washed and completely dried. Parents may find that a child has dermatitis around the mouth. If the irritation extends in a complete circle at least one or more inches out from the lips, the culprit may be lip-licking. The child may have a nervous habit of licking the lips and face as far as the tongue will extend. Oral fluids are irritating to skin with constant exposure, and the child needs to be taught that licking causes the problem rather than soothes it. Other causes of lip inflammation include lip makeup, ingestion of oranges, apples, mangoes, potatoes, carrots, tomatoes and kiwi. An underappreciated sensitizer is neomycin; a component of the most commonly sold topical antibiotic products (e.g., Mycitracin, Neosporin). These products are only safe for preventing infections in minor injuries. If a person develops an allergic reaction when using them as directed, they must be immediately discontinued. Since the appearance of an allergy to neomycin can cause cross-sensitivities with other aminoglycosides, such as gentamicin, one should choose a topical antibiotic free of neomycin. Patients using veterinary products, such as Bag Balm, as hand softening agents may develop a quinolone sensitivity. In order to avoid this, you should be urged to only use products labeled for human use. Benzocaine is a sensitizer that is found in topical products for itch, burns, dermatitis, canker sores, insect bites, teething, and hemorrhoids. If you develop a sensitivity to these products, an alternate local anesthetics (e.g., pramoxine) should be chosen.
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