Best practices for foot eczema?
March 27, 2013 11:29 AM   Subscribe

I'm an adult who's recently developed eczema on the tops of both of my feet. My dermatologist is pretty certain it's not contact dermatitis or anything fungal, so, yay! More chronic skin stuff. Blerg. How can I keep my feet from becoming red, inflamed balls of pain?

I asked this question a while back, and while hydrocortisone kept the rash at bay, it came back with a vengeance and I could not sleep a few nights ago due to my itchy, itchy feet. Saw my dermatologist yesterday, got some Vanos cream (a prescription corticosteroid) and things are already much better.

I take a daily antihistamine, and I get allergy shots. I don't really moisturize consistently - would that help?

What are some common triggers that I should avoid?

Does eczema spread? How can I keep my feet happy and not sad and itchy?
posted by ablazingsaddle to Health & Fitness (15 answers total) 2 users marked this as a favorite
Moisturising may or not help. I find it's more a thing to do once the eczema has receded, to stop it from coming back.

Keep using the steroid cream for a week or two after the eczema clears up - that's the thing a lot of people forget to do (and why it often comes back once you've stopped treating it).

If the itching gets bad at night, get out of bed and give your feet a cold shower until you can't stand it any more. The itching will go away as the blood vessels constrict.

Triggers in my case are shoes and socks (and the things you wash them with). Try an unscented 'sensitive skin' clothes washing liquid, and don't use fabric conditioner or dryer sheets. Go barefoot whenever you can. Don't use soap or anything stronger than water on your feet if you can avoid it.
posted by pipeski at 11:46 AM on March 27, 2013

Also, it doesn't spread as such. The area may get worse if you scratch it and irritate the surrounding skin. It may also occur elsewhere, or it may be isolated to where it is now. Different people have different eczema.
posted by pipeski at 11:47 AM on March 27, 2013

Dairy is a common trigger so avoid cheese, milk, etc.

Hydrocortisone works for a while but, as you've found to your cost (and as I've found with psoriasis), once you stop using a cortisone cream the ailment comes back worse than ever before, so it's not really a long-term solution because it creates a cycle of relief and agony.

A friend at work who had both eczema and dermatitis on the backs of his hands - really badly-inflamed, scaly skin - found that L'Occitane Shea Butter Hand Cream helped enormously - the unscented one, not the lavender or the rose. (This is also good for my psoriasis too.)
posted by essexjan at 11:48 AM on March 27, 2013

I have eczema!

I really really like Aveeno Skin Relief Lotion. It is the one with the dark blue label, and not the overnight one. The Skin Relief Lotion has a cooling agent in it that relieves the pain and itching and the redness and the burning almost immediately. I didn't used to moisturize regularly, but I would use this lotion when things flared up and it immediately soothed. It's amazing!

However, last year I started moisturizing regularly and that has really improved my skin overall. I have had fewer flare-ups of angry itchy eczema as a direct result, even during the bad dry winter months. I have even found that my beloved Aveeno Skin Relief is way too much for non-angry skin on a daily basis, so I use Cetaphil lotions and creams now daily. The Aveeno is on stand-by for the flare-ups.
posted by aabbbiee at 11:51 AM on March 27, 2013

I don't want to threadsit, but here's my medical history and the things I already don't do:

-I have terrible plant allergies, hence the allergy shots and daily anthistamine. No other major allergies.
-Very sensitive skin in general. I already use gentle detergent, mild soap, etc.
-I don't eat dairy. I also don't eat gluten.
posted by ablazingsaddle at 11:52 AM on March 27, 2013

And thanks for the production recommendations - keep 'em coming!
posted by ablazingsaddle at 11:53 AM on March 27, 2013

I was diagnosed with hand eczema just a couple months ago, and I've had success using Eucerin calming cream every night and morning. It's helped a fair amount, though I have to go back to the steroid cream every so often. Stupid eczema.
posted by katers890 at 12:13 PM on March 27, 2013

Make sure your afflicted parts get enough "dry time" between being wet (from a shower) or sweaty (from walking around in shoes all day). Any kind of trapped moisture sends me flaring up like a, well, a flare I guess.

Steroid lotion (i.e., Clobex) is the only thing that has ever helped my mild eczema/psoriasis. Sometimes other creams just make it worse (see moisture thing above). I get it awfully on my hands in the wintertime and in that case, I have to go to sleep with gloved and steroid-creamed hands.

Also avoid an be wary of common immune system weakeners. Stress, poor diet, no exercise, alcohol (big one for me and my sister), excessive heat and cold, etc all contribute to flareups.

Since I've started getting flare-ups, the locations have changed but it really hasn't spread. It used to be on my legs and feet when I was a teenager, now when it comes around, it hangs out on the inside of my elbows and on my palms.

Does anyone in your family have a history of psoriasis? I ask because I was always told I had eczema, then my twin sister developed pretty bad psoriasis and when I mentioned that to my dermatologist, she said, okay well you probably have psoriasis not eczema since it's so closely family-linked.
posted by Katine at 12:35 PM on March 27, 2013

Oops, wanted to mention also,make sure you cover your rash with either a high SPF or cloth when you are out in the sun. Sun can cause flares and can also cause the weakened skin to darken and become hyper-pigmented.
posted by Katine at 12:38 PM on March 27, 2013

Hydrocortisone works for a while but, as you've found to your cost (and as I've found with psoriasis), once you stop using a cortisone cream the ailment comes back worse than ever before, so it's not really a long-term solution because it creates a cycle of relief and agony.

I know this isn't really the place for discussion, but I think that's a common misconception that came about because people have not being given the information they need to use the medication correctly. Eczema recurs in the same spot because it hasn't had time to fully heal. Applying the medication for a couple of weeks after the eczema appears to have cleared up ensures that the eczema hidden deep in the dermis gets a chance to heal as well. When that doesn't happen, it's very easy for the irritation to resurface, which is what leads to the misconceptions about corticosteroids being ineffective, addictive or evil.

Having said that, the best treatment of all is simply not to scratch. It's the hardest thing to do, but the more you resist, the quicker it heals.
posted by pipeski at 1:03 PM on March 27, 2013 [1 favorite]

I haven't had foot eczema, but I have had leg eczema and the dermatologist I saw recommended using unscented lotion on the area to avoid recurrence. His suggestion was unscented Curel
posted by kbuxton at 1:28 PM on March 27, 2013

Moisturizing Socks
posted by plokent at 1:34 PM on March 27, 2013

I've been dealing with eczema from birth. It seriously sucks, but with time you will find the strategies that work for you. Eczema is a constant battle to keep flare-ups at bay, and the crappy part of all of this is that there is no one cure-all for every case. I'll tell you my strategy, though keep in mind that none of it may work for you. I've done gobs of research through the years and have tried some unconventional methods during bad outbreaks, so hopefully I can offer some new information for you.

- DO NOT SCRATCH. EVER. RESIST. IT WILL ONLY MAKE IT WORSE. It is often said that eczema is an itch that causes a rash. The patches originate from scratching the skin (which may be itchy for other reasons), resulting in the irritated rash. Since yours is specifically on your feet, is there a possibility that you could go shoe-less for a few days? Maybe over the weekend? I have a feeling that wearing shoes PERIOD may be making this worse for you.

- Eczema does not necessarily "spread" in the traditional sense that people normally associate with rashes...but it can appear on multiple areas of the body for (seemingly) no particular reason, and if those spots are left untreated, they may grow slightly in size.

- Cortizone cream works well for a lot of people. I can't live without the stuff. I second all of what pipeski says. I also don't buy into the belief that cortizone causes eczema to come back even worse then before, because eczema will come back NO MATTER's a freakin chronic skin condition. Cortizone helps, but you really have to be vigilant with applying as directed, and continuing to apply well after it appears the rash has subsided. Barring prescription steroid cream, it is the only thing that actively resolves my patches of eczema. Plain old moisturizing is never enough for me.

- Beware of allergens. A daily antihistamine is part of my regimen, and definitely makes a difference for me. Keep up with that. If you have pollen allergies, be sure to at least rinse off in the shower before getting into bed, and change your sheets as often as possible during pollen season.

- Like Katine said, make sure that you let the eczema dry out a bit every day. Excessive sweat/moisture (counterintuitively) can make an outbreak much worse. Heavy lotion on actively inflamed patches is a no-no. Cortizone/steroid cream spot treat a few times a day, and perhaps apply a coat of light/unscented/mild lotion after a bath/shower.

- Short epsom salt baths (warm water, 10-15 min) have proven beneficial for me. I explored this route after a trip to the beach (sun and salt water) cleared up a round of eczema.

- Along the same vein, a bit of sun sans SPF always provides me a bit of relief.

- Bleach baths can be effective in treating eczema that is exacerbated by bacteria on the skin.

- Take short, lukewarm showers and baths. Hot water is your enemy.

That's all for now. I may pop back in with other suggestions. Feel free to memail me if you have any questions.
posted by Gonestarfishing at 1:49 PM on March 27, 2013 [1 favorite]

There is very good evidence that problems in the skin's ability to maintain an adequate barrier to the outside world is a major factor in eczema. That's why eczema flares up parts of the body where there is a lot of rubbing and stretching, and why sufferers symptoms often get worse in winter when their skin is drier. Also, genetics.

Daily moisturizing does help to maintain barrier integrity, and like aabbbiee I would also recommend Aveeno.
posted by kisch mokusch at 3:35 AM on March 28, 2013

All the advice about not scratching makes me roll my eyes, because to me that's about as effective as telling an alcoholic "Well, just don't drink!"

The itching caused by eczema takes over my mind, my body- I have never jonesed for anything the way I jones for a scratch. Not scratching it literally makes me tense up and lose focus on everything but the itch itself. There's no point through which you can "power through" and it will stop itching. It will just continue to itch until you scratch it.

And scratching eczema is the most amazing, relieving, delicious feeling ever... up until the point where I break the skin and the itching is replaced by pain and possibly blood and then scarring. But when there's pain, there's no itching. For a long time, the pain was preferable. No, that's a lie. I still think the pain is preferable.

I've had eczema since childhood. It worsened a lot in my 20s. I used Clobetasol for years, though it never healed anything- it just managed the itching. My doctor recently switched me to Desonide, which is far less potent, but it is working better than other creams I've used in the past.
For my really chronic eczema, the Aveeno lotion can sometimes provide a stop to the itching temporarily, until I can use some topical steroid cream on it. For other eczema-prone areas, just moisturizing regularly has helped immensely and I'm having far fewer flare-ups.
posted by aabbbiee at 8:37 AM on March 29, 2013

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