eczema (dermatitis)

Eczema or dermatitis account for a large proportion of skin diseases. The most common occurring on the feet is contact dermatitis, meaning eczema or inflammation of the skin as a result of contact with an external factor, usually something within the shoe or perhaps a reaction to nylon stockings.

Note in the picture below the contact dermatitis as a result of sensitivity to rubber sole inserts.

As bad as all that looks and feels, the bigger problem is the possibility of developing a secondary bacterial infection with a spreading cellulitis. This is particularly dangerous in the debilitated patient or the diabetic or the patient with poor circulation.

Eczema by one estimate affects upwards of 4% of the population. It is more prevalent among people who have asthma or hay fever. In these individuals eczema usually starts in infancy and continues into adulthood. This type of eczema is known as allergic eczema and there is a strong familial tendency.

The other type of eczema as mentioned above is contact dermatitis which is the more common type seen on the foot. Although in most cases it occurs from direct contact with irritant, factors such as stress, profuse sweating, a dry environment and an exposure to hot and cold environments can set it off.

Another type of eczema is neurodermatitis, which usually has emotional origins. This can be particularly bad because the patient will constantly scratch so bad that the eczema will break open and become infected. Note the debilitating case of neurodermatitis below.

It is helpful to know when the outbreaks occurred. Did it happen after playing with the neighbor’s dog, or after spending the afternoon in the park being exposed to ragweed and other grasses? Did you just wear a new pair of shoes or socks?

Even knowing the factors that can set it off, it may be difficult to prevent eczema flare-ups. For no apparent reason the area may start to itch and your normal reaction is to scratch. The problem is that the scratching further inflames the skin and many times will make the rash worse or may spread it beyond its original borders.

The simple solution is to try over the counter hydrocortisone creams or prescription grade cortisone creams if the over the counter brands do not work. Just be aware of the fact that chronic use of topical cortisone creams has a tendency to thin out the skin. They can be supplemented with oral antihistamine to reduce the itch and inflammation. Should the skin become mildly infected adding a topical antibacterial cream like Neosporin or bacitracin can be helpful.

Should the area become grossly infected, oral antibiotics may be necessary. It also should go without saying that removing the external irritant in the case of contact dermatitis is also mandatory.

As a first of line of defense for preventative measures, applying lotions containing vitamin A and E can soothe and calm the skin making a flare-up less likely. Bathing and moisturizing every day is essential, using lukewarm water and a mild non-irritating soap. Immediately after bathing apply liberal amounts of moisturizer to the affected area in an effort to seal in the hydration created by the bath itself.

Some experts recommend adding one of the following to your bath. One half to one cup of baking soda; 1 to 2 cups of Aveeno (colloidal oatmeal sold in stores) or 1 to 2 cups of finely ground oatmeal bought in the grocery store and then run through your coffee grinder.

Fish oil or fish oil capsules can also be very helpful. The inflammation associated with eczema occurs because your body produces unusually high levels of compounds called prostaglandins. Fish oil is known to reduce this inflammation.

British researchers found that evening primrose oil also provides significant relief from eczema as it is rich in omega-6 fatty acids which are chemically similar to the omega-3 fatty acids found in fish oil.

Because of the unique nature of feet constantly being enclosed in shoes, or if barefoot, being exposed to irritants on the ground, proper cleansing and avoidance of the materials or chemicals that have set off the eczema are mandatory.