How best to handle eczema
DEAR DR. DONOHUE: I am in my 80s and have been blessed with eczema. The itching is intense. My doctor has me on two creams, but they aren’t working too well. The doctor doesn’t want me to take cortisone because it could weaken my bones. What would you suggest? Does it have any relationship to poison ivy? — N.N.
ANSWER: Most often, eczema starts at young ages and often improves with time. However, it can make an appearance later in life. Almost always it indicates dry skin. Eczema appears as red patches that have tiny blisters, seen when viewed with a magnifying glass. The skin itches dreadfully. Itching intensifies at night and leads to scratching, which compounds the problem. Scratching turns the skin to leather.
Restoring moisture to the skin is the first step. Baths and showers should be brief, and no irritating soap should be used. The water temperature ought to be on the tepid side, never hot. After bathing, leave some moisture on the skin, and apply a moisturizer like Aquaphor, Eucerin or Lac-Hydrin.
Keep fingernails short, so scratching — when done unthinkingly, as it often is — doesn’t damage the skin. Compresses of cool water control itching. Don’t wear garments of wool or synthetic fibers.
An oatmeal bath before going to bed can give you an itch-free night. The oatmeal is found in drugstores and is called colloidal oatmeal. The pharmacist will help you find a product. There are many brand names.
Antihistamines ease itching. Some cause drowsiness, so you’ll have to experiment to see which one controls your symptoms without making you sleepy.
I understand your doctor’s reluctance to use cortisone products. But does the doctor know that your creams aren’t working for you? Cortisone medicines applied to the skin don’t result in high blood levels and usually are safe. A short course might restore skin health.
Protopic ointment and Elidel cream — neither a cortisone preparation — often control eczema. The FDA issued a warning to users that these preparations might be associated with skin cancer and lymphoma, but the risk is quite small.
Poison ivy is a bit similar to eczema. Its sap causes skin inflammation, so the two are not identical twins.
I apologize to the letter writer. I lost her letter and had to recall what I could from memory.
DEAR DR. DONOHUE: Please explain how high blood pressure brings on kidney disease. — M.L.
ANSWER: When blood rushes through kidney arteries at high pressures, it roughens their lining and promotes the deposition of cholesterol and fat. The arteries harden and narrow. They carry less blood to the kidneys, and that’s responsible, in part, for kidney failure.
The filtration of blood in the kidneys takes place in millions of tiny delicate arteries called glomeruli. High pressure destroys those filtering stations, another contribution to kidney failure.
Increased blood pressure doubles the risk for kidney malfunction. This isn’t something that’s unique to the kidneys. It happens to heart arteries with the consequence of heart attack and to brain arteries with the consequence of strokes.
To add confusion to this topic, kidney diseases, apart from what I mentioned above, also can raise blood pressure. That’s a matter for another day.
DEAR DR. DONOHUE: Someone wrote to you about having bubbles in the urine. You said it was a possible sign of too much protein in the urine. You didn’t say what you can be done about it. Is it dangerous? — Anon.
ANSWER: I’m making far too much of urine bubbles. I mean bubbles that look like a head of beer, not the bubbles the come when one liquid is poured onto another. Urine protein can produce head-of-beer bubbles. Protein shouldn’t be in the urine; it indicates there’s a leak in the kidney’s filters. A person can do nothing about this on his own. He has to: 1. Verify that there is protein in the urine; and 2. Follow his doctor’s advice, which comes only with further testing.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.