【濕疹eczema】如何避免濕疹? Dr.Rex告訴你治好濕疹最重要的幾件事The secrets of controlling eczema(中文/EngSub)

hello, its autumn time people having eczema is having flare ups I make this video to tell you all the evidence based medical tips about eczema that you want let's get started think of the skin as a barrier our environment is filled with substances/pathogens which is potentially harmful it includes many antigens, here it is, which can elicit allergic reactions in human body and many bacteria/germs this is a bacterium they always want to enter our body but our skin is designed to fend them off the first line of defense is stratum corneum a layer of dry hard protein to stop bacteria/antigens below stratum corneum are layers of tightly packed cells there are tiny crevices between these cells they have to be sealed off to become an effective barrier see the bluish area around those cells? it is water yes there is a thin layer of water around those cells to seal off the crevices it's like building a brick wall you have to put some mortar between the bricks to ensure it is waterproof same with the skin the water acts as a sealant to stop antigen from entering the skin bacteria too finds it difficult to get it people with eczema has a problem: the barrier function of their skin is defective first, there are breaks in the stratum corneum it's no longer intact notice that there are holes here and there there are problems with the layers of cells below have you noticed that the bluish color is gone? yes water has been lost through the defects in stratum corneum there are small passage ways between the cells now antigens and bacteria can how find their way and get deep into the skin like this, this antigen gets into the deeper layer more bacteria sticks to the surface of the skin some bacteria, eg Staph aureus can secret toxins these toxins go through the cellular layers and get in like the antigen our body, sensing the invasion of enemy an defensive immune response is triggered these white blood cells will come over this is an inflammatory response; its goal is to eliminate the antigens/bacteria these green and pink circles contain 'cytokines' these cells release cytokines to induce an inflammatory response which in turn neutralize antigens and pathogens cytokines not only is crucial in local response some are carried far and wide via the bloodstream it's like whistle blowing this way more white blood cells will come from afar to rescue a huge inflammatory response is forming hoping to destroy the enemy in one go however these is a down side: histamine is generated in this process, causing intense itch you cannot resist the urge to scratch there will be more breaks in stratum corneum more water in the skin is lost through the breaks more crevices are formed between cells more antigens/pathogens can get through the skin adding fuel to the inflammatory responses; itch intensifies you are bound to scratch more, a vicious cycle is formed to manage eczema, cut your nails short long sharp nails will break the stratum corneum and make eczema worse secondly, I think the most important thing is generous use of moisturizer, which add water between the cells in the skin strengthening the barrier function and help relieve eczema avoid soap for the same reason because soap causes more loss of water from the skin weaker barrier function ensures more entry of antigens use bathing products specially for dry skin/eczema only and these together with moisturizer have to be used regularly as for medication, topical steroids and calcineurin inhibitors(steroid free) are mainstay treatment they control inflammatory response, limiting cytokines formation and reduce itch steroids are of various strengths; the same steroid dissolved in different 'vehicles' may have different properties just like a bullet traveling at 100m/s is much less lethal than one traveling at 1000m/s your doctor will choose the right medication in the correct formation(cream/ointment) for you eczema infected with bacteria may has a big flare up in this case oral antibiotics may be required as for severe eczema a short course of oral steroid may also be needed that's the medical treatment for eczema; there are also DIY treatments first: bleach bath; it makes use of chlorine to kill germs in the skin fewer germs means fewer toxins; less inflammatory response and less itch my earlier video on bleach bath included dilution method by which a milder solution may be obtained normally you can use 6.25% household bleach; add 0.8ml bleach to every 1000ml of water the resulting solution has concentration of chlorine similar to water in a swimming pool soak for 15min each time; then rise the body with water; pad dry and apply moisturizer use bleach bath 2-3 times/week next let's talk about wet wrap: it moisturizes the skin very well for details of how to do it, refer to my earlier video in the links below here you apply generous amount of moisturizer on the skin; wrap it up with a layer of wet tubular bandage then wrap a layer of dry tubular bandage top and go to bed if the inner layer drys out in the middle of the night, remove the outer bandage, wet the inner layer with warm water and put the dry outer layer back on next morning you may remove all the bandages; eczema will improve tremendously lastly, oatmeal soak: blend oatmeal into fine powders put some into a tub of water to obtain a milky/silky solution soak for 15min; it moisturizes the skin and reduce inflammation lastly, let me tell you the secret of treating eczema for many people , failure to use topical steroid, or use adequate amount of steroid is the main reason for treatment failures I really think if steroid is not necessary, that's very good but if redness/itchiness is severe, steroids is necessary to bring a swift recovery we have to use full strength in the shortest possible time to get a result many are reluctant to use steroid, which is understandable but if eczema is not controlled quickly, worsening symptoms will form a vicious cycle so it's better to use all feasible means to control eczema ASAP and stop steroid at earliest possible time rather than use inadequate treatment and let eczema go wild I hope you learn something about eczema today please like, commend and subscribe; remember to hit the bell. Bye bye

Channel: Dr. Rex 醫學幼稚園

Views: 465,017

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Id: _7BKTm82EE0

Length: 15min 31sec (931 seconds)

Published: Sun Oct 25 2020