Q: I have an itch that's driving me crazy. My family doctor says it's eczema and has prescribed a number of salves. None has done any good. What recommendations do you have to take this itch away? -- B.R.
A: Eczema (ECK-suh-muh or eck-ZEE-muh) is a skin rash of maddening itch intensity. Tiny blisters compose the rash -- so tiny, they are hard to see. The blisters rest on a patch of red skin. This is only one description of the skin rash. There are many varieties, but the itch remains at fever pitch in all.
People reflexively scratch the involved skin. Scratching leads to more trouble. The scratched skin becomes thick and dry as leather. It's prone to infections. One of the major goals of treatment is to break the itch-scratch cycle.
The immune system is believed to be responsible, mistakenly directing an assault on the skin for no good reason. People with eczema often come from families that suffer allergies.
Simple measures help immensely. Eczematous people should not wear wool clothes; they ought to stick to cotton or synthetic fibers. When bathing, these people should use tepid water and mild soaps such as Dove, Basis or Oil of Olay. To restore moisture to the skin, after bathing, eczema victims ought to pat themselves with a towel and leave a film of moisture on the skin. Then, while the skin is still damp, they should apply a thin layer of a moisturizer.
If the rash is in full force, forget the moisturizer. More potent creams or ointments are needed. Ones with cortisone are the first choice. Many cortisone creams can be bought without a prescription. Covering the cortisone-treated skin with a cellophane wrap improves penetration. If over-the-counter cortisone creams do not get the job done, then the doctor can prescribe alternate cortisone preparations.
Two somewhat new eczema treatments are Elidel cream and Protopic ointment. Both require a prescription.
Q: I am scheduled for hip replacement in two months. I talked with my cousin, who had the operation done one year ago. He said I would never be able to bend my hips to the fullest after this operation and that his life has been greatly hampered ever since he had it done. I am considering canceling my surgery. What would you advise? -- W.R.
A: I would talk with my orthopedic surgeon and believe the prognosis he or she gives me. Your cousin's case is not typical. Most hip replacement surgeries have people back on the golf course, for instance, in surprisingly short time. I have seen them, and none has the difficulty your cousin has.
Limitation of bending is something that applies only for the first few months after surgery. It is not the norm after that.
Q: I have red, itchy eyelids, and I find it hard to open them in the morning. They are glued together with a hard crust. What is this and what can I do for it? -- R.V.
A: What you describe has all the characteristics of blepharitis. It is an inflammation of the lid margins, and the staph germ is its No. 1 cause.
For a short time you can try a self-help program. Dilute a small amount of baby shampoo with an equal amount of water. With a cotton- tipped applicator gently swab the lid margins with the mixture twice daily. Before swabbing, use a compress moistened with warm water on the lids and let it stay in place for 10 minutes. A washcloth makes a suitable compress. Keep the lids closed while the compress rests on your eyelids.
If the situation has not markedly improved within one week, see a doctor. You most likely will need an antibiotic ointment to put an end to your blepharitis.
Readers may write Dr. Donohue at P.O. Box 536475, Orlando, FL 32853-6475.
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