Ask the Doctor: Eczema and COVID-19

March 18th, 2020

News of COVID-19 coronavirus is dominating global headlines. It is a time of uncertainty, rapidly changing information, and we are lacking evidence and data related to COVID-19. This information should not be taken as medical advice, and patients and caregivers should contact their own health care providers if they have any concerns related to their or their child’s specific condition.

ESC reached out to two Canadian dermatologists to help us better understand the situation. Dr. Neil Shear, MD, FRCPC, is a dermatologist and Head of Dermatology at Sunnybrook Health Sciences Centre and Professor of Dermatology at University of Toronto. Dr. Rachel Asiniwasis, MD, FRCPC, is a dermatologist and researcher with special interest in eczema. They help to shed light on the situation as it relates to eczema patients.

Q: How are eczema sufferers impacted by COVID-19?

Dr. Neil Shear was on the front lines of the SARS outbreak back in 2003, and he shared his perspective:
“Individuals with eczema – including atopic dermatitis and hand eczema – need to take the same precautions against COVID-19 as individuals who don’t have eczema, the most important being good hand hygiene. To help minimize irritation, a gentle cleanser is a good option for those with sensitive skin. Moisturizer can be applied after washing and drying the hands.”

He continues, “Hand sanitizer is safe if hand washing isn’t an option, however hand washing is recognized as a preferred option. Be advised that the alcohol in hand sanitizers may sting or burn the skin and may be drying. It is also recommended to avoid touching your face, eyes, and mouth; however, we know this may be difficult for individuals with facial eczema (and even for those with unaffected skin). This reinforces the need for good hand hygiene.”

Q: Are patients on systemic immune suppressing medication at a greater risk?

Dr. Asiniwasis shared that, “Overall risk may be greater for immune compromised Canadians, including the elderly. Generally, having eczema (atopic dermatitis) itself is not necessarily a risk. However, if patients with eczema are taking systemic immune suppressing medication, they may be at increased risk – although this level of risk is not fully known at the present time regarding COVID-19 infections, and we await further data. These patients need to take every precaution, including staying home during this time of uncertainty.”

Dr. Shear added, “My general advice to eczema patients is to not make any changes to your treatment plan without consulting your doctor, and to follow the same guidelines as the rest of the population to avoid exposure. Eczema sufferers who are concerned with their treatment plan and have questions should contact their health care provider.”

Dr. Shear also provided additional guidance on obtaining topical medication refills and eczema treatments: “At this time, it may also be difficult to see your doctor for prescription refills of topical therapies. Patients and/or caregivers can call their doctor’s office for guidance, as they may be able to coordinate a prescription refill by phone or fax, to avoid a trip to the doctor’s office or walk in clinic.” In some provinces patients may be able to obtain prescription refills directly from their pharmacist.

Q: Where can we get credible information at this time?

Dr. Asiniwasis points us toward credible sources: “I would recommend reviewing the World Health Organization’s most current information on precautions and guidelines and keep up to date. Patients should follow public health recommendations and the travel restrictions of local health authorities. Those who have concerns about their medications or health should contact their prescribing health care provider by telephone. If concerning signs and symptoms arise for COVID-19, appropriate medical care should be sought.”

In addition to the World Health Organization, you can consult the Government of Canada’s Public Health Agency of Canada (PHAC) web page for up-to-date information, as well as your local provincial government authorities for the latest updates and guidelines. You can also visit the Canadian Dermatology Association web page at www.dermatology.ca.

ESC thanks Dr. Shear and Dr. Asiniwasis for their time and contribution to this content and reminds everyone that if you have any questions regarding your specific treatment plan, or any concerns, please consult your health care provider.