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38 DAYSPA | AUGUST 2014 Delicate Conditions products, cold stones, pressure-point massage and stress-relief treatments such as refl exology and aromatherapy. "As long as skin is not in an eruptive stage, you can help soften plaques (scaly patches) with gentle exfoliation," she adds. Natalie Pergar, lead skincare trainer for Éminence (eminenceorganics .com), agrees, and notes that skin- softening Omega-3 supplements may also help. C o n d i t i o n : Condition: ECZEMA Occurrence: Eczema affects up to 30 million Ameri- cans of all ages, although 90% of sufferers develop it before the age of fi ve. People of Afro-Caribbean de- scent may carry a higher risk, and living in a developed country, particularly in an urban environment, also seems to increase risk. History: Mentions of eczema can be traced as far back as the Ebers Papyrus, an Egyptian medical papy- rus written around 1550 B.C. Primary symptoms: Also known as atopic derma- titis (AD), eczema "typically occurs in the skin folds, but, like psoriasis, it can also affect the trunk and face," notes Shapiro. Éminence's Pergar describes the presentation of eczema as dry, itchy, rashy skin; scratching can lead to redness, swelling, crusting, scaling and thickening—or, in extreme cases, weep- ing, painful skin. Possible causes: Eczema is considered an allergic condition and is related to seasonal allergies, hay fever and asthma, according to Shapiro. Dermalogica's King agrees that eczema shares similarities with food aller- gies: both are on the rise and refl ect an overactive re- sponse to allergens that puts the body on a heightened state of alert. "The reaction can occur anywhere on the body, whether an allergen is applied, inhaled or ingest- ed. Eczema is a case of an open barrier," she explains. Eczema is linked to heredity, though it can occur in someone with no known history, and can disappear and return when triggered. Dr. Peter A. Lio, assistant professor of clinical dermatology and pediatrics at Northwestern University Feinberg School of Medicine (feinberg.northwestern.edu) in Chicago, and speak- ing for the National Eczema Association (national eczema.org), notes recent research centered on the discovery of a gene that encodes for a protein called fi laggrin, which plays an important role in creating and maintaining the skin barrier. "The skin's job is to keep bad stuff out while keeping water in," he explains. "If the skin becomes 'leaky,' water gets out, leading to dry, irritated skin, while allergens, irritants and bacteria can get in, causing trouble." Although doctors are certain that eczema in some patients is caused by a genetic defi ciency causing leaky skin, this doesn't explain all cases; in non-genetic cas- es, other factors may play a role, including abnormal immune responses and even nerve endings in the skin that are "trigger happy" when it comes to sending the signal to itch, says Lio. "The other exciting develop- ments surround the role of bacteria in eczema," he adds. "We've known for a long time that eczema patients often get infections (generally staphylococcus aureus), but now we're learning more that just having the bacteria on the skin as a colonizer can apparently drive the infl ammation of eczema." Ultimately, Lio be- lieves, eczema is probably not one disease, but rather several similar conditions that get lumped together. Treatment options: Eczema is often treated simi- larly to psoriasis, with topical steroids and nonsteroid topical emollients. "Proper skin care is essential: Pa- tients with eczema are cautioned not to stay in water You Should Know... "Psoriasis, eczema and rosacea are systemic conditions, so spa professionals should be very careful to avoid any reference to 'curing' them. However, they can help clients identify the external stimuli or triggers that can create or exacerbate them. Some estheticians unwittingly worsen these conditions with services such as hot tubs, mineral baths, mineral scrubs, radical exfoliation, oxygen therapies and other oxidative services. Spa professionals are often unaware of what's hiding in water or what's in products that may actually trigger eczema, psoriasis and rosacea. Even water from a treatment room sink can contain as much chlorine as do pools. "In addition, fragrances, including certain essential oils, can trigger these three conditions. Treatment rooms should disperse essential oils in aerators and other devices to create a fragrance experience as opposed to applying fragrances directly on the skin. And watch out for preservatives—they're another common trigger." —TOM PORTER, FOUNDER AND PRESIDENT, MALIBU C AROMATICS CAN HELP OR HURT A SKIN DISORDER. © SARSMIS/GETTY