House dust mite is a tiny insect that occurs in every home. You cannot see it without a microscope. It mainly lives in bedrooms and mattresses as part of the dust. Many people with eczema are allergic to house dust mite. However, in general, it is not usually advised to do anything about house dust mite. This is because:

    The research studies that have looked into whether reducing house dust mite is helpful have not been conclusive. There is some evidence that reducing house dust mite may help but further research is really needed to confirm this.
    It is impossible to clear house dust mite completely from a home and it is hard work to greatly reduce their number to a level which may be of benefit.
    Treatment with other methods such as emollients and short courses of topical steroids usually works well. Therefore, the effort of trying to eliminate house dust mite is not usually warranted.

A recent guideline from the National Institute for Health and Clinical Excellence (NICE) - referenced at the end of this leaflet - states: "There are conflicting data on the effectiveness of using house dust mite avoidance strategies in the management of childhood atopic eczema. Many of the currently suggested techniques are time-consuming and expensive for parents/carers and it is important to establish their value."

However, some people with severe eczema which is difficult to control with the usual treatments try to clear house dust mite from their home as much as possible. Therefore, for the sake of completeness, the following gives an idea of how to clear house dust mite. But it has to be stressed, it is hard work, it is not usually recommended and the value of this is not clear.

To greatly reduce the numbers of house dust mite:

    Remove carpets (where possible) from the bedroom. Avoid soft furnishing in the bedroom.
    Use dust-tight ('mite-proof') covers for any mattress, duvet and pillow (a good bed retailer will be able to advise). This can be left in place for several months. The usual covers can be put on top of the special covers but should be washed every 1-2 weeks at 60°C.
    Use feather rather than synthetic pillows (this is the opposite to what used to be thought).
    Wet-dust the bedroom furniture every 1-2 weeks. Some people advise dusting even more frequently - even daily dusting.
    Vacuum or clean the bedroom floor regularly. Use a vacuum cleaner with a good filter (this removes the mite and prevents small particles coming out through the vacuum exhaust).
    Vacuum the mattress once a week.
    Regularly ventilate the bedroom (open the door and a window for a while on most days).
    Keep soft toys to a minimum. Put them in the freezer in a plastic bag for 24 hours now and again. This kills any mites on them. If the toys are washable, wash them at 60°C after they have been in the freezer.
    Try to keep humidity low (for example, do not dry washing on the radiator). An electric blanket decreases humidity in the bed which helps to keep mite numbers down in a mattress.

 Choosing the right dog is tricky for families with eczema. But with the right guidance and using evidence from research, there’s a good chance you can find a pup that works with your family’s potential allergies and skin care needs.
What is the risk of getting a dog if your family lives with eczema?

All dogs – regardless of the breed – have the potential to trigger your allergies and eczema.

According to Dr. Ari Zelig, a board-certified allergist in Miami, Florida, allergies are generally caused by exposure to dander (shedding flakes of dead skin). “Common symptoms of a canine allergy,” Dr. Zelig said, “include itchy eyes, nasal congestion, sneezing and runny nose. It’s important to note that environmental allergens such as dog dander can worsen eczema and can penetrate an impaired skin barrier, leading to further inflammation.”

What about those so-called hypoallergenic breeds? Nick Miller is a Boston-based dog trainer and founder of Walden Dog Training; he often fields questions from clients with individualized healthcare needs.

“For families concerned about allergies, dogs with longer-haired coats are less prone to shedding, and therefore tend to be the best option,” Miller said. “These dogs usually have less dander that cause issues for people with skin conditions.”

Before making the decision to bring a dog into your home, Dr. Zelig emphasized the importance of understanding the potential severity of canine allergies. “Highly allergic patients,” he said, “may break out in hives if they come in contact with certain dogs.”

When families with allergies ask about specific breeds, Miller said he usually recommends Portuguese water dogs, soft-coated wheaten terriers and all three sizes of poodles and schnauzers.
How can you determine if someone is allergic to dogs?

A skin test or a blood test can reveal the exact nature of a potential canine allergy. Dr. Anna Fishbein, associate professor of allergy and immunology at Northwestern University, recommended patch testing for any family with eczema before bringing home a dog. She explained that the severity of an allergic reaction can be measured in a laboratory setting.

“We test by aerosolizing the allergen into the lung or nose at different quantities to see how much you need to react and how severe the reaction is,” Dr. Fishbein said. “Most patients often know where they fall in that range [of allergic reactions], but certain dogs (not breed specific) can be more allergenic than others. And meeting with an allergist is the best way to get to the bottom of this.”

Before finalizing any decision, Dr. Zelig advised prospective dog owners to “spend time around a variety of dogs to make sure they don’t provoke any allergy issues.”

“There is no breed that is consistently eczema-friendly,” said Dr. Fishbein. “The concept of a hypoallergenic dog is not based on research. There are different allergens produced by different dogs and these ‘components’ can be tested for with your allergist.”
You’ve finished allergy testing and now you’re ready to get a dog – for real

If you’ve completed allergy testing, talked to your healthcare team and you’ve picked out a dog, the next step is training the dog to minimize your risk of allergic reaction in your home. For many new dog owners with eczema, this means separating parts of your home into allergy-free zones.

“All dogs must learn basic rules, limits and boundaries when introduced to a new home,” Miller said. “I would recommend that an adult keep a new dog near them using a leash to interrupt behaviors they don’t want to see (such as jumping up on furniture). It is also helpful to have high-value treats to reward them when they get off the areas humans might not want them to go.”

Miller explained that establishing “dog-free” rooms in the house could help minimize your exposure to the dog’s dander. “Good dog training isn’t rocket science,” he said. “Set your dog up for success by introducing predictable routines and sensible household rules. Don’t give them too much independence or responsibility before they can handle it. The dog you praise is the dog you’ll see more of over time.”
Your new dog follows all your rules, but you’re still having allergic reactions

Part of the challenge in bringing home a dog is that your allergies may vary in severity over time.

Some people eventually experience fewer allergy symptoms and “get used to being around their dog,” said Dr. Fishbein. “Other patients get more allergic and have severe uncontrollable eczema or asthma, which then reverses when the dog is taken out of the home.”

If your allergies get worse over time, Dr. Zelig suggested that “immunotherapy, also known as allergy shots, can help desensitize you and make you less allergic to your dog.” Scheduling a follow up appointment with your allergist, after you bring a dog home, Dr. Zelig said, will give you an opportunity to review your skin care regimen and any medications that might help decrease or prevent your symptoms.

Wash your dog at least weekly, Miller said, and be sure that the person washing the dog is not the person who’s allergic to the dog to avoid direct contact with any allergens.

“Dogs live in a human-dominated world,” Miller said. “And they need your guidance to succeed in it.”To facilitate your dog search, consider a visit to your local chapter of the Humane Society, which allows families to visit and play with canines who are candidates for potential adoption. Source:nationaleczema.org