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6 Things To Know About Eczema Before and After Surgery

Medically reviewed by Raj Chovatiya, MD, PhD, MSCI
Posted on May 25, 2023

Eczema is a chronic skin condition that can make you more vulnerable to infection. Because of this risk, people with eczema need to be especially careful when facing and recovering from surgical procedures.

One member of MyEczemaTeam shared their worries: “I see my dermatologist tomorrow, and I have a question. I am supposed to have surgery on my back on Monday. I’m wondering if my eczema is going to cause them to cancel it. I have waited a long time for this surgery.”

Another member wrote, “I’m due to have a hip operation in a couple of weeks. I’m concerned that if I have a slight break in the skin, they may cancel my operation. The doctors said that they won’t operate if my skin is bad, due to the risk of infection.”

Unfortunately, sometimes eczema can put a pause on your plans, even those that involve surgery. Here’s what the research has to say, along with some personal experiences shared by MyEczemaTeam members.

1. It’s Possible To Get Surgery Even if You Have Eczema

Eczema isn’t necessarily a deal-breaker for having surgery, especially if the benefits of the procedure outweigh the risks. However, you may need to delay the operation until your skin is in the right condition to recover safely. Only your health care provider can give you specific advice about whether surgery is safe and if your eczema may lead to a delay, so speak frankly with them ahead of time, and always ask whether your skin condition could be a surgery deterrent.

In addition, special preparations and testing before surgery can help predict potential problems and reduce your risk. With collaboration among your health care providers and your due diligence in following their medical advice, you can ensure the best outcome from a surgical procedure.

2. Your Prep May Require Extra Steps

Preventing infections is always critical when preparing for surgery. However, people with eczema and other skin conditions may need to take additional care. Be sure to follow your surgeon’s instructions on how to prepare your skin on the days leading up to your operation, and call them if you have any questions or concerns.

“I remember when I had knee surgery several years ago, I had to wash with a special soap and was cautioned about having surgery with a cut or infection,” one MyEczemaTeam member said.

In addition to perhaps using a specific antiseptic soap, you might be asked to do a patch test if your health care team feels you’re at risk of contact dermatitis — a reaction to any medical products being used. A patch test can show how your skin reacts and help screen for delayed hypersensitivity that could develop around future surgical wounds.

Do your best to eat a healthy diet leading up to surgery to give your body the nutrients it needs to heal. Giving up cigarettes and abstaining from alcohol can also enhance recovery.

3. The Procedure Could Trigger Eczema Flares

Inflammation is the body’s way of responding to trauma, like an injury or surgery. After surgery, inflammation levels are higher because your immune system is working hard to begin the healing process. Eczema is also an inflammatory condition.

As a result, the combination of surgery and underlying eczema can put your immune system into overdrive, negatively affecting the skin and extending the recovery process. However, if anti-inflammatory and immune-suppressing therapies keep your eczema under control, you’re less likely to experience flare-ups or complications.

Continuing your normal eczema treatments, including medications and topical corticosteroids, can prevent eczema from getting worse after surgery. You’ll need to ask your dermatology provider about the safe application of ointments and whether you need to temporarily halt your medications before the procedure. Remember, lifestyle factors like avoiding food triggers, sleeping well, and managing stress also help control inflammation.

4. Surgical Products Could Pose Problems

Another concern with surgical procedures and eczema is the risk of contact dermatitis. Contact dermatitis is a separate condition from eczema but may occur at the same time, and the symptoms often overlap. With contact dermatitis, the skin reacts to a trigger because of either an allergy or a sensitivity. Irritants, like harsh detergents or chemicals, may activate contact dermatitis symptoms.

Studies show that many medical products used for surgery can cause allergic or irritant contact dermatitis. Certain people could react to items and substances such as:

  • Topical antibiotics
  • Adhesives
  • Suture materials
  • Bandages
  • Antiseptics
  • Surgical gloves

Sometimes, the resulting flare-up can be difficult to distinguish from eczema. This is another example of why it’s so important for your dermatologist and surgeon to communicate and assess your risks when planning for surgery on sensitive skin. You should also tell your providers about any past experiences or reactions to chemicals or medical supplies.

5. Incision Sites Require Additional Care

Unfortunately, even if you’re careful, you may experience poor wound healing or infections when wearing a cast or having an incision. Your health care provider can suggest extra measures to keep your skin healthy while healing.

“My daughter had foot surgery on both feet,” shared one member. “She has eczema pretty badly on her feet, and we got them in pretty good shape prior to surgery. But her skin got bad in the cast the first time she had surgery. She also had an infection at the surgical site. For the second foot, we went every week to change her cast and reapply lotions, and that worked out much better. However, she still got a surgical wound infection, which we expected. But fortunately, her doctor was amazing!”

You should receive detailed instructions on aftercare for surgical wounds and schedule a follow-up so your doctor can evaluate your recovery. In general, it’s important to keep surgical sites clean and covered. You may need to change your bandages daily and have stitches removed as advised by your doctor. To help prevent scars, keep your skin out of the sun until it’s fully healed — and always avoid touching the area without first washing your hands thoroughly.

It’s crucial to watch for signs of infection after surgery, such as redness, fever, discharge, chills, or swelling. With eczema, infections may not clear up without treatment. Talk to your doctor promptly to keep the problem from getting worse and to reduce your risk of more dangerous complications.

6. You Can Keep Symptoms At Bay While Awaiting Surgery

If you’re not a good candidate for surgery right now because of an eczema flare-up, temporary fixes might help while waiting for your skin to clear up. Physical therapy, heating pads, pain medication, cortisone injections, and other therapies may help manage your symptoms until it’s a better time for surgery.

Because surgery is an added stress to the body, getting eczema symptoms under control first will give you the best chance for a safe and speedy recovery. Use the extra time to prepare yourself mentally and physically for your operation by eating well, getting enough rest, practicing self-care, and reaching out to your support systems.

Talk With Others Who Understand

MyEczemaTeam is the social network for people with eczema and their loved ones. Here, more than 47,000 members from around the world come together to ask questions, offer support and advice, and connect with others who understand life with eczema.

How has your history of eczema affected your ability to have surgery or other medical procedures? Have you ever had an allergic reaction or a skin infection after an operation? Share your experience in the comments below, or start a discussion on MyEczemaTeam.

    Posted on May 25, 2023
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    Raj Chovatiya, MD, PhD, MSCI is an assistant professor of dermatology at Northwestern University Feinberg School of Medicine in Chicago, Illinois. Learn more about him here.
    Anastasia Climan, RDN, CDN is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.

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