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Eczema
(Atopic Dermatitis)

Definition:
Eczema is a chronic inflammation of the outer layers of the skin. Eczema is most common in infants and children, but it can also occur in adults. Eczema is not contagious.

Causes:
The exact cause of eczema is unknown. Factors that may contribute to eczema include:
  • Genetics
  • Environment
  • Allergies (May be allergies to things that touch the skin such as wool or perfumes in soaps, allergies to dust mites, or allergies to foods. Dust mite allergy is very common in children with eczema. Food allergies are quite rare but do occur.)
  • Stress, especially if it leads to scratching
  • Frequent washing of affected areas
  • Use of rubber gloves in persons sensitive to latex
  • Scratching or rubbing of skin
Risk Factors:
A risk factor is something that increases your chance of getting a disease or condition.
  • Age: five years old or younger (eczema becomes less common after the ages of 5-10)
  • Living in urban areas or places with low humidity
  • Having family members who have eczema or allergic disorders
Symptoms:
The symptoms of eczema vary from person to person. Scratching and rubbing can cause or worsen some of the symptoms.

Symptoms include:

  • Dry, itchy skin
  • Cracks behind the ears or in other skin creases
  • Rashes on the cheeks, arms, and legs
  • Red, scaly skin
  • Thick, leathery skin
  • Small, raised bumps on the skin
  • Crusting, oozing, cracking, or scaling of the skin
  • Worsening in the winter, when inside air is dry due to central heating
Diagnosis:
Your doctor will ask about your symptoms and medical history, and perform a physical exam. You may be referred to a doctor who specializes in skin disorders (a dermatologist) and/or allergies (an allergist).

Treatment:
The main goals of eczema treatment are to:
  • Heal the skin and keep it healthy
  • Stop scratching or rubbing
  • Avoid skin infection
  • Prevent flare-ups
  • Learn to avoid scratching

Treatment options may vary and your doctor may recommend more than one depending on your condition. They include:

Skin Care
  • Avoid hot or long (15 minutes or more) baths or showers.
  • Use mild bar soap or nonsoap cleanser.
  • Air-dry or gently pat dry after bathing and apply gentle moisturizer immediately.
  • Treat skin infections immediately.
Medications
  • Prescription creams and ointments containing cortisone, tacrolimus, or pimecrolimus
  • Antibiotics applied directly to the skin or taken by mouth–only for treating infections
  • Prescription or over-the-counter antihistamines to help prevent itching
Phototherapy
  • Treatment with ultraviolet light (by a doctor)
Prevention:
It can be difficult to prevent eczema, particularly when there is a strong family history. Some studies suggest that breastfeeding reduces a child’s risk of developing eczema. But if you already have eczema, there are several things you can do to try to control it:
  • Follow guidelines for limiting house dust mites in bedding.
  • Avoid direct contact with wool to the skin.
  • Seek advice from your doctor about any use of “natural” or herbal remedies. Some of these may worsen eczema.
  • Avoid scratching or rubbing whenever possible.
  • Follow your doctor’s recommendations for treatment. Improvement may take several weeks or even months after a new medication is started.
  • Maintain a cool stable environment and consistent humidity levels.
  • Recognize and limit emotional stress.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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