Eczema
Atopic dermatitis, commonly known as eczema, is a chronic condition that affects 9.6 million children, usually before the age of five.
There are 16.5 million adults with moderate to severe eczema that started by five years of age. Eczema tends to run in families, and common triggers include dry skin, skin irritants, stress, temperature changes, and allergies. People may be more likely to have eczema if they have hay fever or asthma.
Types of eczema
Not all eczema is the same, and some people may develop the skin condition later in life. Types of eczema include:
Atopic dermatitis — Chronic eczema that often develops in childhood Contact dermatitis — Skin irritation caused by an irritant or allergen Dyshidrotic eczema — Small, deep-seated blisters, commonly on the hands and feet that are itchy and painful Hand eczema — Painful or itchy spots on the hands Neurodermatitis — Eczema that tends to produce only one or two thick, discolored, itchy patches on the skin as a result of scratching Nummular eczema — Round coin-sized, raised, scaly areas that may be difficult to diagnose and treat, possibly caused by insect bites or allergens Stasis dermatitis — Eczema caused by pressure and blood flow in the veins
Eczema symptoms
The most common symptom of eczema is itchy, dry, and scaly skin appearing on the face. Other areas commonly affected are the neck, wrists, elbows, knees, and ankles.
If you have eczema, try not to scratch the affected area, or you may risk a skin infection. Over time, the patches of skin can become darker and thicker, and can itch incessantly. Some foods, such as dairy products, nuts or shellfish, may make eczema worse, so watching your diet may be important.
Treatments and tips for eczema
If you have eczema, it's important to wash your skin with mild soap, take short showers with warm water, use a moisturizer, and manage stress with exercise or relaxation techniques. Sometimes, over-the-counter medications or doctors' prescriptions can help eczema flare-ups. Consult a dermatologist for an individualized treatment plan, including medication and therapies to manage the itching, skin inflammation, scaly skin patches, and to clear infection.
Eczema treatment includes over-the-counter and prescription cleansers, moisturizers, and topical corticosteroids. Using Vaseline and other unscented moisturizers with petroleum jelly can also be effective for maintaining rash-free skin. Thicker pastes and creams like Eucerin Creme and Aquaphor Healing Ointment are most useful for dry skin. Benadryl (diphenhydramine) and other antihistamines can also be helpful for itchy, irritated skin. Topical corticoids (hydrocortisone, betamethasone) help control inflammation and itchiness.
Immunosuppressants (tacrolimus, cyclosporine) and calcineurin inhibitors (methotrexate, azathioprine) are prescriptions used for severe eczema that doesn't respond to other forms of treatment. Due to potential side effects, take these medications for as short of time as possible.
You may have to try several treatments and work with your doctor to determine the plan that is best for you.
For children with eczema
Eczema may appear in babies and kids of all ages. Special considerations when caring for children include:
- Use mild, fragrance-free cleansers
- Take 5- to 10-minute baths in warm—not hot—water
- Apply medication to your child's skin when partially dry, then apply a moisturizer on top of the medication
- Moisturize skin at least twice a day to prevent dryness and cracking
- Keep fingernails short, and wear cotton gloves at night to prevent scratching
Published on April 30, 2020
Sources:
National Eczema Association, Types of Eczema. https://nationaleczema.org/eczema/
Eczema prevalence in the United States. https://nationaleczema.org/research/eczema-prevalence/
Weston WL, Howe W, Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis. UpToDate. 2020. https://www.uptodate.com/contents/atopic-dermatitis-eczema-pathogenesis-clinical-manifestations-and-diagnosis?search=atopic%20dermatitis&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
American Academy of Allergy Asthma and Immunology: Eczema (Atopic Dermatitis) Overview. 2020. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/eczema-atopic-dermatitis
National Institute of Allergy and Infectious Diseases: "Eczema (Atopic Dermatitis) Treatment." 2017. https://www.niaid.nih.gov/diseases-conditions/eczema-treatment
American Academy of Dermatology: "Atopic Dermatitis.
https://www.aad.org/public/diseases/eczema/types/neurodermatitis/symptoms