Eczema or Atopic Dermatitis

Eczema or atopic dermatitis is a chronic skin condition that makes the skin dry, itchy, and red. It affects both adults and children and is associated with other allergy conditions such as food allergies, asthma, and allergic rhinitis. It affects about 17% of the US population, with more females than males. 80% of children with eczema will develop asthma during their lifetime.

What causes eczema?

The exact cause of eczema is unknown, but there is a hereditary tendency to getting eczema. Eczema patients commonly have other allergic conditions. There are many substances or conditions that can trigger an exacerbation with eczema: irritants like soaps and household chemicals, allergens like pollens, dust mites, animal dander, molds, foods, and skin infections. Even changes in temperature, humidity, sun exposure, and sweating can trigger eczema.

When should I have my eczema evaluated?

If self-treatment does not work, you should see a physician for eczema. If your eczema symptoms are interfering with your daily life or sleep, you should see a physician. If in addition to itching, your skin rash becomes painful or there seems to be an infection with red streaks, pus, yellow crusty scabs or water blisters, you should seek treatment with a physician. If your eczema begins to affect your eyes or vision or you have a fever with skin infection, you should seek medical attention immediately.

How is eczema treated?

A thorough history and physical exam is important. Looking for specific eczema triggers to avoid can be helpful in relieving the symptoms and to preventing flare ups of this chronic disease. Allergy testing may be necessary to determine allergy triggers and may include tests for foods, pollens, dust mites, molds, animals, and chemicals. Skin care is very important. Using the right types of soaps, detergents, and moisturizing creams are important in maintaining the health of your skin. Bathing techniques and wet to dry dressings can be very helpful in preventing eczema flares.

Current medications for eczema are topical creams and oral medications. Using topical corticosteroids and other anti-inflammatory creams can help to reduce the inflammation. Using oral antihistamines to control itching is important in improving quality of life for eczema patients. Antibiotics may be helpful for reducing infections. Oral corticosteroids should only be used for serious eczema attacks and should only be used for a short time. Other medications for eczema include immunosuppressive drugs. Ultraviolet light treatments may be helpful in severe recalcitrant eczema. New biologic drugs are available for severe eczema patients that do not respond to other treatments.  Allergy desensitization therapy may help some patients with eczema.