Eczema, also known as atopic dermatitis, is a chronic inflammation of the outer layers of the skin.
The exact cause of eczema is not known. Factors that may contribute to eczema include:
Eczema is more common in people of African or Asian descent.
Factors that increase your chance of eczema include:
- Urban areas or places with low humidity
- A family history of eczema or allergic disorders
- Exposure to certain fabrics, perfumes in soaps, dust mites (common), or foods
- 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
- Immunosuppressant medications
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The symptoms vary from person to person. Scratching and rubbing can cause or worsen some of the symptoms.
- Dry, itchy skin
- Cracks behind the ears or in other skin creases
- Red rashes on the cheeks, arms, and legs
- Red, scaly skin
- Thick, leathery skin
- Small, raised bumps on the skin
- Crusting, oozing, or cracking of the skin
- Symptoms that worsen in the winter when inside air is dry due to central heating
You will be asked about your symptoms and medical history. A physical exam will be done. The diagnosis is made by the appearance and location of the rash. You may be referred to specialist. A dermatologist focuses on skin disorders. An allergist focuses on allergies.
The main goals of eczema treatments are to:
- Heal the skin and keep it healthy
- Stop scratching or rubbing
- Avoid skin infection
- Prevent flare-ups
- Identify and avoid triggers
Treatment options may vary. Your doctor may recommend more than one depending on your condition. They include:
Proper skin care may allow the skin to heal. Treatment may include the following:
- Avoid hot or long baths or showers. Keep them less than 15 minutes.
- Use mild, unscented bar soap or non-soap cleanser. Use it sparingly.
- Air-dry or gently pat dry after bathing. Apply gentle moisturizer when your skin is still damp.
- Treat skin infections right away.
In some cases, medication may also be needed and may include:
- Prescription creams and ointments containing cortisone, tacrolimus, or pimecrolimus
- Prescription or over-the-counter antihistamines to help prevent itching
- Antibiotics applied directly to the skin or taken by mouth in order to treat infections
Oral medications, such as prednisone
cyclosporine for severe cases
If skin care and medications are not effective, light therapy may be used. This may include:
- Treatment with ultraviolet A light and 5-methoxypsoralen (PUVA)
- Photopheresis—For severe cases
It is difficult to prevent eczema. This is most true when there is a strong family history.