Eczema

Introduction to Eczema

Eczema is a general term for a group of conditions that cause the skin to become inflamed, irritated, and intensely itchy. The two major types of eczema are allergic contact dermatitis and atopic dermatitis, with atopic dermatitis being the most common. Many people often use the terms eczema and atopic dermatitis interchangeably.

What Causes Eczema?

The exact cause of eczema remains unknown, though it’s believed to involve a combination of genetic and environmental factors. Individuals with a family history of eczema, asthma, or allergies are more likely to develop the condition. Environmental factors like living in urban areas or colder climates may also trigger or worsen eczema.

Symptoms of Eczema

Eczema can cause a variety of symptoms, which may vary depending on age and the type of eczema. Common symptoms include:

Dry, Red, and Itchy Patches: These are the hallmark symptoms of eczema, often found on the face, neck, elbows, knees, hands, and feet.
Thickened or Leathery Skin: Repeated scratching can lead to the thickening of the skin, making it appear leathery.
Crusts and Scales: In some cases, eczema patches may crack, ooze, or form crusts.
Inflamed Skin: The affected areas can become swollen, warm, and painful.

In infants, eczema typically appears on the cheeks and scalp, while in children and adults, it often affects the creases of the elbows, knees, and other areas prone to friction.

How Is Eczema Diagnosed?

Eczema is usually diagnosed based on the appearance of the skin and a discussion of symptoms with a board-certified dermatologist. A dermatologist may inquire about the onset of symptoms, family history of eczema or allergies, and any potential triggers. In some cases, allergy testing or a skin biopsy may be performed to rule out other conditions.

Treatment for Eczema

Eczema is a chronic condition that can be managed with appropriate care and treatment. A dermatologist can create a personalized treatment plan that may include:

Topical Medications: The first line of treatment for eczema usually involves topical corticosteroids, which help reduce inflammation, redness, and itching. Other topical treatments include calcineurin inhibitors and PDE-4 inhibitors, which are approved for managing mild to moderate eczema.
Moisturizers: Regular application of fragrance-free moisturizers helps prevent dryness, soothe the skin, and reduce flare-ups. It’s recommended to apply moisturizer twice daily, especially after bathing, to lock in moisture.
Bath Therapy: For more severe cases, diluted bleach baths may be suggested to reduce bacteria on the skin and inflammation. Wet wrap therapy, which involves wrapping the affected areas in wet bandages after applying medication, can also help soothe the skin and prevent scratching.
Phototherapy: In cases where topical treatments aren’t effective, phototherapy (light therapy) may be recommended. This involves exposing the skin to controlled amounts of natural or artificial ultraviolet light to reduce inflammation and itching.
Systemic Medications: For severe eczema that doesn’t respond to other treatments, systemic medications may be prescribed. These can include oral corticosteroids, immunomodulators, or biologic drugs like dupilumab, which is approved for treating moderate to severe eczema.
Antihistamines: If itching disrupts sleep, an over-the-counter sedating antihistamine may be recommended to help improve sleep quality, though it won’t treat the eczema itself.

Managing Eczema

Eczema is a lifelong condition that requires ongoing management. To reduce the frequency and severity of flare-ups, consider the following tips:

Avoid Triggers: Identify and avoid environmental triggers such as harsh soaps, fragrances, and allergens.
Maintain a Skincare Routine: Regular moisturizing, gentle cleansing, and protective measures (like wearing soft clothing) can help keep the skin barrier healthy.
Monitor Diet: Some individuals may find that certain foods exacerbate their symptoms. Keeping a food diary can help identify potential triggers.