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
- Excess weight or obesity
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
- Dupilumab injection to reduce swelling in 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.
American Academy of Allergy, Asthma, and Immunology
National Eczema Society
Canadian Dermatology Association
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6/4/2010 DynaMed Plus Systematic Literature Surveillance
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7/14/2017 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115212/Atopic-dermatitis: Blauvelt A, deBruin-Weller M, et al. Long-term management of moderate-to-severe atopic dermatitis with dupilumab and cocomitant topical corticosteroids (LIBERTY AND CHRONOS): a 1-year, randomised, double-blinded, placebo-controlled, phase 3 trial. Lancet. 2017 Jun 10;389(10086):2287-2303.
- Reviewer: EBSCO Medical Review Board
James Cornell, MD
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