Wednesday, March 3, 2010

All about eczema

I frequently get asked about eczema. Here's an overview:

Eczema (also called atopic dermatitis) is a an inflammation of the outermost layer of the skin. The causes are not well understood but it commonly runs in families. It is often linked to asthma and allergies. It can also be related to food allergies, especially in young children.

Symptoms can vary from person to person but usually start early in life. Most patients have dry scaly skin, itching, darkening of circles under the eyes, small bumps, redness especially on cheeks, elbows and backs of knees. Eczema is sometimes known as "the itch that rashes."

There isn't any specific test for eczema. Diagnosis is usually made by history and physical exam, usually by the primary care provider.

Treatment involves avoiding irritating factors, maintaining the skin's hydration and soothing irritation.

Common irritating factors are rapid temperature changes, emotional stress, dry environments or certain soaps and perfumes. Different people can have different triggers so it may take some trial and error to determine your particular cause.

It is important to keep the skin hydrated. Moisturizers and thick creams (such as cetaphil or eucerin) are better than lotions, which contain mostly water. After bathing, apply creams immediately to seal in moisture before the water evaporates. Avoid bathing your baby too often because this can also dry out the skin.

Steroid creams can help with skin irritation. There are many different types of steroid creams of various potencies. In general, they should NOT be used on the face because they can cause thinning of the skin and alteration in pigmentation, especially in dark skinned people. These should be used in consultation with your health care provider.

Eczema can be a chronic condition. It may get better at times but usually never goes away completely. However, it can definitely be managed.

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