Eczema

Eczema, also known as atopic dermatitis, is a chronic skin condition characterized by dry, itchy, and inflamed skin. It is a common condition that affects millions of people in the United States, particularly children, although it can develop at any age. Eczema is part of a group of conditions known as the "atopic triad," which also includes hay fever and asthma. Eczema can be managed with proper treatment, but flare-ups may occur. If you or your child suffer from eczema, consult a doctor to discuss treatment options and strategies for long-term control.

The exact cause of eczema is unknown, but it is believed to result from a combination of genetic and environmental factors. In people with eczema, the skin barrier is compromised, making the skin more vulnerable to irritants, allergens, and infections.

Common triggers include:

• Dry Skin: Eczema-prone skin tends to be dry, which can lead to irritation and itching.
• Irritants: Soaps, detergents, perfumes, and certain fabrics can trigger eczema flare-ups.
• Allergens: Dust mites, pet dander, pollen, and certain foods can exacerbate eczema.
• Climate: Extreme temperatures, low humidity, or sudden weather changes can worsen symptoms.
• Stress: Emotional stress can be a contributing factor to eczema flare-ups.

• Atopic Dermatitis: The most common type, often seen in children, characterized by dry, itchy, and inflamed skin. It is linked to a compromised skin barrier and can be triggered by allergens, irritants, or stress.

• Contact Dermatitis: Caused by direct contact with irritants or allergens, leading to localized redness, itching, and inflammation. It includes:

  • Irritant Contact Dermatitis: Results from exposure to substances like soaps or chemicals.
  • Allergic Contact Dermatitis: Triggered by allergens such as certain metals, fragrances, or plants.

• Dyshidrotic Eczema: Characterized by small, itchy blisters on the hands and feet, often triggered by stress, allergies, or exposure to moisture.

• Nummular Eczema: Appears as circular, coin-shaped patches of dry, itchy skin, often triggered by dry skin or environmental factors.

• Seborrheic Dermatitis: Affects areas rich in oil glands, such as the scalp and face, resulting in red, greasy patches and dandruff. Common in infants (cradle cap) and adults.

• Stasis Dermatitis: Occurs in the lower legs due to poor circulation, leading to swelling and skin irritation. It often affects older adults and is associated with varicose veins.

• Seborrheic Dermatitis: Often seen on oily areas like the scalp and face, causing red, flaky patches. It's common in infants (cradle cap) and adults.

• Neurodermatitis: Triggered by chronic itching and scratching, leading to thick, scaly patches of skin, often on the neck, wrists, or ankles.

• Family History: Eczema tends to run in families, especially if there is a history of eczema, asthma, or hay fever.
• Age: While eczema can occur at any age, it is most common in infants and young children. Many children outgrow the condition, but it can persist into adulthood for some individuals.
• Environmental Factors: Exposure to allergens, irritants, or harsh climates may trigger or worsen eczema symptoms.
• Prevalence: Approximately 10% of the U.S. population experiences some form of eczema, with most cases occurring in children under 5 years old.

Eczema symptoms can vary from person to person, but the hallmark symptom is itchy skin. Scratching can lead to further skin damage, inflammation, and infection. Symptoms can occur anywhere on the body but are most commonly found on the face, hands, and the insides of the elbows and knees.

Common symptoms include:

• Dry, sensitive skin
• Itching (pruritus), which can be severe
• Red, inflamed patches of skin
• Dark-colored patches of skin (hyperpigmentation in some individuals)
• Scaly, crusted areas
• Oozing or weeping blisters (in severe cases)
• Thickened, leathery skin due to chronic scratching (lichenification)

If you notice signs of infection, such as increased redness, swelling, pain, or pus-filled blisters, consult a doctor immediately, as these may indicate a secondary skin infection.

Diagnosing eczema typically involves a clinical examination and a review of your medical history. A doctor may ask about your symptoms, family history, and any potential triggers that may be causing flare-ups.

There are no specific tests for eczema, but your doctor may perform tests to rule out other skin conditions or allergies, such as:

• Patch Testing: To identify any allergens or irritants that may be contributing to flare-ups.
• Skin Biopsy: Rarely, a small sample of skin may be taken to rule out other conditions.

Consult a doctor to get a proper diagnosis and to distinguish eczema from other conditions that may cause similar symptoms, such as psoriasis or contact dermatitis.

Treatment for eczema focuses on relieving symptoms, reducing flare-ups, and repairing the skin barrier. Treatment plans are individualized based on the severity of the condition, and it is important to work with your doctor to find the most effective approach.

Common treatments include:

• Moisturizers: Daily use of fragrance-free, hypoallergenic moisturizers helps restore the skin barrier and reduce dryness. Apply after bathing while the skin is still damp.
• Topical Steroids: Corticosteroid creams or ointments can help reduce inflammation and itching during flare-ups. These should only be used as directed by a doctor.
• Topical Calcineurin Inhibitors: These non-steroidal creams can help control flare-ups and reduce inflammation.
• Antihistamines: Oral antihistamines may be recommended to help control itching, especially at night. Consult a doctor to determine if antihistamines are appropriate for you.
• Immunosuppressants: For severe eczema that does not respond to topical treatments, your doctor may prescribe oral medications to suppress the immune system.
• Biologics: Newer treatments are available for moderate to severe eczema. Biologics target specific pathways in the immune system to reduce inflammation. 

Eczema is a chronic condition, but many children outgrow it, or their symptoms become less severe as they age. While there is no cure for eczema, the condition can be managed effectively with treatment, lifestyle changes, and careful skin care. Flare-ups can occur at any time, but maintaining a regular skin care routine and avoiding triggers can reduce their frequency and severity.

• Maintain a Moisturizing Routine: Keeping your skin well-hydrated can help prevent dryness, which often leads to flare-ups.
• Avoid Irritants and Allergens: Try to minimize contact with known triggers like harsh soaps, perfumes, and allergens.
• Manage Stress: Implement stress-reducing strategies to help prevent flare-ups related to emotional stress.
• Proper Bathing Habits: Use gentle, fragrance-free cleansers and avoid hot water when bathing.
• Protect Your Skin: During cold, dry weather, wear protective clothing and continue moisturizing frequently.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on August 17, 2024.

References

Eczema - StatPearls - NCBI Bookshelf (nih.gov)

https://www.ncbi.nlm.nih.gov/books/NBK538209/

Eczema: Symptoms, treatment, causes, and types

https://www.medicalnewstoday.com/articles/14417