Eczema
What is eczema?
Eczema or atopic dermatitis is a common inflammatory skin condition. It is chronic and tends to flare when triggered. Every person with eczema has different triggers. Most people who have eczema developed the condition during childhood, but eczema often persists in adulthood. Eczema affects about 13% of children and 10% of adults in America.
A hallmark of eczema is severe itching that causes extreme scratching, leading to worsening inflammation. The skin then swells, cracks, weeps, crusts and scales. Though it is not contagious, eczema has a negative impact on the quality of life of its sufferers.
What are the symptoms of eczema?
Eczema makes the skin red and itchy with inflamed patches. It is a systemic disease meaning it causes inflamed, itchy and irritated skin all over the body.
Babies with eczema have red, scaly patches of skin on their face or chest and perhaps the limbs. After age one, the skin lesions tend to manifest around the mouth, neck, behind the knees and inside the elbows. Childhood eczema can disappear with age. However, children are often left with easily irritated, dry and sensitive skin.
The symptoms of eczema in adolescents and adults include dry skin, itching, red to brownish patches of skin on the hands, feet, ankles, wrists, neck, chest and eyelids. Classically, eczema and atopic dermatitis occur behind the knees and inside the elbows. Over time, chronic scratching leads to thickened lesions and cracked, scaly skin.
Triggers that can cause eczema to flare are individual but include sweating, stress, heat, fragrances, itchy fabrics, pet dander, soaps, detergents, dust, pollen, metals and hot dry air. Disinfectants, environmental and food allergies can also be triggers.
What causes eczema?
The cause is multifactorial involving a genetic susceptibility that affects the skin’s ability to retain moisture and protect against bacteria, irritants and allergens. Environmental factors include allergies and irritants. A compromised skin microbiome and immune system conditions play a role. People with a family history of hay fever and asthma are at higher risk.
How is eczema diagnosed?
Diagnosis is usually made based on skin examination, symptoms and health history. If allergies are suspected, allergy testing, and patch testing may be recommended. There is no lab test to diagnose eczema, but occasionally a biopsy may be performed to confirm the diagnosis
How is eczema treated?
There is no cure for eczema. Atopic dermatitis typically comes and goes over time. Treatment is designed to prevent a flare, calm the skin, control itching and prevent infections and skin thickening. Usually a combination of treatments is necessary to treat all the symptoms. Topical and oral medications include anti-inflammatory medications to reduce itching, redness and inflammation; and moisturizers to improve the skin barrier to keep out bacteria, allergens and irritants.
While treatment can control symptoms for months or years, there is still the risk of flaring. So it is important for patients to recognize the things that trigger their flares and avoid them. Lifestyle changes including liberal use of safe moisturizers, shorter warm baths, and the use of mild soaps and detergents may help prevent eczema flares.
Adults with severe or stubborn disease may receive phototherapy (light therapy), immunosuppressants and steroids. Long term topical therapy is often necessary. Newer therapies include crisaborole (Eucrisa) ointment for mild to moderate AD, and dupilumab (Dupixent) for moderate to severe AD.
When you or a loved one suffers with red, itchy skin contact our office in Asheville, NC. We will listen to your concerns and help you learn to control your eczema.
