Eczema

What is eczema?

Eczema is a common skin condition that causes itchy, red, dry, and irritated skin. The type of eczema you have can determine what type of rash you develop and where on your body it occurs. Eczema is also called atopic dermatitis. It typically starts during infancy or early childhood and can persist into adulthood. However, eczema can occur in people of any age.

What causes eczema?

The cause of eczema isn’t completely understood. However, researchers think that it’s triggered by an overactive immune system. Eczema tends to flare when your skin is exposed to external irritants, which cause your immune system to overreact. We’ve listed common triggers for flare-ups below. Additionally, researchers have found that some people with eczema don’t make enough of a protein called filaggrin (filament aggregating protein). This protein is responsible for helping your skin stay moisturized and healthy.

What are some triggers of eczema?

An eczema flare-up happens when one or more eczema symptoms appear on the skin. Research has shown that external and internal factors can contribute to flares of eczema. Common triggers include:

• Chemicals or preservatives found in cleansers and detergents
• Scented products
• Cigarette smoke
• External allergens such as pollens, mold, dust, or dust mites
• Rough scratchy material, like wool
• Synthetic fabrics
• Sweating
• Temperature changes
• Stress
• Food allergies
• Animal dander
• Upper respiratory infections

What are the types of eczema?

There are a number of different types of eczema, including the following:

• Atopic dermatitis causes dry, itchy skin that often appears with a red rash. It is the most common type of eczema.
• Contact dermatitis is caused by exposure to something that irritates the skin or triggers an allergic reaction.
• Dyshidrotic dermatitis affects fingers, palms of the hands, and soles of the feet. It causes itchy, scaly patches of skin that flake or become red, cracked, and painful. The condition is more common in women.
• Nummular dermatitis presents as round, red, very itchy scaly patches. It is more common on the lower legs and is usually caused by a break in the skin and a history of very dry skin.
• Stasis dermatitis is typically seen on the lower legs and is caused by poor blood flow.

What are the symptoms of eczema?

The main symptom of eczema is itchy, dry, rough, flaky, inflamed, and irritated skin. It can flare up, subside, and then flare up again. Eczema can occur anywhere but usually affects the arms, inner elbows, backs of the knees, cheeks, and scalp. It’s not contagious and sometimes becomes less severe with age. Other symptoms include:

• Intense itching
• Red or brownish-gray patches
• Small, raised bumps that ooze fluid when scratched
• Crusty patches of dried yellowish ooze, which can signal infection
• Thickened, scaly skin
• Sore or raw-feeling skin

Many people find their symptoms get worse at night, making it difficult to sleep. Scratching eczema further irritates and inflames the skin. This can cause infections that must be treated with antibiotics. Sometimes, mild eczema can be managed at home by avoiding triggers and keeping skin moisturized. However, it’s best to see a doctor when symptoms are hard to manage or are getting worse. Visit the doctor if:

• Eczema isn’t responding to over-the-counter treatments
• Symptoms are keeping you awake at night
• Symptoms are making it hard to complete everyday tasks
• Skin is blistering or weeping fluids
• Skin is peeling
• Skin is getting thick or scaly

How is eczema treated?

The right treatment for you will depend on the type and severity of your eczema. You might find it helpful to combine more than one treatment. Options include:

Medications

Oral over-the-counter (OTC) antihistamines can relieve itching. They work by blocking allergic reactions triggered by histamine. However, they can cause drowsiness, so it’s best to take them when you don’t need to be alert. Examples include:

• Cetirizine (pyriton)
• Diphenhydramine (Benadryl)
• Fexofenadine (Allegra)
• Loratadine (Claritin)

Cortisone (steroid) creams and ointments can relieve itching and scaling. But they can have side effects after long-term use, including:

• Thinning of the skin
• Irritation
• Discoloration

Low potency steroids, like hydrocortisone, are available OTC and can help treat mild eczema. High potency steroids for moderate or severe eczema can be prescribed by a doctor. A doctor might prescribe oral corticosteroids when topical hydrocortisone isn’t helping, These can cause serious side effects, including bone loss. To treat an infection, a doctor may prescribe a topical or oral antibiotic. Immunosuppressants are prescription medications that prevent your immune system from overreacting. This prevents flare-ups of eczema. Side effects include an increased risk of developing cancer, infection, high blood pressure, and kidney disease.