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What Is Eczema?

Eczema, or atopic dermatitis, is a skin disease caused by increased sensitivity to the environment. It causes dry irritated skin. It often runs in families and may occur with hay fever, asthma, and nasal allergies. It cannot be caught. Eczema is very common, affecting 1% of adults and 5% to 10% of children in the United States. In most people, eczema goes away completely by adulthood.

This sensitivity causes inflammation (redness), itching, and scratching. Scratching, however, often makes itching worse and can cause breaks in the skin, increasing risks of infection.

What Causes Eczema?

Causes of eczema or things that make it worse include stress; very hot or cold air; foods including wheat, milk, eggs, and pod vegetables such as beans, peas, and lentils; certain types of cloth; perfumes; dust mites; and animal hair.

What Are the Symptoms of Eczema?

Eczema produces a rash that is red, swollen, itchy, dry, flaky, hard, thick, oozing, and crusty. The rash appears most commonly on the face, hands, and feet, inside the elbows, and behind the knees.

How Is Eczema Diagnosed?

The health care provider can usually diagnose eczema without doing tests but may order general blood tests and skin testing when the diagnosis is unclear or when trying to determine the cause of the eczema.

How Is Eczema Treated?

Four main ways of treating eczema involve avoiding triggers that cause or worsen it; keeping skin moist with special lotions, soaps, and bath products; treating redness and swelling with anti-inflammatory medicines (corticosteroid creams and pills), tar, and light therapy; and helping stop itching with antihistamines, creams, and pills.

Simple, nonmedicated moisturizing cream may be used daily. Steroid creams are for severe itching.

Medicines taken by mouth (pills) to relieve itching include antihistamines, which calm nerve endings in skin. Corticosteroids given as pills can stop inflammation and itching and reduce redness, but they do have side effects (e.g., stomach ulcers, weight gain) when taken long term.

Covering the rash with bandages helps by keeping creams and lotions on the skin and protecting skin from being scratched.

DOs and DON’Ts in Managing Eczema:

  • DO avoid triggers of the rash, including stress.
  • DO moisturize your skin daily, even when you have no symptoms. Use an odor-free oil-based cream or ointment (not lotion), best applied just after bathing while skin is still damp. Use hypoallergenic products when possible. For severe itching, also use a very mild over-the-counter steroid cream (1% hydrocortisone). Bathe with warm, not hot, water and mild soap.
  • DO take all pills prescribed by your health care provider. Don’t stop taking the medicines unless your health care provider approves.
  • DO avoid foods that cause your eczema to worsen.
  • DO exercise daily, but avoid excessive sunlight exposure and skin damage with a sunblock (SPF 15 or greater).
  • DO wash clothing and linens in fragrance-free soap; double rinse when possible.
  • DO call your health care provider if you have signs of infection (worsening redness, pus); wheezing or trouble breathing; or a severe stomachache or bone pain when taking steroid pills.
  • DON’T let your skin or home become too dry. A home humidifier may help.
  • DON’T forget your daily skin regimen even if you feel well. Plan ahead for trips by saving some of your usual products.
  • DON’T drive, cook, or operate machinery while using antihistamines if they make you sleepy.

Contact the following sources:

  • American Academy of Dermatology
    Tel: (866) 503-SKIN (7546)
  • Asthma and Allergy Foundation of America
    Tel: (800) 727-8462

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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