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Eczema

(Atopic Dermatitis)

Definition

Eczema is an inflammation of the skin. It causes areas of itchy, and red skin. Eczema may be ongoing or happen in flare ups when symptoms get worse for a time.

Causes

It is not clear what causes the inflammation to happen. Things that may play a role include:

Risk Factors

Things that may increase the risk of eczema are:

  • Having asthma or allergies
  • Living in city or places with low humidity
  • Eczema or allergies in family members
  • Regular contact with things that irritate the skin such as:
    • Fabrics
    • Perfumes in soaps
    • Dust mites (common)
    • Rubber gloves for people sensitive to latex
  • Stress—scratching can be a habit with stress
  • Washing area often
  • Scratching or rubbing of skin
  • Medicine that lowers the immune system
  • Excess weight or obesity

Symptoms

Eczema may cause some of the following:

  • Dry, itchy skin (very common)
  • Red rashes on the cheeks, arms, and legs
  • Red, scaly skin
  • Thick, leathery skin
  • Small, raised bumps on the skin
  • Crusting, oozing, or cracking of the skin

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The diagnosis is often made based on how the skin looks. Tests may be done to rule out other problems or to look for an infection.

Treatment

Eczema cannot be cured. Treatment can help to ease itching and redness. It may also reduce the number of flare ups.

Treatment to ease symptoms may include:

Skin Care

To ease stress on skin:

  • Avoid hot or long baths or showers.
  • Use mild, unscented bar soap or non-soap cleanser.
  • Do not scrub area. Air-dry or gently pat is better to dry skin.
  • Gentle moisturizers should be used after a shower when skin is still damp.
  • Treat skin infections right away.
  • Look for possible irritants. Avoid them when possible.

Scratching the skin can make symptoms worse. It can also damage the skin and increase the risk of infection. Medicine may help if itching is intense.

Medicine

Medicine may be needed to ease symptoms. Examples include:

  • Prescription creams and ointments. They can ease flare up and irritation of skin.
  • Prescription or over-the-counter antihistamines to help ease itching.
  • Antibiotics to treat infection. It may be given as a cream or pill.
  • Pills to reduce inflammation of the skin.
  • Monoclonal antibody shots to reduce inflammation.

Phototherapy

Light therapy may be tried if other care is not helpful. It will include time exposed to sunlight or artificial UV light. A medicine may be used to make skin more sensitive to the light. This light does have risks of premature aging of skin and skin cancer. The doctor will review benefits and possible risks.

Prevention

There are no steps to prevent eczema. Flare ups may be prevented through steps above.

RESOURCES:

American Academy of Allergy, Asthma, and Immunology
https://www.aaaai.org

National Eczema Association
https://nationaleczema.org

CANADIAN RESOURCES:

Canadian Dermatology Association
https://www.dermatology.ca

Health Canada
https://www.canada.ca

REFERENCES:

Atopic dermatitis. American Academy of Dermatology website. Available at: https://www.aad.org/public/diseases/eczema/atopic-dermatitis. Accessed October 30, 2019.

Atopic dermatitis. EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/condition/atopic-dermatitis/. Updated June 20, 2019. Accessed October 30, 2019.

Atopic dermatitis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: https://www.niams.nih.gov/health-topics/atopic-dermatitis. Updated July 2016. Accessed October 30, 2019.

Eczema and atopic dermatitis. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/eczema-and-atopic-dermatitis. Updated June 2017. Accessed October 30, 2019.

6/4/2010 DynaMed Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T115212/Atopic-dermatitis: Alexander DD, Cabana MD. Partially hydrolyzed 100% whey protein infant formula and reduced risk of atopic dermatitis: a meta-analysis. J Pediatr Gastroenterol Nutr. 2010;50(4):422-430.

1/4/2016 DynaMed Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T115212/Atopic-dermatitis: Zhang A, Silverberg JI. Association of atopic dermatitis with being overweight and obese: a systematic review and metaanalysis. J Am Acad Dermatol. 2015;72(4):606-618.

7/14/2017 DynaMed Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T115212/Atopic-dermatitis: Blauvelt A, deBruin-Weller M, et al. Long-term management of moderate-to-severe atopic dermatitis with dupilumab and cocomitant topical corticosteroids (LIBERTY AND CHRONOS): a 1-year, randomised, double-blinded, placebo-controlled, phase 3 trial. Lancet. 2017;389(10086):2287-2303.

Last reviewed October 2019 by EBSCO Medical Review Board Monica Zangwill, MD, MPH  Last Updated: 10/30/2019