Eczema
Eczema
(Atopic Dermatitis)
Definition
| Eczema |
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Causes
- Genetics
- Environment
- Allergies to certain fabrics, perfumes in soaps, dust mites (common), or foods
- Stress, especially if it leads to scratching
- Frequent washing of affected areas
- Use of rubber gloves in persons sensitive to latex
- Scratching or rubbing of skin
Symptoms
- Dry, itchy skin
- Cracks behind the ears or in other skin creases
- 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
- Symptoms that worsen in the winter when inside air is dry due to central heating
Diagnosis
Treatment
- Heal the skin and keep it healthy
- Stop scratching or rubbing
- Avoid skin infection
- Prevent flare-ups
- Recognize and avoid triggers, if there are any
Skin Care
- Avoid hot or long baths or showers. Keep them less than 15 minutes.
- Use mild, unscented bar soap or nonsoap cleanser. Use it sparingly.
- Air-dry or gently pat dry after bathing. Apply gentle moisturizer right after.
- Treat skin infections right away.
Medications
- Prescription creams and ointments containing cortisone, tacrolimus, or pimecrolimus
- Oral medications, such as prednisone or cyclosporine—For severe cases
- Antibiotics applied directly to the skin or taken by mouth—Only for treating infections
- Prescription or over-the-counter antihistamines to help prevent itching
Phototherapy
- Treatment with ultraviolet (UV) light by a doctor
- Photopheresis—For severe cases
Prevention
- Breastfeeding
- For bottlefed infants, using a certain kind of formula—Ask the doctor if your baby should have 100% whey protein formula
- Exposing your child to pets at an early age
- Taking probiotics while pregnant and after giving birth if you are breastfeeding
- Follow guidelines to limit house dust mites in bedding.
- Avoid direct contact with wool to the skin.
- Talk to your doctor about any natural or herbal treatments. Some of these may make eczema worse.
- Apply a moisturizer to your skin often.
- Avoid scratching or rubbing.
- Follow your treatment plan. Improvement may take several weeks or even months after a new medicine is started.
- Maintain a cool, stable environment. Keep humidity levels the same.
- Recognize and limit emotional stress.
RESOURCES
American Academy of Allergy, Asthma, and Immunology http://www.aaaai.org
National Eczema Society http://www.eczema.org
CANADIAN RESOURCES
Canadian Dermatology Association http://www.dermatology.ca
Dermatologists.ca http://www.dermatologists.ca
References
Atopic dermatitis. American Academy of Dermatology website. Available at: http://www.aad.org/skin-conditions/dermatology-a-to-z/atopic-dermatitis. Accessed March 11, 2013.
Atopic dermatitis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Atopic%5FDermatitis/. Accessed March 11, 2013.
Barnetson RS, Rogers M. Childhood atopic eczema. BMJ. 2002;324:1376-1379.
Brehler R, Hildebrand A, Luger T. Recent developments in treatment of atopic eczema. J Am Acad Dermatol. 1997;36:983-994.
Holscher B, Frye C, Wichmann HE, Heinrich J. Exposure to pets and allergies in children. Pediatr Allergy Immunol. 2002;13:334-341.
Mohla G, Horvath N, Stevens S. Quality of life improvement in a patient with severe atopic dermatitis treated with photopheresis. J Am Acad Dermatol. 1999;40(5 Pt 1):780-782.
Saarinen UM, Kajosaari M. Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Lancet. 1995;346:1065-1069.
Skin allergy. American Academy of Allergy, Asthma, and Immunology website. Available at: http://www.aaaai.org/patients/allergic%5Fconditions/eczema.stm. Accessed March 11, 2013.
Wahn U, Bos JD, Goodfield M, et al. Efficacy and safety of pimecrolimus cream in the long-term management of atopic dermatitis in children. Pediatrics. 2002;110(1 Pt 1):e2.
7/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Langan SM, Flohr C, Williams HC. The role of furry pets in eczema: a systematic review. Arch Dermatol. 2007;143:1570-1577.
6/4/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: 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.
1/4/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Dotterud CK, Storr O, Johnsen R, Oien T. Probiotics in pregnant women to prevent allergic disease: a randomized, double-blind trial. Br J Dermatol. 2010;163:616-623.
