Chances are, you or someone you know are affected by eczema. About 1 in 12 people in the United States are generally affected by atopic dermatitis, the most common form of eczema, per the National Eczema Association (NEA).
According to FamilyDoctor.org, atopic dermatitis is a chronic, inflammatory skin condition that the NEA notes is linked to an overreactive immune system. Eczema can cause considerable discomfort for those people who have it. It can start in early childhood, though people of all ages are afflicted. It may disappear as a child grows older, or persist into adulthood.
Symptoms of eczema include red or pink dry, itchy, rashy, scaly skin that may ooze clear fluid when scratched. The National Eczema Society notes that babies tend to develop it on their face and scalp, though it can appear anywhere on the body, especially in older infants and children. Allergens, such as pet dander; chemical irritants, including scented soaps or laundry detergents; dry skin; stress; hormonal changes; or infections can cause an eczema flare-up.
Scientists donâ€™t know the exact cause of atopic dermatitis, but the condition runs in families where people either have atopic dermatitis, asthma, or hay fever, according to the American Academy of Dermatology (AAD). The disease is not contagious.
For a diagnosis, see a dermatologist, which is a doctor specializing in skin, hair, and nails. As Alyssa Daniel, MD, a dermatologist in Charlotte, North Carolina, explains, the doctor will take your medical history and examine you â€œOccasionally, if the patientâ€™s story and examination results are not entirely clear, a skin biopsy can be done,â€ she says, which NYU Langone Health echoes. Blood or skin patch tests may be done to rule out other conditions, according to FamilyDoctor.org.
Treatment options for atopic dermatitis include topical or oral medication, copious usage of moisturizers, as well as diet and lifestyle changes. Maintaining the health of the skin barrier and reducing inflammation are major concerns, says Dr. Daniel.
Treatments may include:
Topical Corticosteroid Creams or Ointments Including hydrocortisone, triamcinolone, or Clobex (cobetasol propionate 0.05 percent), these are applied to the rash to help reduce inflammation and itching.
Antimicrobial Therapies â€œBleach or vinegar baths and topical antimicrobials can help keep the bacterial, viral, and yeast colonization of the skin down, which decreases inflammation as well,â€ says Daniel.
Moisturizers and Emollients to keep skin soft and flexible, preferably choose fragrance-free products without a lot of irritating additives. Daniel adds: â€œGentle cleansers and room vaporizers can be used to help keep the skin hydrated.â€
Avoiding Flare-Up Triggers â€œSome patients have issues with food sensitivities and other allergic triggers,â€ says Daniel. â€œRemoving those particular foods and allergens from the environment can be helpful.â€
Additional treatments can include:
Topical Nonsteroidal Medication These include crisaborole, pimecrolimus, and tacrolimus.
Oral Antihistamines Hydroxyzine and Benadryl, among others, can be used to address itching.
Dupixent (dupilumab) Dupilumab is an injectable medication for moderate-to- severe cases that addresses the immune systemâ€™s overreaction to eczema triggers.
Of course, thereâ€™s a lot more to learn in the management of eczema. â€œI always encourage patients to be inquisitive but not to believe everything they read or hear. Some â€˜naturalâ€™ treatment options also carry risks, and unless the provider is trained how to recognize and monitor those risks, there could be negative outcomes,â€ cautions Daniel.
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Send any treatment questions to a board-certified dermatologist, the AAD recommends. But if you want to brush up on the lingo as you seek answers, use the following glossary:
Acne The most common skin condition, particularly among teens and young adults. Its symptoms include pimples, blackheads, whiteheads, skin lesions, cysts, and nodules. It appears when skin pores become clogged with dead skin cells and bacteria.
Alkaline A substance that has a pH of more than 7 because it is a basic solution, meaning it contains more hydroxide ions than hydrogen ions. It is the opposite of acidic, which has a pH of less than 7. Soaps tend to be alkaline or basic, with a pH of 9 to 10; while human skin is more acidic, with a pH of 4 to 6. This difference can cause soap to worsen atopic dermatitis symptoms, making nonsoap cleansers a better option.
Allergen A substance that is usually harmless but is capable of triggering an immune system response in some individuals that results in an allergic reaction. Common allergens include pollen, animal dander, mold, dust mites, medication, insect venoms, various foods, and substances such as rubber and latex. Allergens can trigger atopic dermatitis flare-ups.
Allergy A chronic condition in which an ordinarily harmless substance, known as an allergen, causes an abnormal reaction by the immune system. An allergic response can trigger an atopic dermatitis flare-up.
Antihistamine Medicine used to counteract histamine, a chemical that contributes to inflammation and is released by the body during an allergic reaction. Examples of antihistamines that are used in the treatment of atopic dermatitis include Benadryl (diphenhydramine) and hydroxyzine.
Antimicrobial Therapy Therapy to remove microbes, such as Staphylococcus aureus bacteria, from the skinâ€™s surface. A bleach bath with antibacterial medication is an example of such a therapy in atopic dermatitis treatment.
Asthma A chronic disease in which the airways that carry air in and out of the lungs become inflamed and cause breathing problems. Allergens can trigger asthma, but infection, exercise, cold air and other factors can also be culprits. Atopic dermatitis can run in families where people have asthma and having asthma may make you more likely to have atopic dermatitis as well.
Astringent A substance that can cause skin tissue to shrink and contract, temporarily and locally. Calamine lotion is an example of an astringent used to dry out oozing lesions caused by atopic dermatitis.
Atopic Dermatitis Also known as eczema, atopic dermatitis is a chronic inflammatory skin condition that is associated with an overreactive immune system. Symptoms include itchy, dry, scaly skin that may weep with clear fluid when scratched. The exact cause of the condition is unknown, but risk factors include a family history of atopic dermatitis, asthma, or hay fever. Atopic dermatitis is not contagious.
Atopic Triad Atopic dermatitis, hay fever (allergic rhinitis), and asthma form the atopic triad, as all are associated with heightened immune responses to allergens. A family history of any of the three conditions can be a risk factor for having one or more of them.
Atrophy of the Skin Thinning of the skin. It can be a side effect of topical corticosteroid use to treat atopic dermatitis.
Bath Treatment Immersing the skin in water to hydrate it and help relieve atopic dermatitis symptoms. Bath treatments are often followed by oily moisturizers to seal in moisture. Bath water can contain bath oil, baking soda, mild bleach, vinegar, salt, or oatmeal.
Biologic A type of genetically engineered drug. The first biologic approved by the U.S. Food and Drug Administration (FDA) to treat atopic dermatitis was dupilumab. The injectable medication helps to prevent the immune system from overreacting to triggers.
Bleach Bath Therapy A potential treatment for baby eczema that involves using 6 percent bleach dissolved in bathwater. Experts advise using Â½ cup of bleach for a full bathtub of water and Â¼ cup of bleach for a half-full bathtub. If youâ€™re using a smaller tub for your baby or toddler, add 1 teaspoon of bleach per 1 gallon of water. Check with your dermatologist before trying a bleach bath to treat eczema.
Clobetasol Clobetasol propionate 0.05 percent (Clobex), a potent topical corticosteroid medication that is used to reduce inflammation and itching in the treatment of atopic dermatitis.
Contact Dermatitis A skin condition resulting from touching an irritant or allergen. Skin may become red or inflamed.
Cradle Cap A form of seborrheic dermatitis in infants in which thick scaly, greasy patches form on the scalp.It usually disappears within a few months.
Cream A semisolid blend of oil and water that is applied to the skin. Creams used in the treatment of atopic dermatitis can contain medicine, or they can be used to moisturize and protect the skin barrier.
Crisaborole Topical A nonsteroidal medication (sold under the brand name Eucrisa) that is applied to the skin to treat atopic dermatitis.
Cyclosporine An immunosupressant medication that can help slow down the symptoms of severe atopic dermatitis. Using it comes with an increased risk of infection. It is used â€œoff-labelâ€ and is not approved by the FDA to specifically treat forms of eczema.
Dandruff Dry skin on the scalp that flakes off. Can be caused by seborrheic dermatitis, though it can have other causes, such as psoriasis or fungal infections of the scalp.
Dermatitis Skin irritation or inflammation, which can have many causes and come in many forms.
Dermatologist A doctor specializing in the treatment of diseases and conditions relating to skin, hair, and nails.
Dermis A connective tissue layer under the top layer of skin, which is the epidermis. The dermis contains nerves, blood vessels, glands, and hair follicles.
Discoid Eczema See nummular eczema.
Dyshidrotic Eczema A skin condition that is associated with seasonal allergies and is characterized by itchy blisters on the edges of fingers, toes, hand palms, and foot soles.
Dupilumab An injectable medication for moderate to severe atopic dermatitis cases that targets the immune systemâ€™s overreaction to triggers.
Eczema A group of conditions characterized by skin that is red, itchy, and inflamed. The most common type is atopic dermatitis, which is often referred to simply as eczema. Yet other conditions that can be referred to as eczema include contact dermatitis, dyshidrotic eczema, eczema herpeticum, nummular eczema, seborrheic dermatitis, and stasis dermatitis.
Eczema herpeticum An infection usually caused by the herpes simplex 1 virus (the virus that causes cold sores). Eczema herpeticum affects people with atopic dermatitis and other inflammatory skin conditions. Clusters of small blisters that are red, purple, or black; itchy; painful; and oozing can erupt. Fever and chills are other potential symptoms of this infection.
Eczema Symptoms Itchy skin is a common symptom. Other skin-related symptoms include dryness, redness, inflammation, swelling, a leathery appearance, scaliness, oozing, crusting, or patches that are darker than the skin they surround.
Emollient A substance that softens, soothes, and moisturizes the skin, and is used in lotions, creams, and ointments. Ingredients can include fatty acids, cholesterol, and ceramides.
Filaggrin A protein that helps maintain a healthy stratum corneum (uppermost layer of the skin). Some individuals with eczema have a mutation of the gene responsible for creating filaggrin, resulting in an inadequate amount of the protein. The result is very dry skin that is infection-prone.
Epidermis The outer layer of the skin where cells form, mature, and die.
Flare or Flare-Up A sudden appearance or worsening of symptoms in a disease or condition. In conditions such as atopic dermatitis, triggers can bring on a flare-up.
Follicle A tube-like cavity in the skin in which a hair grows. The opening of the follicle on the skin surface is the pore.
Follicular Accentuation Goosebump-like raised areas around hair follicles that are more commonly seen in people with darker skin who have atopic dermatitis.
Gravitational Dermatitis See stasis dermatitis.
Humectant A water-attracting substance that promotes the retention of moisture in the skin. Examples include include glycerin, alpha hydroxy acids, and other sugars.
Hydrocortisone A topical corticosteroid medication used to reduce inflammation and itching. It is used in the treatment of atopic dermatitis and can be obtained by prescription or over-the-counter, depending on strength.
Hypoallergenic Products formulated to reduce the chance of allergic reactions by avoiding ingredients that are most likely to trigger them. Yet the FDA warns that there are â€œno federal standards or definitions that govern the use of the term â€˜hypoallergenic,â€™" and that "manufacturers of hypoallergenic cosmetics are not required to substantiate their claims to FDA."
Immunosupressant A medication that helps suppress the immune system, such as cyclosporine, methotrexate, or Imuran (azathioprine). They can help slow down the symptoms of severe atopic dermatitis. Using them comes with an increased risk of infection, so they are typically used for short time periods to give skin a chance to heal. They are used â€œoff-label,â€ meaning your doctor may prescribe them even though they are not approved by the FDA to specifically treat forms of eczema.
Inflammation The immune systemâ€™s response to an irritant. Signs of skin inflammation can include swelling, pain, itchiness, warmth, redness, and loss of function.
Irritant A substance that produces an uncomfortable physical reaction. Common eczema irritants include cigarette smoke; soaps and household cleaners; fragrances; and fabrics such as wool and polyester.
Itch-Scratch Cycle A condition where itchy skin makes you scratch, and the more you scratch the itchier skin gets, in a continuous cycle. It can lead to skin injury, infection, and scarring.
Lipids Fatty substances in the skin that help it to retain moisture and strength, including ceramides, cholesterol and free fatty acids.
Lotion A semisolid mixture of oil and water that is watery and acts as an emollient. Lotion is used in topical medicine and moisturizers. Lotion is less moisturizing than creams and ointments.
Methotrexate An immunosupressant medication that can help slow down the symptoms of severe atopic dermatitis. Using it carries an increased risk of infection. It is not approved by the FDA to specifically treat forms of eczema, and is therefore used â€œoff-label.â€
Moisturizer A substance that will hydrate skin and help it to retain moisture, thereby making skin softer and more pliant. They can include lotions, gels, creams, and ointments, among other preparations, and often involve some combination of oil and water.
Nonsteroidal A medication that does not contain steroids.
Nummular Dermatitis See nummular eczema.
Nummular Eczema A skin condition characterized by round lesions that can ooze fluid. It can resemble ringworm. Dry skin and allergens are among the causes. Also known as discoid eczema and nummular dermatitis.
Ointment A clear, greasy, semisolid substance that contains no water and acts as an emollient. Ointment is used in topical medicine and moisturizers.
Papular Eczema Small bumps on the arms, legs and torso that are more commonly seen in people with darker skin who have atopic dermatitis.
Petrolatum Also called petroleum jelly (a common brand is Vaseline), it is a colorless or pale yellow semisolid substance derived from petroleum. It can temporarily provide relief to the irritated skin that comes with atopic dermatitis and help it retain moisture.
Petroleum Jelly See petrolatum.
pH level The level of acidity or alkalinity of a solution or substance, measured on a scale where 7 is neutral, numbers below that are acidic, and numbers above are alkaline or basic. If the pH of a skin product is too different from the pH of the skin, damage could result.
Pimecrolimus An atopical calcineurin inhibitor (brand name Elidel) designed to inhibit the immune systemâ€™s response to triggers that make symptoms of atopic dermatitis, such as itchiness and redness, flare up. It is prescribed for individuals older than age 2 who have not responded well to topical steroid treatments. Common side effects include burning, and the FDA has placed a black box warning on this drug for potentially increasing the risk for cancer.
Potency The scale by which topical corticosteroid drugs are classified by strength, ranging from Class 1 (â€œsuper potentâ€) to Class 7 (â€œleast potentâ€).
Probiotics Live bacteria microorganisms in food, supplements, and topicals that may offer health benefits. Early research suggests that â€œsome strains of probiotics might be beneficial for symptoms of atopic dermatitis.â€
Prurigo Nodules Hard, raised bumps that can appear in the skin of people with atopic dermatitis after repeated scratching.
Rash An area of irritated skin that may be itchy, red, swollen, and painful. Blisters or patches of raw skin may appear in the affected area. The rash of atopic dermatitis is dry, red, and scaly skin.
Sebaceous Glands Glands that secrete the oil sebum and are usually found in hair follicles.
Seborrheic Dermatitis A form of eczema that typically appears in places on the body where there are a lot of oil-secreting (sebaceous) glands, such as the scalp, upper back, nose, eyebrows, ears, and chest.
Seborrheic Eczema See seborrheic dermatitis.
Sebum The skinâ€™s own natural moisturizing oil. A product of the bodyâ€™s sebaceous glands, it contains mostly triglycerides and fatty acids, but also squalene, wax esters, and cholesterol.
Skin Biopsy An outpatient procedure in which dermatologist removes a small piece of skin from a patient for lab testing. It can be used to determine whether a skin condition is atopic dermatitis or another condition.
Skin Patch Test A test that exposes skin to a suspected allergen and then observes it for signs of an allergic reaction. A healthcare professional will apply an allergen to a patch, which he or she then places on the skin. A patch test can determine whether a person has contact dermatitis, atopic dermatitis, or another allergic condition.
â€œSoak and Sealâ€ Treatment Bathing or showering, followed by the use of an oily moisturizer to hydrate skin and seal in moisture. This therapy can help relieve atopic dermatitis symptoms.
Stasis Dermatitis A form of eczema that is associated with poor blood flow to the extremities. This type of eczema causes discolored skin, swelling, dryness, itchiness, and varicose veins. Also known as venous eczema, venous stasis dermatitis, and gravitational dermatitis.
Stratum Corneum As the outermost layer of the epidermis, it plays an important protective role in the skin barrier. With atopic dermatitis, the stratum corneum can become cracked and irritated, so hydrating it is important to soothing symptoms.
Systemic Steroids Corticosteroid medicines that are given orally, intravenously, or intramuscularly. Healthcare professionals sometimes administer prednisone and hydrocortisone in this fashion to treat atopic dermatitis. But the International Eczema Council discourages their use except in special circumstances due to the risk of adverse side effects and rebound flare-ups after a patient stops using them.
Tacrolimus Atopical calcineurin inhibitor (brand name Protopic) that inhibit the immune systemâ€™s response to triggers that make symptoms of atopic dermatitis, such as redness and itchiness, flare up. It is intended for individuals older than age 2 who have not responded adequately to topical steroid treatments. Common side effects include burning, and the FDA has placed a boxed warning on it because it could raise the risk for cancer.
Topical A medication applied to the skin. Many treatments for eczema are topical, and used to manage symptoms and reduce inflammation.
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Topical Calcineurin Inhibitors Topical nonsteroidal treatments that act to inhibit the immune systemâ€™s response to triggers that make atopic dermatitis symptoms, such as redness and itchiness, flare up. Theyâ€™re used when individuals older than age 2 have not responded adequately to topical steroid treatments. Pimecrolimus cream and tacrolimus ointment are two drugs in this class that are available by prescription. Yet common side effects include burning and the FDA has placed boxed warnings on them about a possible risk of cancer.
Topical Corticosteroid Anti-inflammatory medicine that is applied to the skin for the treatment of atopic dermatitis. Delivered in lotions, ointments, creams or sprays, they are classified by strength, ranging from Class 1 (â€œsuper potentâ€) to Class 7 (â€œleast potentâ€). Examples of topical corticosteroids include Class 7 over-the-counter hydrocortisone and Class 1 Clobetasol propionate 0.05 percent cream. Common side effects can include thinning of the skin, stretch marks, the presence of small red blood vessels known as telangiectasias, or darkening and lightening of the skin. Topical corticosteroids are also known as topical steroids.
Topical Steroid See topical corticosteroids.
Triggers A substance or condition that causes symptoms to appear. Eczema triggers can include dry skin, allergens, irritants, stress, becoming too hot or cold, sweating, infection, or hormones.
Ultraviolet Therapy See phototherapy.
Venous Eczema See statis dermatitis.
Wet Wrap Therapy A therapy to rehydrate skin affected by atopic dermatitis. Fabric wraps made of cotton or gauze are soaked in water and applied to the affected skin, followed by a dry layer of clothing, vinyl gloves, or plastic food wrap. Patients leave them on for a period of several hours to overnight.
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