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Eczema is a non-contagious skin condition in which patches of skin become itchy, inflamed, rough, cracked or even blisters depending on the type of eczema.
Risk factors
Genetic Factors
There is a strong genetic component to atopic dermatitis, although the specific details of how it is inherited remain incompletely understood.
It can be inherited from parents with allergic disorders. This include asthma, atopic dermatitis, and hay fever. Parents with this disorders have a higher risk of having children with eczema.
Environmental Factors
Environmental factors that may trigger or worsen eczema or atopic dermatitis include
· Skin irritants, which may include wool or synthetic clothing, soaps or detergents, cosmetics or perfumes, dust/sand, chemical solvents, chlorine
· Extreme temperate, cold or hot temperatures or dry air or extremely humid air.
· Lack of moisturizing after bathing
Allergies
People who are prone to allergies have a greater risk of developing eczema or atopic dermatitis than those who do not have allergies. Some allergens that may be associated with eczema include:
· Plant pollen
· Animal dander
· Molds
· Certain foods
Eczema or Atopic dermatitis can develop at any age, but the highest risk is in infants and children. It is estimated that of people who eventually develop eczema, more than half develop symptoms in the first year of life, and almost all develop symptoms before age 5.
The condition often improves in adulthood, but half of those affected in childhood are affected throughout life.
Common Symptoms of Eczema
What are the signs and symptoms of eczema?
Dry skin.
Itchy skin.
Red rashes.
Bumps on the skin.
Scaly, leathery patches of skin.
Crusting skin.
Swelling.
When to see a Doctor.
If you have significant itchy rashes that don’t come under control with moisturizers or occasional use of over-the-counter hydrocortisone, go see a dermatologist.
Diagnosis of Eczema
The doctor is likely to make a diagnosis by examining your skin or child’s skin and reviewing your medical history.
No lab test is needed to identify eczema.
If you suspect a certain food caused your child's rash, tell the doctor and ask about identifying potential food allergies
Treatment of Eczema
Eczema can be persistent. You may need to try various treatments over months or years to control it. And even if treatment is successful, signs and symptoms may flare up.
Recognizing the condition early is important so that you can start treatment. If regular moisturizing and other self-care steps don't help, your doctor may suggest one or more of the following treatments:
Medications for Eczema
· Creams that control itching and help repair the skin. The doctor may prescribe a corticosteroid cream or ointment. Apply it as directed, after you moisturize. Overuse of this drug may cause side effects, including thinning skin.
The doctor may recommend other creams containing drugs called calcineurin inhibitors — such as tacrolimus. Avoid strong sunlight when using these products.
· Drugs to fight infection. Your doctor may prescribe an antibiotic cream if your skin has a bacterial infection, an open sore or cracks. He or she may recommend taking oral antibiotics for a short time to treat an infection.
· Oral drugs that control inflammation. For more-severe cases, your doctor may prescribe oral corticosteroids — such as prednisone. These drugs are effective but can't be used long term because of potential serious side effects.
Therapies
· Wet dressings. An effective, intensive treatment for severe atopic dermatitis involves wrapping the affected area with topical corticosteroids and wet bandages. Sometimes this is done in a hospital for people with widespread lesions because it's labor intensive and requires nursing expertise. Or, ask your doctor about learning how to do this technique at home.
· Counseling. Talking with a therapist or other counselor may help people who are embarrassed or frustrated by their skin condition.
· Relaxation, behavior modification and biofeedback. These approaches may help people who scratch habitually.
Infant eczema
Treatment for eczema in babies (infantile eczema) includes:
· Identifying and avoiding skin irritants
· Avoiding extreme temperatures
· Lubricating your baby's skin with bath oils, creams or ointments
See your baby's doctor if these measures don't improve the rash or if the rash looks infected. Your baby may need a prescription medication to control the rash or to treat an infection. Your doctor may also recommend an oral antihistamine to help lessen the itch and to cause drowsiness, which may be helpful for nighttime itching and discomfort.
Lifestyle and home remedies to Help Manage Eczema
To help reduce itching and soothe inflamed skin, try these self-care measures:
· Moisturize your skin at least twice a day.
· Apply an anti-itch cream to the affected area.
· Take an oral allergy or anti-itch medication.
· Don't scratch.
· Apply bandages.
· Take a warm bath.
· Choose mild soaps without dyes or perfumes.
· Use a humidifier.
· Wear cool, smooth-textured clothing.
· Treat stress and anxiety.
References
Atopic dermatitis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115212/Atopic-dermatitis . Updated July 3, 2017. Accessed December 20, 2017.
Understanding your child’s eczema. National Eczema Association website. Available at: https://nationaleczema.org/eczema/children/. Accessed December 21, 2017.
1/4/2016 DynaMed Plus Systematic Literature Surveillance http://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.