Eczema is a group of conditions that cause flare-ups of red, dry, itchy skin. Skin irritation can occur in response to a variety of factors, depending on the type of eczema. The symptoms can vary from mild to severe. Eczema can be uncomfortable, but there are many treatments to bring relief to you or your child.
Types of Eczema:
Atopic dermatitis is another name for eczema. With atopic dermatitis, skin inflammation can be aggravated by sensitivity to environmental allergens like pollen, dust or animal dander. This type of eczema most frequently starts during infancy or childhood. It sometimes persists into or starts in adulthood. You are more likely to have atopic dermatitis if you have allergies or asthma.
Contact dermatitis is an allergic reaction that can co-exist with eczema and worsen rashes and itching. With contact dermatitis, a rash appears after an allergen or irritant touches your skin. It can be difficult to identify the trigger as sometimes the rash does not appear for hours, days or weeks after contact with the allergen. The most common examples of allergic contact dermatitis are plants (poison ivy) and metals (nickel, gold).
Nummular eczema is a round eczema patch that can appear after an injury to the skin. Because of how these “coin shaped” rashes appear, nummular eczema is often confused with ringworm, but it is not an infection.
Seborrheic dermatitis is a common flaky, itchy rash that affects areas where the body has many oil glands. When this type of rash appears on the scalp, it is also known as dandruff, or in babies, “cradle cap”. Doctors think seborrheic dermatitis may be caused by a reaction to common yeast that lives on the skin.
Dyshidrotic eczemais characterized by small blisters on the palms, sides of the fingers, and soles of the feet. Flare-ups of dyshidrotic eczema may be caused by sweat or irritants.
Stasis dermatitis usually occurs in the lower legs, and results from poor blood flow. People who are overweight, inactive or have certain medical conditions (heart disease) are more likely to develop stasis dermatitis. This type of rash can get confused with eczema but is not allergic.
Neurodermatitis is a rash that appears mostly after chronic scratching. The cause of the itching is unknown for most patients but thought to be due to overstimulation of nerves in the skin. Neurodermatitis can be linked to other conditions such as obsessive-compulsive disorder and anxiety disorders. Other risk factors include having dry skin, having other forms of eczema, being female, and being between the ages of 30 and 50.
What Causes Eczema?
Doctors don’t know the exact cause of eczema. However, people with eczema have a more sensitive skin barrier which cannot fully function as intended. The skin has a lower ability to stay hydrated, fight infection and protect against allergens or irritants. This makes the skin likely to become dry and irritated. The dryness can cause itching, and scratching leads to further inflammation of the skin. There are genetic causes of eczema in some patients as well.
Eczema is not contagious. Genetics and your environment/exposures contribute to your chances of developing eczema. Your eczema may worsen certain times of the year due to the presence of allergens like pollen, or because of physical factors like dry winter air.
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Eczema tends to flare up for periods of time. Your eczema may be concentrated on one area of your skin, or they may happen in different areas. An eczema rash is almost always dry and itchy. It may also be red, cracked or, peeling. Over time, the skin may become discolored (darker or lighter), and the rash may feel thick, or scaly.
Eczema Symptoms in Infants:
Infants most frequently get eczema on the face and scalp. The chest, back, arms, and legs are also common areas for eczema in infants.
Eczema Symptoms in Children:
In children, eczema commonly affects the creases of the skin such as the neck, wrists, ankles, elbows, and behind the knees.
Eczema Symptoms in Adults:
In adults, hand eczema is common. Adult eczema also frequently appears on the face, feet, wrists, and knees.
The primary goals of eczema treatment are to repair the skin barrier by:
Restoring hydration (moisture) to the skin
Reduce itching and trauma to the skin from scratching
Reduce inflammation of the skin
Avoid triggers like allergens and irritants that can flare skin symptoms
Treat or prevent infection of the skin
Eczema Treatment at Home:
There are many ways to prevent flare-ups and ease your eczema rashes when they occur. Some of these can be done at home, without a prescription.
Moisturize several times a day with moisturizing products that are thick and greasy. Look for moisturizers containing mineral oil or petrolatum (petroleum jelly). These products help return moisture to the skin and create a barrier. After a bath or shower, use products all over the skin before dressing in order to ‘lock in’ the moisture.
Using oral antihistamines (allergy medications given by mouth) may ease symptoms and aid your sleep if itchiness is keeping you up at night. Look for antihistamines that cause drowsiness as a side effect, to take before bedtime, and non drowsy antihistamines to use during the day to prevent scratching
Apply topical hydrocortisone, which can be found over the counter in low-dose creams or ointments. This directly reduces inflammation and itching of the skin and is especially helpful for smaller or more localized rashes.
Reduce exposure to triggers if you know what usually makes your eczema worse. Avoid irritants on your skin. An allergist can help identify environmental and contact allergens that may be making your eczema worse.
Relaxation techniques can improve eczema symptoms and reduce the urge to scratch. Scientific studies have shown that stress-relieving actions like meditation can reduce the symptoms of eczema.
Prescription Eczema Treatments:
If your eczema is severe or at-home treatments aren’t working, there are several options a doctor can prescribe to reduce your symptoms.
Topical corticosteroids are available at low doses over the counter and higher doses by prescription. This steroid medication is applied directly to the rash and reduces itching, redness and swelling.
Antibiotics may be necessary to treat any skin infections that occur with your eczema.
Biologic medications work by reducing inflammation and lessening the immune responses that cause eczema. These medications come in injectable and pill forms and are considered only when all other treatments have not worked. They are expensive unless approved by your insurance company and prescribed by a specialist (allergist or dermatologist), but in most cases are extremely safe and effective. Some injectable medications are even safe to be used on children as young as 6 months old.
Light therapy (phototherapy) uses UV light to treat and prevent inflammation. Only adults should use phototherapy. This treatment is usually on performed by a dermatologist.
When to See a Doctor:
If you have a rash or itchy patch of skin that is bothering you, it may be time to see a doctor. Some signs that you should see a doctor are:
You notice sudden changes in your eczema, or it becomes more severe
You’re having a hard time sleeping at night due to itchiness
Your eczema becomes infected (look for pus, blisters, redness, warmth, and fever)
Your current eczema cream or other treatments are not working as intended
Your doctor will diagnose your condition by examining your skin, so it’s best to go when you have an active flare-up.
How WellNow Allergy Can Help
If eczema has been bothering you, WellNow Urgent Care can help. Our skilled healthcare providers offer exams and treatments for eczema, as well as many other injuries and illnesses. If your eczema is uncontrolled, severe or you think may be triggered by allergies, you can even visit one of our specialized WellNow Allergy clinics for personalized allergy testing and care.