Summing Up Eczema
Written By: Aparna Tamirisa, M.D.
Edited By: Karan Sra, M.D.
Eczema is a common skin condition that causes chronically dry, itchy, and red skin. Eczema generally starts in infancy and childhood but is diagnosed in adults as well. It is among a spectrum of allergic conditions including allergic rhinitis and asthma. There appears to be an inherited predisposition to these conditions. If one is diagnosed with eczema, one can frequently find relatives who have a history of either eczema, allergic rhinitis, or asthma. In children, there is a rare association of eczema with allergies to certain foods.
In infants, eczema can be found generally on the front of the arms and legs, cheeks, or scalp. In children and adults, eczema is commonly found in the creases of the elbows and knees, the back of the neck, the face, wrists, and forearms. With chronic scratching the skin may undergo changes and become darker and more thick and scarred. Other skin changes include bumps of the face, upper arms, and thighs due to plugged hair follicles, darkening of the skin around the eyes, and skin creasing on the palms.
Eczema is diagnosed by physical exam and history. Factors that strongly suggest eczema include chronic itching, a personal or family history of allergic conditions as enumerated above, and early age of onset.
It is important to understand that eczema is a chronic condition which may improve and worsen. While the symptoms of eczema can be controlled with medication and home care, it is not a curable condition. It is also important to remember that symptoms of eczema can become cyclical – irritation and itching of the skin can lead to increased scratching which can then lead to further skin inflammation and itching. Thus it is important to treat the symptoms.
It is important to avoid aggravating factors such as heat or dryness, excessive sweating, stress, and exposure to certain chemicals or solvents found in soaps, detergents, cosmetics, perfumes, and cleaning products. It is important to keep the skin well moisturized with hypoallergenic emollients. Creams such as Cetaphil or Eucerin or ointments such as Vaseline or Aquaphor are best as these do not contain much water. Lotions are less effective as they contain more water. It is best to apply emollients immediately after bathing. It is advised to avoid hot baths or baths longer than 10 to 15 minutes as this can cause drying of the skin. To treat skin inflammation and irritation, topical steroid creams or ointments are generally used. Steroids should be used as prescribed by your physician as prolonged use can lead to thinning of the skin. Your doctor may suggest other treatments based on severity and history of medication use for the eczema. For control of itching, your doctor may recommend oral antihistamines such as Diphenhydramine or Hydroxyzine.
See your dermatologist if you are concerned that you may have eczema. At our center, clinical trials on treatments for eczema are also available. If interested please contact our offices in Webster at (281) 333-2288 and the Museum District at (713) 528-8818.