Atopic dermatitis – more commonly known as eczema – is a chronic, recurring, itchy rash that usually develops during early infancy and childhood.
In many cases there is a family history of eczema, asthma, or allergies. Eczema can be very mild, some slight scaly patches on the infant’s face and/or trunk, or can present as weeping, oozing patches involving the arms or legs or even a larger body surface area.
Fortunately, most cases of eczema resolve by the age of 10, however about 10-15% continue into adulthood. Although less common eczema can start in adulthood. It is important to differentiate eczema from psoriasis, fungus infections, and other less common skin disorders, in order to know the prognosis and proper therapy.
Because the skin in eczema is “spongiotic” it does not have the same barrier function of normal skin hence it more susceptible to staphylococcus aureus infections. In addition, the itching associated with eczema can be profound resulting in intense scratching which also can cause skin infections. The first approach if possible is to treat the skin without medicines.
Excellent skin care remains extremely important. Being gentle with the skin is very important.
Bathing and Moisturizing
Luke warm baths with aveeno (oatmeal power) can soothe the skin. Pat dry gently and immediately applying moisturizers can help hydrate the skin.
Moisturizers create a barrier between the skin and environmental elements that can irritate eczema. Applying moisturizer frequently throughout the day will help keep moisture in and irritants out.
Topical corticosteroids remain the first line therapy for eczema. There are various strengths of topical strengths of topical steroids ranging from class 1 (strongest) to class 6 (weakest). Prolonged use of the stronger topical steroids is not recommended for greater than 2 weeks at a time, and not to be used on face, axilla, groin, under breast because they can result in thinning of the skin i.e. stretch marks.
Topical calcineurin inhibitors do not act as quickly as topical corticosteroids however they do not cause skin thinning, so they can be used on more sensitive areas.
KNOW THE FACTS
- It’s common. More than 30 million people in the United States have some form of eczema.
- It’s not contagious. You can’t catch eczema or spread it to others through physical contact.
- It’s treatable. Although there is no cure for eczema, there are effective treatments available now, and more are on the way.
- It’s more than skin deep. Eczema is an immune system over-reaction, and for millions, a serious, life-changing disease.
Ultraviolet light therapy can be used to help alleviate inflammation and itching in the skin. This treatment is often used for widespread eczema and increases vitamin D production and helps bacteria fighting systems in the skin.
Immunosuppressants are prescribed for moderate-to-severe eczema and work by lowering the body’s immune response which is overactive in eczema. There are several medications that fall into this category, such as systemic corticosteroids, methotrexate, cyclosporine and retinoids. Your doctor will monitor your closely when taking these medications as they can have other negative side effects.
DUPIXENT is a biologic medication used to treat moderate-to-severe eczema. DUPIXENT is used to treat adult patients with moderate-to-severe atopic dermatitis (eczema) that is not well controlled with prescription therapies used on the skin (topical), or who cannot use topical therapies. DUPIXENT can be used with or without topical corticosteroids.
Antihistamines such as hydroxyzine (prescription) or Benadryl are effective in decreasing itch however they can produce sedation. Anti-histamines are the first line therapy for itching. It is very important to eliminate the itching because the itch-scratch cycle perpetuates eczema into a more chronic state.
Fortunately there are new medications in development that may help who have not benefited from conventional therapy. If you would like to be seen by a dermatologist and participate in a clinical trial, please call Ashley at 609-443-0424
Identifying Eczema Triggers
- Metals, in particular, nickel
- Soaps and household cleaners
- Certain fabrics such as wool and polyester
- Antibacterial ointment like neomycin and bacitracin
- Formaldehyde, which is found in household disinfectants, some vaccines, glues and adhesives
- Isothiazolinones, an antibacterial that is found in personal care products like baby wipes
- Cocamidopropyl betaine used to thicken shampoos and lotions
- Paraphenylene-diamine, which is used in leather dyes and temporary tattoos, among other things
- Change in season
- Hot weather
- Cold, dry weather
- Low humidity
- High humidity
- Bacteria on the skin
- Long, hot baths or showers (especially when not immediately followed by a moisturizer)
- Excessive scratching or rubbing of the skin
- Pet dander
- Dust mites
- Cigarette smoke (including second-hand smoke)
- Insect bites
- An excess of sebum (oil) on the skin
- Overgrowth of naturally occurring yeast on the skin
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