Eczema is also known as Atopic Dermatitis. Most often, atopic dermatitis will come and go, often based on external factors. Although its cause is unknown, the condition appears to be an abnormal response of the body’s immune system. In people with eczema, the inflammatory response to irritating substances overacts, causing itching and scratching. Eczema is not contagious and, like many diseases, currently cannot be cured. However, for most patients the condition may be managed well with treatment and avoidance of triggers.
Although there is a variation in presentation, most often characterized by dry, red, extremely itchy patches on the skin. Eczema is sometimes referred to as “the itch that rashes,” since the itch, when scratched, results in the appearance of the rash. Eczema can occur on just about any part of the body; however, in infants, eczema typically occurs on the forehead, cheeks, forearms, legs, scalp, and neck. Chronic scratching causes the skin to take on a leathery texture because the skin thickens (lichenification).
A topic dermatitis usually starts in infancy from the ages of two to six months. The skin is dry and the rash is quite itchy, so infants may be restless and rub against the sheets, or scratch if able. The rash may involve the face or it may cover a large part of the body. As the child gets older, the rash may become more localized. In early childhood, the rash is commonly on the legs, feet, hands and arms. As a person becomes older, the rash may be limited to the bend of the elbows, knees, on the back of the hands, feet, and on the neck and face. As the rash becomes more established, the dry itchy skin may become thickened, leathery and sometimes darker in coloration. The more the person scratches, the worse the rash is and the thicker the skin gets. Many children with atopic dermatitis outgrow the condition before school age; some continue to have problems as an adolescent or even as an adult.
One of the most important components of an eczema treatment routine is to use a ceramide moisturizer. Because eczema is usually dry and itchy, the most common treatment is the application of lotions or creams to keep the skin as moist as possible. These treatments are generally most effective when applied directly after bathing (within three minutes is a common recommendation) so that the moisture from the bath is “locked in.” Cold compresses applied directly to itchy skin can also help relieve itching. If the condition persists, worsens, or does not improve satisfactorily, another effective treatment is the application of nonprescription corticosteroid creams and ointments to reduce inflammation.
Alternatives to nonprescription corticosteroids include more potent prescription corticosteroid creams and ointments, and light therapy. Narrow Band UVB phototherapy is offered at Sand Dermatology.