Eczema refers to a group of inflammatory disorders that are characterized by redness and itching. The cause of eczema is not complete understood, but genetics and family history play and importart part. In most people with eczema, there is an abnormality in the outermost layer of the skin, called the epidermis. This makes the skin more susceptible to allergens or irritants and allows too much water or moisture loss. There are several different types of eczema, includings atopic, nummular, dyshidrotic, and allergic, but all of them are characterized by severe itching, dryness, and redness. There is no specific test to diagnose eczema, although a skin biopsy or patch testing may be helpful.
Identifying and eliminating factors that worsen your eczema can help to control symptoms. Some possible triggers include:
Cold or dry weather or environments
Rapid temperature changes
Stress or anxiety
Exposure to certain chemicals or products (soaps, detergents, perfumes, colognes, cosmetics, smoke, dust, or certain clothing fibers)
Patients with eczmea have difficulty retaining moisture in their skin, so an important part of your skincare routine should be limiting water loss and moisturizing your skin. The best moisturizers for people with eczema are thick creams (such as Eucerin, Cetaphil, and CeraVe) or ointments (such as petroleum jelly, Aquaphor, and Vaseline). These products are preferred over lotions, which are less effective at moisturizing the skin. Moisturizers are most effective when applied immediately after bathing, but should be used at least twice daily.
When bathing or showering, you should avoid hot water and long bath times (>10 minutes). Use lukewarm water and mild, unscented soap. If your are itching, avoid scractching. It is best to pat your skin or apply a cool compress.
Eczema is a chronic condition; it typically improves and then flares (gets worse) periodically. Some people have no symptoms for several years. Eczema is not curable, although it is possible to control your symptoms with a variety of self-care measures and medications. Treatments commonly used include:
Topical Corticosteroids: These are topical creams or ointments which can be used to decrease inflammation, redness, and itching. There are many different products and strengths available, but some examples are triamcinolone, hydrocortisone, and clobetasol.
Topical Non-steroidals Anti-inflammatories: These relatively newer treatments for eczema are effective at controlling eczema, but do not work as quickly as topical steroids. The benefit is that they do not have some of the side effects of steroids and can be used on areas such as the face or groin. Examples of these products include: tacrolimus (Protopic), Pemcrolimus (Elidel), or crisaborale (Eucrisa).
Immunosuppressive Medications: For patients with severe eczema, sometimes short courses of oral steroids, but they are not recommended for routine or prolonged use. For patients with recurrent flares sometimes medications that weaken the immune system are used (methotrexate, cyclosporine, azathioprine).
Injectable Biologic Medications: A medication called dupilumab (Dupixent), has been approved for adults and children as young at 6 years with moderate to severe eczema.
Anti-itch Medications: Oral anti-histamine medications may be help at relieving some itching. These include: diphenhydramine (Benedryl), hydroxyzine, or cetirizine (Zyrtec).